External Heart

Blood flow through the heart and systemic circulation

Superior/Inferior Vena Cava (oxygen poor blood)

Right Atrium

Right Ventricle

Pulmonary Trunk

Pulmonary Arteries

Lungs

Pulmonary Veins (oxygen rich blood)

Left Atrium

Left Ventricle

Aorta

Explain the innervation of the heart

Sympathetic Innervation : Fight or Flight , Increases HR, force of contraction, dilation of coronary arteries, originates from T1-T5 spinal nerves. Sympathetic Ganglia from Superior cervical - T4 contribute.

Parasympathetic Innervation: Rest and Digest. Decreases HR. Reduced force of contraction. Constricts the coronary arteries. Vagus Nerve (CN X).

Ventricles are thick muscular chambers pumping blood —-

out of the heart

Atria are recieving chambers that — the ventricles

top off

Atria have ears

Auricles

Aorta pumps blood to the

rest of the body

Hearts Position in Body

Thorax and Mediastinum

Middle Mediastinum is the heart

Heart lies —-

Right atrium and right ventricle are anterior to their counterparts.

Usually — of midline

Similar to a pyramid with —,—, and — surfaces

obliquely

left

apex, base, four

Cardiac Apex formed by

inferolateral part of the left ventricle

Cardiac Base

— aspect of the heart

Opposite the —

Formed mainly by the —- with lesser contribution by the —-

Receives four pulmonary — and — and —

Posterior

Apex

Left Atrium

Right Atrium

Veins

SVC

IVC

Anterior (sternocostal) surface of heart

Formed mainly by the — ventricle

Right

Diaphragmatic (inferior) surface of the heart

Formed mainly by the — and partly by the right

left ventricle

right

Right Pulmonary Surface

Formed mainly by the —-

right atrium and auricle

Left Pulmonary Surface

Formed mainly by the —

left ventricle

Borders

Right Border:

Inferior Border:

Left Border:

Superior Border:

Right Border: Right Atrium and Extends bw SVC and IVC

Inferior Border: Right Ventricle and slightly by left ventricle

Left Border: Left Ventricle and slightly by left auricle

Superior Border: Right and Left Atria and auricles

Pericardiocentesis

Surgical puncture of the pericardial activity for the aspiration of fluid

Relieves pressure of the accumulated fluid in the heart

Needle inserted into pericardial cavity through the 5th intercostal space left to the sternum

Because of the cardiac notch in the left lung, the needle misses the pleura and lungs, but it penetrates the pericardium

Surface Projections

APEX

Superior border:

Right border:

Inferior Border:

Left Border:

APEX: 5th left intercostal space in the midclavicular line

Superior border: 2nd left intercostal space to 3rd right costal cartilage

Right border: 3rd right costal cartilage to 6th right costal cartilage

Inferior Border: 6th right costal cartilage to the apex of the heart

Left Border: Apex of heart to the 2nd left costal cartilage

Marks division between atria and ventricles

Coronary Sulcus - completely encircles the heart

Contains trunks of the coronary vessels

— sulci — of which have arteries that run through them

4

3

Sulci which seperates the two atria

Interatrial sulcus

Hidden by pulmonary trunk and aorta

Two interventricular Sulci

Anterior interventricular sulcus: Anterior interventricular artery (LAD) and Great Cardiac Vein

Posterior Interventricular Sulcus: on diaphragmatic surface of the heart / contains Posterior interventricular artery and Middle cardiac vein

Vessels that supply oxygenated blood are the —-

Vessels that remove poorly oxygenated blood are the —

Coronary arteries

Cardiac veins

Coronary artery and veins course along the —- in sulci

Epicardium

Two main arterial branches

Left coronary artery

Right coronary artery

Openings to R and L coronary Arteries are located in the aorta above the — in aortic sinuses

aortic valve leaflets

L aortic sinus opens to left coronary artery

R aortic sinus opens to right coronary artery

The coronary arteries receive blood from aorta during —-

Diastole - relaxation and filling

Left coronary artery supplies blood to

Left Atrium and Ventricle

Anterior 2/3 of the interventricular septum

Parts of the right ventricle

Bundle of His (AV Bundle)

Left Coronary Artery gives off two branches

Left anterior descending artery aka anterior interventricular branch. Travels in anterior interventricular sulcus. Supplies Apex, L and R ventricles, Interventricular Septum

Left circumflex artery. Travels in left coronary sulcus. Wraps around left side to reach posterior heart. Suppies Posterior and lateral left ventricle, left atrium.

Right Coronary Artery

Travels in right coronary sulcus. Supplies blood to: Right atrium, Right ventricle, SA node, AV node, part of left ventricle, posterior 1/3 of the interventricular septum

Right Coronary Artery 4 branches

Right Marginal Artery aka Acute marginal artery. Supplies Right ventricle and apex of the heart.

SA Nodal Branch. Courses between right atrium and opening of SVC. Supplies SA node.

Posterior Interventricular Artery aka Posterior Descending Artery. Supplies: Right and left ventricles and posterior 1/3 interventricular septum.

AV Nodal Branch. Comes off of the branch of the Posterior Interventricular Artery. Supplies AV Node.

SA Node

Pacemaker of the heart, tells it when to contract. How often to contract. Fastest repolarizing tissue in the heart.

Coronary Dominance determined by the coronary artery (right or left) that gives off the —-

Posterior Interventricular Artery

Most of the time the dominant side is the right coronary artery

The heart is drained by veins that empty into a dilated structure called the —-

Which runs from — to — in coronary sulcus on the — side of the heart

Drains directly into the —

Coronary Sinus

Left to Right

Posterior

Right Atrium

Veins that empty into coronary sinus

Great Cardiac Vein: begins at apex, runs in anterior interventricular sulcus, follows the LCX posteriorly, gradually dilates and becomes the coronary sinus

Middle Cardiac Vein: Begins at apex, runs in the posterior interventricular sulcus (on the inferior surface of the heart)

Small Cardiac Vein: Begins in the inferior anterior section of the coronary sulcus between the right atrium and right ventricle

Autonomic Innervation

Heart supplied by a superficial and deep —-

Superficial:

Deep:

Cardiac Plexus (network of nerve fibers from the ANS)

Superficial: Inferior to aortic arch , between aortic arch and pulmonary trunk

Deep: Between aortic arch and tracheal bifurcation