Reg 3 week 3: Coronary circulation, ECG and Internal heart

Sympathetic innervation to cardiac plexus

Cervical and upper thoracic sympathetic trunks

Parasympathetic innervation to cardiac plexus

Vagus nerve

Superficial (ventral) part of cardiac plexus

Inferior to aortic arch and ant to right pulmonary artery

Deep (dorsal) part of cardiac plexus

Ant to tracheal bifurcation, superior to point of division of pulmonary trunk and post to aortic arch

P wave

artial depolarization

QRS wave

ventricular depolarization

T wave

Ventricular repolarization

Umbilical vein takes blood from ______ to ______ with _______ blood

Umbilical vein takes blood from placenta to heart with oxygenated blood

Shunt through right to left artium using what

Foramen ovale

Ductus arteriosus

Reduced pulmonary flow; connects pulmonary trunk to aorta

Ductus venosus

connects the umbilical vein to the inferior vena cava, bypassing the liver

Tetralogy of fallot

Ventricular septal defect, pulmonary valve stenosis and overriding aorta all lead to right ventricular hypertrophy

Right auricle has ____ walls (of right atrium)

Trabeculated walls

Main cavity of right atrium has smooth walls to...

Reduce turbulence

Does super vena cava have a valve

No,

What is the AKA for the rudimentary valve of the inferior vana cava

Eustachian valve

Coronary sinus

Opens into right atrium between inf vena cava and right AV orifice, has rudimentary valve

Right AV orifice is guarded by what

Tricuspid valve

Fossa ovalis

Shallow depression on right side of inter atrial septum, indicates site of foramen ovale during intrauterine life

Foramen ovale

Communicates both atria during intrauterine life (to bypass lungs)

What happens if right to left shunt remains patent (foramen ovale)

Cyanosis

How does right ventricle communicate with right atrium

Right AV orifice

Below conus arteriosus, right ventricular wall have muscular formed by _______ ________

Trabeculae carne

Chordae tendineae

Tendinous cords; 3 sets of papillary muscles project into lumen of ventricles and attach by their bases to ventricular wall

Pulmonary sinus

Pocket-like spaces between cusps of pulmonary valve and trunk

Left auricle in left atrium has trabeculated walls created by....

Pectinate muscles

Left AV orifice forms communication between _____ and _____

LA and LV

Part of left ventricle below aortic orifice is known as...

Aortic vestibule

Remaining left ventricle has irregular valves due to presence of....

Trabeculae carneae

Ventricular septal defects usually involve....

Membranous part of interventricular septum

Where is the membranous part of the interventricular septum and why is it more prone of ventricular septal defects

At the top; no muscle —> more prone to atrialventricular defect

What're the three semilunar cusps that guard the aortic orifice

Right left and posterior

Aortic sinuses

Pocket-like spaces between cusps of aortic valve and wall of aorta

Right and left coronary arteries are located in which aortic sinuses

Right and left sinuses

Aortic sinus AKA

Sinuses of valsalva

Left ventricular hypertrophy

Lose wall elasticity —> more work to pump blood out

Causes of left ventricular hypertrophy

High blood pressure

Aortic valve stenosis

Athletic training *

Stenosis heart murmur

Vavular stenosis, when valve cusps are thickened and passage through valve is narrowed

Regurgitation heart murmur

When valves lose competency and cusps can't close in compete apposition —> (back flow of blood

Diastolic murmurs

ARMS and PRTS

Atrial regurg and mitral stenosis

Pulmonary regurg and tricuspid stenosis

Systolic murmurs

Opposite of ARMS and PRTS

Main branches of right coronary artery (4)

1. Sinoatrial nodal branch

2. Right marginal branch

3. AV nodal branch

4. Posterior interventricular branch

Dominance of coronary arterial system is determined by....

Which artery gives off the posterior interventricular branch

Which coronary artery (left or right) has more dominance of giving off the posterior interventricular branch

Right coronary artery (67%)

Left coronary artery originates from...then does what

Left aortic sinus then runs posterior to pulmonary trunk and divides into anterior interventricular and circumflex arteries

Anterior interventricular artery descends...

Toward apex of heart in interventricular sulcus and anastomoses with terminal branches of posterior interventricular artery

Anterior interventricular artery also known as....

Widow maker (because goes to left ventricle —> fatal heart attacks)

Circumflex artery curves around...

Left aspect of heart (branch from left coronary artery)

Left coronary artery typically supplies most of...

The left ventricle

Coronary blood flow occurs mainly during...

Diastole due to compression of coronary blood vessels during systole

During systolic phases, coronary blood flow is less than that during diastole, meaning

Minimal blood flow during iso-volumetric contraction phase

During diastolic phases, coronary blood flow is more than that during systole, meaning

Maximal blood flow during iso-volumetric relaxation phase

Venous drainage of heart and its 3 tributaries

Coronary sinus

-great cardiac vein

-middle cardiac vein

-small cardiac vein

What does great cardiac vein accompany

Anterior interventricular artery and enters left end of coronary sinus

What does middle cardiac vein accompany

Posterior interventricular artery and joins right end of coronary sinus

What does small cardiac vein accompany

Right o coronary artery and joins the right end of coronary sinus

Angina pectoris

Severe chest pain usually retrosternal due to ischemia of cardiac muscles

Myocardial infarction is

Necrosis of part of the myocardium due to prolonged ischemia due to narrowing of coronary arteries

What is myocardial infarction usually complicated by

Fatal ventricular fibrillation