GA The Heart and Pericardium

The anterior interventricular artery runs with the_________________ vein.

greater cardiac

The apex of the heart is beneath the:

5th intercostal space at the left midclavicular line

Which valve is between the right atrium and right ventricle?

Tricuspid

The groove that separates the atria from the ventricles is the:

Coronary sulcus

The base of the heart faces:

Posteriorly

The respiratory tract is derived from the

foregut

Foregut (embryology)

the trilaminar disk laterally folding to form tube like structure and part of yolk sac incorporated into body cavity (primitive gut), then part of foregut, midgut and hindgut

The respiratory tract starts as _________

respiratory diverticulum (lung bud), blind ended pouch

Tracheoesophageal fistula (TEF)

when the trachea and esophagus don’t fully separate and form their own tubes

when the respiratory diverticulum begins getting pinched off it is now known as?

tracheal bud

what are the 4 stages of lung development?

pseudoglandular period, canalicular period, terminal saccular period, alveolar period

when does the pseudoglandular period take place?

6-16 weeks

Pseudoglandular period

resembles an exocrine gland, no air spaces within the lungs/not functional, all major elements of the lung have formed except those involved in gas exchange

when is the canalicular period?

16-26 weeks

Canalicular period

lumina of bronchi and terminal bronchioles become larger and lung tissue becomes highly vascular, canals/tubes within the lungs

when is the terminal saccular period?

26 weeks to birth

Terminal saccular period

alveolar ducts give rise to terminal saccular (primordial alveoli), terminal saccules are lined by type I alveolar cells and type II alveolar cells, sufficient amount of surfactant is produced

Type I alveolar cells

squamous/flat/thin, allows for gas exchange

Type II alveolar cells

cuboidal, produce and secrete surfactant to decrease surface tension on alveolar sacks, make them easier to expand

Alveolar period

alveolocapillary membrane becomes sufficiently thin to allow gas exchange, about 95% of mature alveoli develop postnatally, lungs become more vascular

when is the alveolar period?

32 weeks gestation to 8 years of life

Pericardium location

middle mediastinum, posterior to the body of the sternum, 2nd-6th costal cartilages and T5-T8 vertebrae (T6-T9 when standing)

Pericardium description

double-walled fibroserous sac which enclose the heart and root of the great vessels, conical in shape

The pericardium is influenced by movements of the ______.

heart, great vessels, sternum, and diaphragm

The pericardium is bound by the _______ and ________ ligaments.

pericardiacophrenic, sternopericardial ligaments

Fibrous pericardium

outer tough fibrous layer made up of dense irregular connective tissue, not in direct contact w the heart, protective function

Serous pericardium

parietal layer and visceral layer (epicardium), cavity contains 5-30ml of serous fluid

two layers of the serous pericardium

parietal layer (orange) and visceral layer/epicardium (blue)

Arterial supply of the pericardium

branches from the internal thoracic, pericardiacophrenic, musculophrenic, and inferior phrenic arteries, and thoracic aorta

Nerve supply of the pericardium

phrenic and vagus nerves (GVA/sensation), sympathetic trunks (thoracic splanchnic nerves, T1-T4, sympathetics)

The heart faces _____.

left laterally and anteriorly

pericarditis

inflammation of pericardium, due to trauma/infection, vessels that supply it get leaky and extra serous fluid, can lead to pericardial effusion

pericardial effusion

extra fluid in the pericardium, can lead to cardiac tamponade

cardiac tamponade

tachycardia bc level of oxygen so low, backflow of blood

pericardiocentesis

removal of fluid from the lungs

what are the external surfaces of the heart?

sternocostal, diaphragmatic, pulmonary

Sternocostal external surface of the heart

touching the sternum and costals

Diaphragmatic external surface of the heart

touching the diaphragm

Pulmonary external surface of the heart

touching the right and left lungs

Important landmarks superficially on the heart

coronary sulcus, interventricular sulcus (anterior and posterior), sulcus terminalis, coronary artery and branches, coronary sinus and cardiac veins (all but two smaller veins drain into coronary sinus)

Anterior surface of the heart

formed mainly by the RV

Anterior surface of the heart is also known as

sternocostal surface

Left pulmonary surface

faces the left lung and consists of the LV and part of LA

Right pulmonary surface

faces the right lung and consists of the right atrium

Inferior surface of the heart

formed mainly by the LV and partly by the RV, closely related to the central tendon of the diaphragm

