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the heart has ____ chambers
4
the heart has ____ atria and ____ ventricles
2
on average, the heart weighs _____ grams
250-350
on average, the heart weighs _____ ounces
9-12
what weight can be calculated with echo
left ventricular weight
typical cardiac output in a min
3-6 L/min
typical cardiac output in a day
3,500/6,000 L/day
on average, the the heart contracts _____ times a minute
60-100
the heart lies _____ to the sternum within _____
posterior, middle mediastinum
what angle does the heart lie at
45
between what intercostal spaces does the heart lie
middle and fifth intercostal spaces
what is the apex of the heart
the cone or the bottom of the heart
what does the apex of the heart rest on and at which rib space
the diaphragm below the 7th rib space
what is the base of the heart
LA and the great vessels
what are the great vessels
Ao and PA
what makes up the superior border of the heart
LA and RA
what makes up the inferior border of the heart
almost entirely RV and a small portion of the LV
what makes up the right border of the heart
RA
what makes up the left border of the heart
LV and small portion of the LA
what makes up the anterior border of the heart
RV and small portions of the RA and LV
what makes up the posterior border of the heart
LA and LV
what are the two layers of the pericardium
parietal and visceral
what does the pericardium contain and how much
serous fluid, 10-20 mL
what does the IV sulcus separate
the RV and LV externally
what does the AV sulcus separate
the LA and LV externally
what does the coronary sulcus separate
RA from RV externally
what does the sulcus terminalis separate
anterior and posterior portions of the RA
what is the crux of the heart
posterior portion of the heart where all 4 of the chambers come together
what determines the dominance of the heart
which coronary artery feeds the crux of the heart
what is the epicardium
AKA visceral layer
outermost layer of the heart composed of epithelial cells
what is the myocardium
middle layer
composed of muscle fibers and cells, is responsible for contraction
what is the endocardium
innermost layer that lines the inside of the myocardium
covers the valves and tendons and is composed of simple squamous cells
what are the two portions of the right atrium
posterior smooth walled portion, anterior thin walled trabeculated portion
what portion of the right atrium do the IVC and SVC enter
posterior smooth walled portion
what is the posterior smooth walled portion of the right atrium derived from
embryonic sinus venosus
what is the anterior thin walled trabeculated portion of the RA derived from
original embryonic RA
what is the crista terminalis
muscular ridge that internally separates the two portions of the RA
what is the RA appendage
hollow triangular shaped area, lined by pectinate muscle
what is the main function of the RV
maintain pulmonary circulation by sending deoxygenated blood to the lungs
the RV can be described as
crescent, shallow
what are the two portions of the RV
RVIT and RVOT
what is the RVIT composed of
tricuspid valve and its apparatus
where is the RVOT
located just below the pulmonic valve, is smooth walled
in the RV, what are the inflow and outflow tracts separated by
parietal band
septal band
moderator band
in the RV, the inflow walls are heavily
trabeculated
from where to where does the moderator band extend
anterior free wall of RV to IVS
what is the function of the moderator band
provides a quick path for conduction system to reach the ventricular wall
in what view is the moderator band best visualized
apical 4 chamber
what is the function of the left atrium
receives oxygenated blood from the pulmonary veins
what are the two portions of the left atrium
anterior and posterior
what is the purpose of the anterior portion of the left atrium
stores more blood. it is thicker than the right
what is the purpose of the posterior portion of the left atrium
it is where the 4 pulmonary veins enter. smooth walled
what is the function of the left atrial appendage
moderates intravascular volume
how does the left atrial appendage appear
as a small finger-like outpouching of the muscular wall of the LA
how is the left atrial appendage typically seen
through TEE, but it can sometimes be seen transthoracially
through TEE and a transthoracic approach, what views can the left atrial appendage be seen in
PSAX basal view and apical 4 chamber view
what plays a role in TIA and stroke in atrial fibrillation
LAA (left atrial appendage)
what is the function of the left ventricle
pump oxygenated blood through the aorta to the rest of the body
how does the left ventricle appear
ovoid or egg shaped
what is the main pumping chamber of the heart
left ventricle
LV makes up _____% of cardiac mass
75
the walls of the LV are _____ to _____ times thicker than that of the RV
3 to 4
what is the LVIT composed of
mitral valve and its apparatus
where is the LVOT located
just below the aortic valve
where is the IAS located
between the LA and the RA
what is the purpose of the IAS
prevents mixing of oxygenated and deoxygenated blood
what are the three regions in which an IAS defect can occur
sinus venosus
septum secundum
septum primum
where is the sinus venosus located
between junction of SVC and IVC within atrium
where is the septum secundum located
in the mid portion
where is the foramen ovale located
septum secundum
what is the foramen ovale
prenatal opening in the IAS to allow for fetal circulation
what happens to the foramen ovale postnatally
it closes and becomes the fossa ovalis
where is the septum primum located
at the level of the endocardial cushion (AV valves)
where is the IVS located
between the LV and the RV
what is the purpose of the IVS
prevents the mixing of oxygenated and deoxygenated blood
what are the two regions of the IVS
membranous portion
muscular portion
where is the membranous portion of the IVS located
between the outflow tracts
what is the membranous portion of the IVS made up of
thin membrane
where is the muscular portion of the IVS located
from the membranous portion to the apex
where are the AV valves located
between the atria and the ventricles
which AV valve is on the left side
mitral
which AV valve is on the right side
tricuspid
what causes the AV valves to open and close
response to pressure changes in systole and diastole
when do the AV valves open and why
diastole to allow blood from atria into the ventricles
when do the AV valves close and why
systole to prevent backflow of blood from ventricles into the atria
what are the names of the leaflets in the mitral valve
anterior and posterior
in the mitral valve, the _____ leaflet is larger
anterior
what is the anterior leaflet adjacent to
non-coronary cusp of the valve
what is the MV annulus
fibrous ring around the valve where the leaflets insert
what are the names of the leaflets in the tricuspid valve
anterior
posterior
septal (medial)
the tricuspid valve is _____ than the mitral valve in the heart
further down
what are the papillary muscles
small muscular columns attached to the inside of the ventricle walls
how many papillary muscles to each valve have
tricuspid has 3 and mitral has 2
how are the papillary muscles attached to the leaflets
via chordae tendineae
the chordae tendineae prevent the leaflets from prolapsing into the _____ during systole
atria
where are the semilunar valves located
between the ventricles and the great vessels
which semilunar valve is located on the left
aortic valve is located to the left
which semilunar valve is located on the right
pulmonary valve is located on the right
where are the sinuses of valsalva located
just distal to the AV in the aortic root
where do the coronary arteries originate
sinuses of valsalva
