Cardiac anatomy

355-410

What is the most anterior structure of the heart

Hint chamber

RV,

Lateral chest x ray projection identifies RV dilation/hypertrophy by showing RV and it’s outflow track.

what device is being deployed in this fluoroscopy

1. device

2. access

3. function

1. Lariat device

2. Epicardial

3. Closing t

what device is this

Study this image

completed

Cannulation of the femoral artery should be ___.

Precisely in the inguinal fold

above the inguinal fold

1 finger breath below the inguinal fold

6cm below the inguinal fold

1 finger breadth below the inguinal fold

However, it's important to note that relying solely on the inguinal fold can be misleading due to anatomical variations among patients. The inguinal crease may not accurately correspond to the location of the common femoral artery, potentially increasing the risk of complications.

T or F TEE is commonly used for a pericardiocentesis

False

An elevated RVedp is found in which pathology?

lv infarct

MR

RV infarct

A.S.

RV infarct

What is the correctorder of a quad bypass as they would appear on the Aorta

SVG

1. OM

2. RCA

3. LAD

4. DIAG

3rd degree

st elevation in leads V1 & V2 is an infarction in

Septal

When reviewing an IVUS or OCT image for evaluation of lesion,

T or F for each

Flow dynamics pd/pa is visible

lesion length is visible

lumen dimension is visible

F

T

T

Would you use a scoring/cutting balloon on a fibrous plaque blockag?

True

What heart block is most likely to become lethal

2nd degree heart block type 2

ST segment elevation in leads V5, V6, I, aVL indicates which culprit vessels? Choose the

CX

What are the three symptoms of a RP bleed

hypotens

abdominal or flank pain

tachycardia

Midazolam is the generic name of ______ that causes _____

Versed

Sleepiness

Proper dosage of heparin for peripheral interventions?

Typically, 70-100 units/kg administered intravenously.

Which catheter is the BEST option to use to cannulate an LAD with a high takeoff?

AL1

what interventional device utilizes the use of high pressure heparinzed saline to remove

thrombus

angiojet

Lisinopril belongs to which drug class

ACEi

Yes or no is diabetes a contraindication of coronary stenting

NO

Which of these meds are used for preop known contrast allergy

Solumedrol

Diphenhydramine

Hydralazine

ancef

famotidine

solumedrol

diphenhydramine

famotidine

The posterior tibial pulse is located where on the body

Near the medial malleolus

A drug often used to treat spasm, Verapamil belongs to which drug class?

CCB

what NYHA class is this …

Patients experience

symptoms with less than

ordinary activity, meaning

they are comfortable at rest

but experience limitations

during minimal exertion.

CLASS 3

THIS IS CLASS 2

Characterized by marked

limitation of physical activity,

where comfortable at rest,

but less than ordinary activity

results in fatigue, palpitations,

or dyspnea

what are these arrows pointing at

Calcification

When performing a thermodilution cardiac output, 10 cc of injectate enters into the ___,

and the temperature change is measured in the ___

RA

PA

Afterload is most impacted by ________?

the systemic vascular resistance

Preload is mostly impacted by

Increased filling pressures

Identify the structural heart device and access.

What vessel can be viewed on the anterior side of the heart

LAD

In a lateral chest x ray the coronary sinus is orientated _____ and located near the ______ aspect of the heart

orientated horizontally

near the posterior inferior aspect of the heart

Which structure forms the patents right cardiac border?

what structure normally appears as a circle on the superior aspet of the cardiac silhouette in the AP chest radiograph

Transverse aortic arch or the aortic knob

What is another name for the aortic knob

Transverse aortic arch

When viewing the heart in LAO projection what structures form the right cardiac border

Right atrium and right ventricle.

LABEL THEM

1. AO

2. PA

3. MITRAL

4. TV

1/2?

3/4

What standard echo transducer position is shown

Apical 4 chamber

review this image

name these views

what view

what are these 3 views

label structures

label structures

label structures

which heart valves are attached to the chordae tendinea

The heart valves attached to the chordae tendineae are the mitral valve and the tricuspid valve. These structures prevent the valves from inverting during ventricular contraction.

The MV and the TV have chordae tendinea attached to prevent ************** during ***** *****

These structures prevent the valves from inverting during ventricular contraction.

What valves are opened during ventricular systole

The aortic and pulmonary valves are opened during ventricular systole, allowing blood to be ejected from the heart into the aorta and pulmonary artery.

