p.8
Pericardial Sinuses and Clinical Relevance
What is demonstrated in the images regarding the pericardial sinuses?
How to palpate the pericardial sinuses in lab.
p.12
Structure and Function of the Heart
Where is the apex of the heart oriented?
Toward the left side of the body on the inferoanterior aspect.
p.4
Anatomy of the Mediastinum
What is the middle mediastinum primarily associated with?
The heart and its surrounding structures.
p.24
Coronary Arteries and Myocardial Infarction
What is coronary dominance?
A variation in the blood supply to the heart, specifically regarding the posterior interventricular artery.
p.1
Divisions of the Mediastinum
What is the location of the mediastinum in relation to the lungs?
It is located between the two lungs.
p.19
Coronary Arteries and Myocardial Infarction
Where does the circumflex branch of the left coronary artery travel?
In the coronary sulcus around the left margin of the heart.
p.24
Coronary Arteries and Myocardial Infarction
What is the significance of coronary dominance?
It affects the blood supply to the ventricles and overall surface area of the heart.
p.1
Divisions of the Mediastinum
Into what divisions is the inferior mediastinum further divided?
Anterior, middle, and posterior mediastinum.
p.6
Innervation and Blood Supply of the Pericardium
What type of fibers provide sensory innervation to the fibrous and parietal serous pericardium?
GSA fibers in the phrenic nerve.
p.25
Venous Return from the Heart
What exception exists regarding the blood drainage from the heart's surface?
The small anterior cardiac veins and Thebesian veins drain directly into the heart's chambers.
p.23
Coronary Arteries and Myocardial Infarction
What does Image A represent in terms of coronary arteries?
The typical blood supply to the heart from the coronary arteries.
p.23
Coronary Arteries and Myocardial Infarction
How does Image B affect the myocardium supply?
It shows that more of the myocardium is supplied by the left coronary artery (LCA).
p.24
Coronary Arteries and Myocardial Infarction
In right dominant hearts, which artery supplies the posterior interventricular artery?
The right coronary artery (RCA).
p.13
Structure and Function of the Heart
What is the function of the auricle in the atria?
To allow more blood to expand into the atrium.
p.25
Venous Return from the Heart
What are the three major tributaries involved in venous return from the surface of the heart?
Great cardiac vein, middle cardiac vein, and small cardiac vein.
p.16
Anatomy of the Mediastinum
Which intercostal spaces is the left ventricle located?
Deep to the third to fifth left intercostal spaces, near the mid-clavicular line.
p.6
Innervation and Blood Supply of the Pericardium
What is referred pain from the parietal serous pericardium associated with?
Dermatomes in the supraclavicular region of the shoulder and lateral neck.
p.5
Pericardium: Structure and Function
How does the fibrous pericardium help the heart?
It helps retain the heart's position in the thoracic cavity and limits cardiac distension.
p.11
Pericardium: Structure and Function
What is the purpose of reflecting the pericardium in the in-situ view of the heart?
To expose the fat covering the cardiac muscle.
p.7
Pericardial Sinuses and Clinical Relevance
Where is the transverse pericardial sinus located?
Between the outgoing arteries (aorta, pulmonary trunk) and incoming veins (superior vena cava).
p.23
Coronary Arteries and Myocardial Infarction
What is demonstrated in Image C?
An absent right coronary artery, with the left coronary artery supplying all myocardium.
p.23
Coronary Arteries and Myocardial Infarction
What does Image D show about the left coronary artery?
It only branches into the anterior interventricular artery, while the right coronary artery supplies the posterior interventricular artery and the circumflex artery.
p.17
Structure and Function of the Heart
How many cusps does the aortic semilunar valve have?
Three cusps (left, right, and posterior).
p.17
Structure and Function of the Heart
What happens to the sinuses of the aortic semilunar valve after ventricular contraction?
They fill with blood and passively close.
p.25
Venous Return from the Heart
What artery does the middle cardiac vein travel with?
The posterior interventricular artery in the posterior interventricular sulcus.
p.20
Coronary Arteries and Myocardial Infarction
From where do both coronary arteries emerge?
From the ascending aorta.
p.12
Structure and Function of the Heart
What clinical implications arise from the relationship between the left atrium and the esophagus?
Problems with the left atrium often affect the esophagus and vice versa.
p.20
Coronary Arteries and Myocardial Infarction
What are some branches of the right coronary artery mentioned?
Right marginal artery and SA nodal artery.
p.5
Pericardium: Structure and Function
What happens to the heart during inspiration?
The heart changes shape and elongates because the great vessels are anchored.
p.3
Structure and Function of the Heart
Why is the muscular wall of the left ventricle larger than that of the right?
Because it requires more blood pressure to pump blood throughout the body than to the lungs.
p.11
Structure and Function of the Heart
What does the term 'in situ' refer to in the context of the heart?
The heart being viewed in its natural position.
p.7
Pericardial Sinuses and Clinical Relevance
What are the two clinically important recesses formed by the serous pericardium?
Transverse pericardial sinus and oblique pericardial sinus.
p.14
Anatomy of the Mediastinum
Why are the sulci of the heart important?
They assist in understanding where the four chambers will be located.
p.2
Blood Circulation: Pulmonary and Systemic Circuits
What is the systemic circuit?
The circulation between the heart and the body.
p.10
Pericardial Effusion and Cardiac Tamponade
Where can a needle be placed during a pericardiocentesis?