The inferior surface if the heart is also known as

diaphragmatic surface

Left and right auricles

dilations in the left and right atriums

Base of heart

posterior aspect of the heart formed mainly by the LA facing the bodies of T5-T8 vertebrae (T6-T9) when standing

Apex of the heart

located in the left 5th intercostal space at the MCL (mid clavicular line) and is formed by the inferolateral part of the LV

Superior border of the heart (green)

formed by the LA and RA and auricles

Inferior border of the heart (pink)

formed mainly by the LV and partly by the left auricle

Left border of the heart (red)

formed mainly by LV and partly by the left auricle

Right border (yellow)

formed by RA and extends from SVC to IVC

What color is crista terminalis in the photo of right atrium?

green

what color is pectinate muscles in the photo of right atrium?

light blue

what color is the sinus venarum in the photo of right atrium?

pink, easier for blood to flow bc smooth

what color is the venous in the photo of right atrium?

orange

what color is the fossa ovalis in the photo of right atrium?

dark blue, on the intratrial septum

Fossa ovalis is a remnant of what fetal structure?

foramen ovale

Purpose of the foramen ovale

bypassing the lungs, allowed blood to move from right to left atrium

what color is the tricuspid orifice in the photo of right atrium?

red

what is another name for the tricuspid valve?

right atrioventricular

what color is the conus ateriosus in the left ventricle photo?

red, leads into pulmonary trunk

what is another name for the conus arteriosus?

infundibulum, leads into pulmonary trunk

what color is the pulmonary valve in the left ventricle photo?

yellow

Pulmonary valve is also known as

semilunar valve

what color is the papillary muscles in the left ventricle photo?

green

what color is the trabeculae carne in the left ventricle photo?

light blue

what color is the moderator band in the left ventricle photo?

orange, strengthen/support papillary muscles

what are two landmarks you will only find in the right ventricle?

conus arteriosus and moderator band

Moderator band is also known as the

septomarginal band

what color is the chordae tendonae in the left ventricle photo?

dark blue, anchored to papillary muscles and tricuspid valve and prevent regurgitation

what color is the tricuspid valve in the left ventricle photo?

pink, prevent retrograde flow

what color is the pulmonary vein openings in the photo of the left atrium?

green, superior and inferior on right and left sides (4 of them)

what color is the mitral orifice in the photo of the left atrium?

black line

Mitral valve is also known as…

bicuspid valve, left atrioventricular valve

what color are the pectinate muscles in the photo of the left atrium?

dark blue, localized to the auricle in left and widespread in right

what color is the fossa ovalis in the photo of the left atrium?

orange

what color are the papillary muscles in the photo of the left ventricle?

light blue

what color are the chordae tendonae in the photo of the left ventricle?

light purple

what color are the trabeculae carne in the photo of the left ventricle?

light green

what color is the mitral valve in the photo of the left ventricle?

red

what are the first branches off of the ascending aorta?

right and left coronary arteries, supply blood to heart itself

what are the terminal branches of the left coronary artery?

anterior interventricular (supplies both ventricles and septum), circumflex (supplies left atrium and ventricle)

what branch do 40% of people have off of the circumflex artery?

SA nodal branch

what branch do 60% of people have off of the right coronary artery?

SA nodal artery

what branch do 80% of people have off of the right coronary artery?

AV nodal artery

Branches off of the right coronary artery

posterior interventricular (supplies both ventricles), right marginal (supplies right ventricle)

what color is the left coronary artery in the anterior heart photo?

green

what color is the right coronary artery in the heart photo?

pink

The left and right coronary arteries branch off of the…

ascending aorta

What terminal branch of the left coronary artery is highlighted in light blue?

anterior interventricular artery

What terminal branch of the left coronary artery is highlighted in red?

circumflex

what branch of the right coronary artery is highlighted in dark blue?

right marginal artery

what branch of the right coronary artery is highlighted in yellow?

posterior interventricular artery

what vein/artery is highlighted in light blue?

left marginal

what vein/artery is highlighted in orange?

left posterior ventricular

what are the veins that drain into the coronary sinus?

greater cardiac vein, middle cardiac vein, small cardiac vein, left marginal vein, left posterior ventricular vein

Which vein travels with the anterior interventricular artery and is highlighted in red?

greater cardiac vein

which vein travels with the right marginal artery and is highlighted in dark blue?

small cardiac vein