What anchors the heart valves in fibrous rings that are connected by triangular pads ( Trigone ) that create a rigid structure around the valves

The cardiac skeleton

Annulis

Annuli Fibrosi

what is the most front facing cardiac valve or anteriorly positioned

pulmonic valve

What is the largest cardiac valve

TV

but just slightly larger orifice

RA does not generate as much pressure as LA so orifice area is larger for both to admit same amount of blood

The worm like muscle strains within the RV chambers are termed

trabeculae carneae.

They are found chiefly in the RV where they provide a mesh in which to entrap transvenous pacemaker leads

and to distinguish native LV and RV

Trabeculae carneae

The left bundle branch is divided by what two

Left

anterior and posterior fascicle

The diaphragmatic surface of the LV is also called the

inferior surface of the heart.

label the surfaces of the heart

what angle is this rao or lao

RAO

label the surfaces in this RAO image

review this image

review complete

The RVOT is also known as the 2x

Infundibulum

Conus Arteriosus

The infundibulum is also known as the 2x

RVOT

Conus Arteriosus

The normal pacemaker of the heart is the

sinoatrial node (SA node)

Sa node lies at the junction of the

right atrium and superior vena cava.

in biventricular lead placement, access to the coonrary sinus is sometimes difficult due to obstruction by the

Thebesian valve, the valve of the coronary sinus

the cells are separated by intercalated discs while the sarcomere are separated by ** ******

Z lines

What ions are involved in muscle contraction in the heart

*****

*****

sodium

and minor role chloride

missing 2

calcium

potassium

sodium

and minor role chloride

Ion movement in cardiac contraction

1. Depolarization

   phase 0 is…..

   **** Influx

1. Depolarization

Sodium influx Na+

Initial repolarization phase 1

***** and **** efflux

K+ and Cl- efflux

Plateau phase

phase 2

***** influx

Phase 2

Ca 2+ influx

Repolarization phase 2

*****efflux

K+ efflux

Restine membrane potential phase 4

maintained by na+/K+, ATPase, and ** leak channels

K+ leak channels

What is the central anatomic structure of the sarcomere which is believed to have a globular heads spiraling from its side which facilitate cross bridge linking btx two filamints

and

is it thick or thin filament

Myosin is a thick filament protein that plays a crucial role in muscle contraction by interacting with actin filaments.

The epicardium is also termed the ***** of the pericardium

visceral pericardium

What type of tissue grows over implanted valves and stents

endothelium

inside lining of all organs, quickly grow over implanted devices to make the surface less thrombogenic

What refers to the walls of a body cavity

Parietal

What type of tissue lines inside of closed body cavities,

Serous membranes - Simple squamous epithelium that secretes serous fluid, providing lubrication.

What type oof tissue lines the cavities that open to external environment

mucous membranes

secretes mucus for protection and moisture

What kind of tissue covers the external surface of the body

cutaneous membrane

stratified squamous epithelium (keratinized)

The ______ peritoneum covers the organs in the abdominal cavity, reducing friction and providing a smooth surface for movement.

visceral

The ______ peritoneum lines the abdominal cavity walls and diaphragm, forming the outer layer of the peritoneal sac.

parietal

The peritoneum provides ______ between organs, allowing for smooth movement, and helps protect them from friction and damage.

lubrication and cushioning

It acts as a sack not engulfing the organs just cushioning them

the main function of the pericardium and its fluid is to

provide lubrication and protection for the heart, reducing friction during heartbeats.

how much pericardial fluid is contained in the pericardial sac

approximately 15 to 50 milliliters

CaO2 and CvO2 stands for what

arterial oxygen content and venous oxygen content, respectively.

(CaO2 - CvO2) gives you an idea of ____________ by the tissues

the oxygen extraction used

How much oxygen is extracted by the tissues

When finding Fick CO you are using arterial and venous ____ _____ not arterial and venous oxygen saturation percentage

contents

This is if you either use the actual oxygen contents from blood samples or (Ao sat - Pa sat) x hgb x Constant …. which would just be avo2 diff which uses the o2 content of both as CaO2 - CvO2 then you would convert from d/cl to L/min

We can determine pt’s blood flow (CO) if we know 3 things

VO2(oxygen consumption),

CaO2

CvO2.

just don’t forget to use proper units and conversion factors.

usually cardiac output will give you dL so divide the number by 10

to turn ml/min to L/min you need to do what

divide by 1000

How many joules should be used for the initial defibrillation shock in a patient with VF or pulseless VT?

120-200 Joules

What is the recommended dose of epinephrine during a cardiac arrest?

and whats the time on that

1mg every 3-5 min

What medication is typically administered after unsuccessful shock in a patient with VF/pulseless VT?

E