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2012-04-01 19:28:17

The Heart
Show Answers:

  1. Where is the heart?
    In the middle mediastinum of the thoracic cavity.

    (thorax between lungs)
  2. Circulatory System - Overview

    Waste eliminates? (3)

    Lymphatic System consists of what fluids? (2)
    • Waste elimination:
    • 1) H2O
    • 2) Salts
    • 3) Nitrogenous waste

    • lymphatic
    • 1) interstitial fluid
    • 2) water
  3. What is an artery?

    What is a vessel? (vein)

    Purpose of the Vena Cava? (superior/inferior), drains into LA/RA?
    Carries blood away from the heart (oxygenated).

    Vessel: towards the heart (deoxygenated).

    Vena cava: (superior/inferior) large veins which drain blood into the right atrium.

    Pulmonary Artery drains into the LA.
  4. Cardio-pulmonary circulation.

    left heart chambers, circuit?

    right heart chambers, circuit?

    Which receives oxygenated or deoxy blood? Where is it pumped?
    • Left: systemic circuit (pumps blood from left side of heart --> systemic vessels in peripheral tissues --> right side of heart)
    • -Receives oxygenated blood pumps to body

    • Right: Pulmonary circuit (pumps blood from right side of heart --> pulmonary vessels --> lungs --> left side of heart)
    • -Receives De-oxygenated blood, pumps to lungs
  5. The Thoracic Cage. (T1-T12)


    Where is the sternal notch?

    Where is the sternal angle?
    Protect heart/lungs.

    Sternal notch: above manubrium.

    Sternal angle: bottom of manubrium.
  6. Position of the heart in the thorax.

    Apex (interventricular sulcus)
    auricle (dog ear shape on right atrium)

    (4 chambers)

    What is between the atrium/ventricles?
    • Between: coronary (crown) sulcus.
    • -Consists of "coronary" arteries.

    Fibrous skeleton separates the atria from the ventricles.
  7. Where is the Ligamentum arteriosum?

    (i.e., Where does it pass through?)
    Ligament between the arteries.

    (passes from left pulmonary artery to the root of the Aorta)
  8. Pericardium.

    Define the origin of peri and cardio.

    The pericardium consists of what 3 layers? (outer/inner)
    Pericardium: where the heart is; consists of a thick membrane.

    Inner layer = visceral pericardium or "Epicardium"

    Parietal layer = serous or "Parietal Pericardium"

    Outside layer of parietal pericardium = fibrous pericardium.
  9. The Serous Pericardium can further be divided into what two layers?
    1) Parietal layer: lines inner surface of the fibrous pericardium.

    2) Visceral layer: (of serous pericardium) covers outside of heart.
  10. What is the Pericardial space, or cavity?

    The accumulation of fluid in the pericardial space between the visceral & parietal pericardium prevents, what?
    A serous fluid filled space between parietal & visceral layers.

    Accumulation of fluid: prevents the heart chambers from expanding & filling.

    *There is no potential space between the fibrous & parietal layers.
  11. Formation of Serous Lined Coelomic Cavities.
  12. Embryonic development of the heart

    (movement into the pericardium)

    *See page 186 in lecture guide!
    -Be able to draw this structure and label the parts!
  13. What are the 3 heart wall structures? (internal anatomy)
    (layers of inside the chambers to the outside)

    Which layer contains intercalated discs?

    Which is the aka, visceral layer of serous pericardium?
    • 1st layer: endothelium (lines the heart)
    • -endocardium

    • 2nd layer: myocardium (muscle of the heart)
    • *Intercalated discs

    3rd layer: epicardium (visceral layer of serous pericardium)

    Parietal pericardium (mesothelium; loose/dense fiber)
  14. How is myocardium unique?



    gap junctions?
    Striated (like skeletal muscle)

    Nucleus is single and central (one)

    Branched pattern

    Gap junctions: through intercalated discs.
  15. 1) RA

    Posterior wall is made of what muscle?

    What is the Anterior wall consist of? (muscle)
    ~Separated by?
    ~Joined by?

    Name 3 parts you can see or that is located in the RA.
    Sinus venarum - smooth walled.

    • Anterior wall is "Pectinate muscle"
    • ~Separated by "Crista Terminalis"
    • ~Joined by Pectinate-lined, "Right Auricle"

    • Parts:
    • 1) Coronary sinus
    • 2) Fossa Ovalis
    • 3) SA node & AV node
  16. 2) RV

    Consists of what 4 parts?

    Define the 5 parts.
    • 4 parts
    • 1) Trabeculae Carnae ("beams of meat")
    • -support and structure of walls of ventricle.

    • 2) Conus Arteriosis ("Cone of the artery" / a "funnel")
    • -smooth walled, cone shaped outflow leding to Pulmonary trunk.

