[ANA] 9 CV System: The Heart

formed by blood vessels that carry blood to and from the lungs

pulmonary circuit

formed by blood vessels that transport blood to and from all body tissues and back to the heart

systemic circui

WHICH IS NOT TRUE: Location of the Heart

a. located in the anterior superior mediastinum
b. located in between the lungs and the two pleural cavities
c. rests on the superior surface of the diaphragm
d. lies in the thorax posterior to the sternum and costal cartilages

a. - located in the MIDDLE INFERIOR mediastinum

WHICH IS NOT TRUE: Sternal Angle of Louis

a. formed from the junction of manubrium and clavicle
b. inferior to the supraclavicular notch
c. corresponds to 4th-5th intervertebral space at the back
d. medial to the second rib

a. - formed from the junction of manubrium and STERNAL BODY

WHICH IS NOT TRUE: Shape & Orientation of the Heart

a. pyramidal shaped
b. oblique position in the thorax
c. pointed apex lying to the left of the midline and anterior to the rest of the heart
d. base as the broad posterior and superior surface comprised of the left ventricle

d. - base as the broad posterior and superior surface comprised of the left ATRIUM

WHICH IS NOT TRUE: Apex

a. directed downward, forward to the left
b. closer to the thoracic wall
c. apical impulse felt as the only palpable heart pulsation
d. felt at the 5th right intercostal surface midaxillary line

d. - felt at the 5th LEFT intercostal surface MIDCLAVICULAR line

right superior corner fo the heart

3rd chondrosternal junction (3rd costal cartilage joining the sternum)

left superior corner of the heart

2nd costal cartilage; a finger's breadth lateral to the sternum

right inferior corner of the heart

6th costal cartilage; a finger's breadth lateral to the sternum

left inferior corner of the heart

5th intercostal space at the midclavicular line

form the left border of the heart

left ventricle, left auricle

forms the right border of the heart

right atrium

forms the inferior border of the heart

right ventricle, part of the left ventricle

forms the anterior surface of the heart

right atrium, right ventricle (greater)

forms the inferior surface of the heart

right ventricle, left ventricle (greater)

forms the posterior surface of the heart

left atrium

another term for the anterior surface of the heart

sternocostal surface

another term for the posterior surface of the heart

diaphragmatic surface

the only part of the left atrium seen anteriorly

left auricle

triple-layered sac that encloses the heart

pericardium

Enumerate: Layers of the Pericardium (External to Internal)

1. fibrous pericardium

2. parietal serous pericardium

3. pericardial cavity

4. visceral serous pericardium

Enumerate: Layers of the Heart (External to Internal)

1. epicardium (visceral serous pericardium)

2. myocardium

3. endocardium

4. heart chamber

WHICH IS NOT TRUE: Fibrous Pericardium

a. strong layer of loose connective tissue
b. acts as a tough outer coat that holds the heart in place
c. keeps the heart from overfilling with blood
d. blends with adventitia of the roots of the great vessels and diaphragm

a. - strong layer of DENSE connective tissue

WHICH IS NOT TRUE: Serous Pericardium

a. Parietal layer serves as the inner lining of the fibrous layer
b. Visceral layer serves as part of the heart wall directly on the surface of the heart
c. Pericardial cavity is a slit-like space between parietal and visceral layer
d. The parietal and visceral layer that meet at the apex of the heart, which serves as the attachment of the mediastinum

d. - The parietal and visceral layer that meet at the GREAT BLOOD VESSELS, which serves as the attachment of the mediastinum

outermost layer of the heart usually lined with fat in older people

epicardium

middle layer of cardiac muscle tissue that is responsible for contraction

myocardium

circularly and spirally arranged muscle network that pumps blood in the right direction

bundles

formed from the dense connective tissues of the myocardium that surrounds the heart valves and lies in the plane between the atria and the ventricle

cardiac skeleton

WHICH IS NOT TRUE: Functions of the Cardiac Skeleton

a. Anchors valve cusps
b. Prevents overdilation of valve openings
c. Point of attachment for cardiac bundles
d. Blocks direct spread of electrical impulses from atria to ventricles leading to the contraction of ventricles before atria

d. - Blocks direct spread of electrical impulses from atria to ventricles leading to the contraction of ATRIA before VENTRICLES

inner layer of simple squamous epithelium resting on connective tissue lining the heart chambers and valves

endocardium

separates the right atria and ventricles

atrioventricular grooves

divides the atria longitudinally

interatrial septum

divides the ventricles longitudinally

interventricular septum

TRUE OR FALSE: The two septa, there is no communication between the left and right atrium, nor between the left and right ventricle.

TRUE

marks the division between atria and ventricles, extending horizontally circling the boundary between atria and ventricles

atrioventricular groove or coronary sulcus

marker of the separation of the right atrium from the right ventricle

right coronary artery

separates the right and left inferior surfaces

interventricular sulcus

vertically and anteriorly separates the right ventricle and left ventricle

anterior interventricular sulcus

marker of the separation between the right and left ventricles

LAD / anterior interventricular artery

vertically separates right ventricle from left ventricle on the heart's inferior surface

posterior interventricular sulcus

medical term for the entire right border of the heart

sulcus terminalis

receiving chamber of oxygen-poor blood from the systemic circuit

right atrium

venous opening to the heart for structures superior to the diaphragm

superior vena cava

venous opening to the heart for structures inferior to the diaphragm

inferior vena cava

venous opening to the heart for muscles in the heart itself; main venous drainage of the heart

coronary sinus

valve that directs blood from RA to RV

tricuspid valve

ear-like structure that projects anteriorly from the corner of the RA

right auricle

structures and portions covered by the smooth wall in the right atrium

• posterior RA

• inter-atrial septum

anterior ridges found on the right auricle and right atrium which function for the contraction of the heart

musculi pectinati or contraction of the heart

C-shaped ridge that separates the anterior and posterior aspects of the heart

crista terminalis

term used to describe the outside equivalent of the crista terminalis

sulcus terminalis

significant structure located on top of the crista terminalis below the opening of the SVC

sino-atrial node

used as a landmark for locating sites where veins enter the right atrium

crista terminalis

Identify the location of the following structures with reference to the crista terminalis:

a. superior vena cava
b. inferior vena cava
c. coronary sinus
d. fossa ovalis

a. posterior to the superior bend
b. posterior to the inferior bend
c. anterior to the inferior bend
d. posterior to the inferior bend

depression in the right side of the interatrial septum which is seen as a semilunar structure on top

fossa ovalis

a communication between the two atria in utero

foramen ovale

WHICH IS NOT TRUE: Foramen Ovale

a. Closes due to change in pressure upon first breath
b. Pathway of bypass from the mother's placenta, to the RA, to the LA, to the systemic circuit
c. closes to become the ductus arteriosus
d. occurs in utero

c. - closes to become the FOSSA OVALIS

makes up most of the heart's posterior surface or the base; receiving chamber for oxygen-rich blood from the pulmonary circuit

left atrium

openings of the left atrium

pulmonary veins (2 on each side)

valve of the LA that directs blood to the LV

bicuspid valve or mitral valve

triangular structure that serves as the only anteriorly visible part of the LA

left auricle

structure in the left atrium covered by the smooth wall

internal wall

WHICH IS NOT TRUE: Left Atrium

a. pectinate muscles in left auricle
b. pectinate muscles in left ventricle
c. absence of fossa ovalis
d. four pulmonary veins

b. - NO pectinate muscles in left ventricle

forms most of the anterior surface of the heart; receives blood from RA and pumps blood to the pulmonary trunk

right ventricle

characteristic shape of right ventricle that is obtained because its cavity is flattened by the walls of LV

crescentic shape

valve in the right ventricle that directs blood to the pulmonary trunk; closes upon back-flow of blood

pulmonary or pulmonic valve

ventricular equivalent of pectinate muscles in the atria

trabeculae carnae

trabeculae carneae of the LV marked as ridges

etched wall

trabeculae carneae of the LV that connects the IV septum and the margin of the RV

moderator band or septomarignal band

structure in the LV not found in the RV

septomarginal band or moderator band

finger-like projections that serve as attachments of the cusps of the tricuspid valve

papillary muscle

attachments to the papillary muscles that project superiorly from the papillary muscles to the flaps or cusps of the valves

chordae tendineae

TRUE OR FALSE: Chordinae tendineae keep the valves shut to allow backflow to the area and to prevent valves from everting into the atria.