    • 3) Chordae tendinae ("tendonous cords")
    • -responsible for anchoring leaflets of valve

    • 4) Papillary muscle (ant., post, & septal (papilla = nipple)
    • -Conical projections of myocardium that project via Chordae tendinae to Tricuspid Valve (3 pap. muscles = 3 leaftlets)

    • 5) Moderator Band
    • -Muscle bundle that runs from interventricular septum to ant. pap. muscle.
    • -Contains elements for transmission of eletrical impulse.
    • -Prevents over dilation of ventricle.
  17. 3) LA

    Receives what veins?

    Joined by?
    Receives 4 Pulmonary veins.

    Joined by "Pectinate-lined Left Auricle"
  18. 4) LV

    Consists of what 3 parts?
    1) Trabeculae carnae

    2) Chordae tendinae

    • 3) Pap muscles: Ant. & Post.
    • -2 pap muscles = 2 leaflets)
  19. Valves of the heart.

    AV valves.

    The RA and the RV are separated by which valve?

    The LA & LV are separated by which valve?
    RA & RV are separated by TRICUSPID VALVE.

    LA and LV are separated by the Bicuspid or Mitrial Valve.
  20. Valves of the heart.

    SL valves.

    Which valve lies between the ascending aorta and the LV?

    Which valve lies between the Pulmonary trunk and the RV?

    Which are rare examples of ARTERIES having VALVES?
    Between the ascending aorta and the LV = Aortic SL Valve.

    Between the Pulmonary trunk & the RV = Pulmonary SL Valve.

    *The Aorta & Pulmonary trunk are RARE examples of ARTERIES HAVING VALVES.
  21. What are the basic functions of the atria/ventricles?

    What is a septum?
    atria: collecting

    ventricles: pumping

    • Septum: separates the atria/ventricle.
    • 1) interatrial septum
    • 2) interventricular septum
  22. Of the atria/ventricles, which consists of both arteries & veins?

    Pulmonary arteries (carries..)

    Pulmonary veins (returns..)

    Which is oxygenated/deoxygenated?
    • P. arteries: carry deoxygenated blood to lungs (away from heart).
    • -Collects in the right atria.

    P. veins: return oxygenated blood toward the heart.
  23. Path of blood flow through heart.

    Number the Heart flow of blood, 1-10, through the atria/ventricles.
    • 1) RA
    • 2) RV
    • 3) Pulmonary Trunk
    • 4) n/a
    • 5) From left/right sides of heart into the LA
    • 6) LA
    • 7) LV
    • 8) Aorta
    • 9) n/a
    • 10) Superior/Inferior Vena Cava, REPEAT.
  24. What is COPD of the heart? (pathology)
  25. What portion of the RA consists of pectinae and smooth muscle?
    1/2 Smooth and 1/2 Pectinae.
  26. SL valves don't have what two muscles?
    Cordae tendinae & papillary muscles.
  27. Systole, what chambers are involved?

    Diastole, what is involved during this phase?
    Systole: ventricles only

    Diastole: ventricular relaxation
  28. The Fetal Heart (p. 719)

    Define/Locate the foramen ovale and the ductus arteriosus.

    What does the ductus arteriosus become?
    Foramen ovale (channel): a hole to enable blood to move from right to left atrium.

    Ductus arteriosus (arterial duct): duct of the arteries to re-channel oxygenated blood from going into the lungs, to going into the aorta.

    -Becomes LIGAMENTS of the arteries.
  29. Do we want a lot of pressure from our RV going to our lungs?

    When an infant is said to be born with a "hole in the heart", what does this mean?
    No. Too much pressure/blood can actually cause damage.

    Hole in heart: a malformed part of the Membranous Interventricular Septum ("ventricular septal defect" or VSD).

    *Differs from "atrial septal defect" (ASD); patent foramen ovale in the interatrial septum.
  30. Atrial Septal Defect (ASD); p. 679

    Aka: "patent foramen ovale"
  31. Coronary Arteries (check PPT - Heart)

    p. 661-662; 667

    What do they do?

    Where does the LEFT coronary artery branch into? (3)

    Where does the RIGHT coronary artery branch into? (2)
    The arterial supply of O2 to the muscles of the heart.

    • Left:
    • 1) Anterior Interventricular Artery
    • 2) Circumflex artery
    • 3) Left marginal arteries.

    • Right:
    • 1) Right marginal Artery
    • 2) Posterior Interventricular Artery
  32. Cardiac Veins, define.

    Name the 6 veins: AGMSSC

    What does the "Great Cardiac Vein" become and empty into?

    Where does the Middle & Small Cardiac Veins epty into?

    Whcih DO NOT empty into the coronary sinus?
    C. Veins: venous drainage of deoxygenated blood from the muscles of the heart.