FALSE - Chordinae tendineae keep the valves shut to PREVENT backflow to the area and to prevent valves from everting into the atria.

characteristic shape of the left ventricle

conical shape

WHICH IS NOT TRUE: Left Ventricle

a. forms the apex of the heart and dominates the heart's inferior surface
b. has thinner papillary muscles compared to the RV
c. pumps blood into the systemic circuit
d. 3x thicker than the RV muscle to contract at a higher force to counter resistance from systemic circulation

b - has BIGGER papillary muscles compared to the RV

two vein systems that directly drain to the right atrium and no longer pass through the coronary sinus

• anterior cardiac vein

• vena cordis minimae

area of the RV bulging toward the pulmonary trunk

infundibulum or conus arteriosus

area of the LV bulging toward the aorta

aortic vestibule

HEART CHAMBERS: has etched wall

RV and LV

HEART CHAMBERS: has moderator band

RV

HEART CHAMBERS: has three types of trabeculae carneae

RV

HEART CHAMBERS: 3 small papillary muscles

RV

HEART CHAMBERS: 2 big papillary muscles

LV

HEART CHAMBERS: where IV septum bulges towards

RV

HEART CHAMBERS: SVC, IVC, coronary sinus, AVC, VCM

RA

HEART CHAMBERS: fossa ovalis

RA

HEART CHAMBERS: sulcus terminalis and SA node

RA

HEART CHAMBERS: tricuspid valve

RA

HEART CHAMBERS: mitral valve

LA

HEART CHAMBERS: pulmonary valve

RV

HEART CHAMBERS: aortic valve

LV

flaps of endocardium reinforced by cores of dense connective tissue

cusps of heart valves

enforce the one-way flow of blood through the heart

valves

WHICH IS NOT TRUE: AV Valves

a. tricuspid and bicuspid
b. prevents backflow from ventricles into atria during ventricular contraction
c. close when pressure is greater in the atria
d. closure is regulated by chordae tendineae and papillary muscles

c. - close when pressure is greater in the VENTRICLES

WHICH IS NOT TRUE: Semilunar Valves

a. pulmonary and aortic valves
b. prevents backflow from great vessels into ventricles; closing and filling up during back flow of blood
c. pushed open by ventricular contraction and interventricular pressure
d. rich in chordae tendineae

d. - NO chordae tendineae nor papillary muscles

Give what is asked: Tricuspid valve

a. Type
b. No. of Cusps
c. Location
d. Clinical valve heart point
e. Clinical valve landmark structure

a. right AV valve
b. 3
c. junction of RA-RV
d. inferior right point
e. 5th RICS, sternal margin

Give what is asked: Mitral valve

a. Type
b. No. of Cusps
c. Location
d. Clinical valve heart point
e. Clinical valve landmark structure

a. left AV valve
b. 2
c. junction of LA-LV
d. apex point
e. 5th LICS, midclavicular line

Give what is asked: Pulmonary Valve

a. Type
b. No. of Cusps
c. Location
d. Clinical valve heart point
e. Clinical valve landmark structure

a. semilunar valve
b. 3
c. junction of RV-pulmonary trunk
d. superior left point
e. 2nd LICS, sternal margin

Give what is asked: Aortic valve

a. Type
b. No. of Cusps
c. Location
d. Clinical valve heart point
e. Clinical valve landmark structure

a. semilunar valve
b. 3
c. junction of LV-aorta
d. superior right point
e. 2nd RICS, sternal margin

caused by the vibration of blood and heart walls during valve closure

heart sounds