    • 1) Anterior Cardiac Veins: drain RV into RA.
    • 2) Great Cardiac Vein: becomes Coronary Sinus; empties into the RA.
    • 3) Middle Cardiac Vein: empties into Coronary Sinus
    • 4) Small Cardiac Veins: empties into Coronary Sinus
    • 5) Smallest cardiac veins (Thebesian)
    • 6) Coronary Sinus

    *Anterior cardiac and Thebesian veins DO NOT empty into the Coronary Sinus
  33. "Running Mates"

    Which vessels travel together around the heart? (cardiac veins)

    1) The Great Cardiac Vein
    2) The Middle3 Cardiac Vein
    3) The Small Cardiac Vein
    1) The Great Cardiac Vein runs along side the Anterior Interventricular artery

    2) The Middle Cardiac Vein runs along side the Posterior Interventricular artery.

    3) The Small Cardiac Vein comes from the same area as the Right Marginal artery.
  34. What prevents spread of impulse to the ventricles from the atria?

    What is the function of the AV Node?
    The Cardiac Skeleton prevents spread to ventricles.

    AV node: transmits impulses to ventricles via AV bundle (bundle of His)
  35. Congestive Heart Failure (CHF)

    What is atheriosclerosis?

    What does it often lead to the formation of?
    Artheriosclerosis: "hardening of the arteries" is a degenerative vascular disorder.

    Forms: a Thrombus (blood clot).

    *Linked to over 50% of all deaths in the US and of morbidity & mortality in other countries of the western world.
  36. Briefly describe the Autonomic innervation of the Heart.

    Sympatheitic response
    Parasympathetic response

    Pressure detection?
    Increase/Decrease HR?
    BP increase/decrease?
    • Sympathetic
    • Detects: low BP and/ or high CO2 concentrations.
    • Cardio-accelaratory: centers in M. Oblongata sends signals via cardiac nerves to SA and AV nodes in heart.
    • HR: increase by faster/stronger impulses
    • Vasoconstriction to arteries & veins
    • BP: Increase b/c of vasoconstriction.

    • Parasymp.
    • Detects: high BP and/ or low CO2 concentrations.
    • Cardio-inhibitory: centers in M. Oblongata sends signals via Vagus nerves to SA and AV nodes in heart.
    • HR: decrease by slower/weaker impulses.
    • Vasodilation to arteries/veins.
    • BP: decreases b/c vessel diameter increases.
  37. The Cardiac Skeleton of the Heart.

    What's the function of this dense conn. tissue skeleton? (3)
    1) Support

    2) Reinforcement

    3) Separation of impulse from atria to ventricles.
  38. Locate the SA Node and AV node.
    SA = lateral border of SVC, superior border of right auricle and sulcus terminalis.

    AV = right AV opening, opening of coronary sinus, and tendon of todaro.
  39. Heart sounds; what causes the heart sounds? (valves)


    Lub: systole causes AV valves to close.

    Dub: diastole causes SL valves to close.
  40. What is the result of a

    1) HEART BLOCK, and

    1) Occlusion of arterial supply to the interventricular septum = bundle branch necrosis = heart block

    2) NO blood supply to septum = necrosis of bundle branches.
  41. The right coronary artery supplies...(4)

    The left coronary artery supplies..(3)
    • Right Coronary Artery:
    • 1) anterior 2/3 of septum
    • 2) moderator band
    • 3) anterior papillary of right ventricle
    • 4) atrioventricular conduction system

    • Left Coronary Artery:
    • 1) the posterior 1/3 of septum.
    • 2) SA Node
    • 3) AV Node
  42. What does the "Pacemaker", connect to? (4)

    Where do pacemakers send impules?
    • 1) SA Node
    • 2) AV Node
    • 3) Bundle of His
    • 4) Right & left bundle branches

    Impulses sent around the "heartblock".
  43. What is Arrhythmia?

    (Hint: what is fibrillation?)

    Fibrillation: unsynchronized depolarization of cells.
  44. Innervation of the Heart

    Parasympathetic nerves innervated by?

    Sympathetic nerves innervated by?

    Locate the above and the Cardiac Plexus on slide
    Para: Vagus N.

    Symp: Cardiac N.
  45. CO2 concentrations.

    Low BP has (low or high) CO2 concentration?

    High BP has (low or high) CO2 concentration?
    • LBP: high CO2 concentration
    • HBP: low CO2 concentration
  46. Autonomic Control Over HR and BP.

    What are the sensors for HR & BP?

    Which pressure is associated w/ "fight or flight", "vegatative"?

    Explain the pathway for a DECREASE in BP & HR w/ HBP according to their vaso-centers & cardiac centers.

    Explain the pathway for an INCREASE in BP & HR w/ LBP.
    • Sensors:
    • 1) Baroreceptors (located at the Carotid and Aortic arch)
    • 2) Chemoreceptors

    • Vegetative: HBP
    • Fight/Flight: LBP

    • HBP: Vasodialation center --> Parasymp. --> relax art. & vein --> decrease BP.
    • Cardiac inhibitory center: --> Parasymp. (Vagus N.) --> SA & AV Nodes --> decrease HR.

    • LBP: Vasoconstriction center --> Symp. --> constrict art & vein --> increase BP.
    • Cardiac accelatory center --> Symp. (cardiac n.) --> SA & AV Nodes --> increase HR.