Alongside the sternum, substernally, or at the apex of the heart.
p.6
Innervation and Blood Supply of the Pericardium
Which nerve carries sensory innervation to the visceral serous pericardium?
The vagus nerve (CNX) with GVA fibers.
p.12
Structure and Function of the Heart
What is the inferior surface of the heart called?
The diaphragmatic surface.
p.21
Coronary Arteries and Myocardial Infarction
What are classic symptoms of a heart attack?
Chest heaviness or pressure, sweating, pain radiating to the left arm, and nausea.
p.11
Anatomy of the Mediastinum
What can be observed within the layer of fat in the in-situ view of the heart?
The outline of several blood vessels.
p.22
Coronary Arteries and Myocardial Infarction
When might coronary bypass be necessary?
When there are insufficient branches of cardiac blood flow to deliver oxygen to tissues.
p.22
Coronary Arteries and Myocardial Infarction
What is a Coronary Artery Bypass Graft (CABG)?
A procedure that uses a vessel from another region of the body to bypass an occluded coronary artery.
p.15
Anatomy of the Mediastinum
What are the three 'knobs' outlined in red on the left side of the heart's anterior view?
Aortic arch (AA), pulmonary trunk (PT), and left atrium (LA).
p.13
Blood Circulation: Pulmonary and Systemic Circuits
What brings blood back from the lungs to the heart?
The pulmonary veins entering the left atrium.
p.16
Anatomy of the Mediastinum
What is the location of the left border of the heart?
Extends between the left second rib and fifth intercostal space at the mid-clavicular line.
p.15
Anatomy of the Mediastinum
How can the esophagus be followed in relation to the trachea?
The esophagus is posterior to the trachea, which is more anterior.
p.25
Venous Return from the Heart
Where does the coronary sinus lie?
Between the base and the diaphragmatic surface of the heart.
p.20
Coronary Arteries and Myocardial Infarction
What is the function of the left coronary artery?
It supplies blood to the left side of the heart.
p.5
Pericardium: Structure and Function
What is found within the pericardial cavity?
Normally only serous fluid, which allows the heart to move without friction.
p.18
Coronary Arteries and Myocardial Infarction
What important branch supplies blood to the sinoatrial node?
The branch to the sinoatrial node from the right coronary artery.
p.18
Coronary Arteries and Myocardial Infarction
What is another name for the anterior interventricular artery?
LAD (Left Anterior Descending artery).
p.26
Venous Return from the Heart
What is the function of the cardiac veins?
To return deoxygenated blood from the heart muscle to the right atrium.
p.14
Anatomy of the Mediastinum
What does the anterior interventricular sulcus house?
The anterior interventricular artery and great cardiac vein.
p.2
Blood Circulation: Pulmonary and Systemic Circuits
What is the role of the right ventricle?
To pump oxygen-poor blood to the lungs in the pulmonary circuit.
p.2
Blood Circulation: Pulmonary and Systemic Circuits
What happens to blood after it returns from the pulmonary circuit?
It is oxygen-rich and pumped to the rest of the body by the left ventricle.
p.10
Pericardial Effusion and Cardiac Tamponade
What can happen if cardiac tamponade is left untreated?
It can lead to heart failure.
p.22
Coronary Arteries and Myocardial Infarction
What is a commonly used vessel for CABG?
The great saphenous vein from the lower limb.
p.19
Coronary Arteries and Myocardial Infarction
What areas does the circumflex branch supply?
The left border of the heart, posterior aspect of the left ventricle, and left atrium.
p.10
Pericardial Effusion and Cardiac Tamponade
What is the advantage of the substernal approach during pericardiocentesis?
It allows the needle to pass through the cardiac notch of the left lung.
p.20
Coronary Arteries and Myocardial Infarction
What are the two main coronary arteries highlighted in the images?
The right coronary artery (RCA) and the left coronary artery (LCA).
p.12
Structure and Function of the Heart
Which parts of the heart make up the anterior surface?
Primarily the right ventricle, but also parts of the right atrium and left ventricle.
p.6
Innervation and Blood Supply of the Pericardium
From which artery does the pericardiacophrenic artery originate?
The internal thoracic artery.
p.18
Coronary Arteries and Myocardial Infarction
What does the right coronary artery supply?
The anterior surface of the right atrium and right ventricle.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
How does oxygen-rich blood return to the heart?
Via the pulmonary veins (four in total) to the left atrium.
p.26
Venous Return from the Heart
Which artery does the middle cardiac vein accompany?
The posterior interventricular artery in the posterior interventricular sulcus.
p.14
Anatomy of the Mediastinum
What is the function of the coronary sulcus?
It demarcates the separation between the atria and the ventricles.
p.13
Anatomy of the Mediastinum
Where is the apex of the heart located?
In the 5th intercostal space at approximately the mid-clavicular line.
p.7
Pericardial Sinuses and Clinical Relevance
How can the transverse pericardial sinus be approximated during surgery?
By placing a finger posterior to the aorta and pulmonary trunk and anterior to the superior vena cava.
p.7
Pericardial Sinuses and Clinical Relevance
What is the clinical relevance of the oblique pericardial sinus?
It can be used to stabilize the heart during cardiac surgery.
p.16
Anatomy of the Mediastinum
Which intercostal spaces is the right atrium located?
Deep to the right third, fourth, and fifth intercostal spaces.
p.16
Anatomy of the Mediastinum
Where is the right ventricle located?
Deep to the left parasternal border and the third through fifth left intercostal spaces.
p.9
Pericardial Effusion and Cardiac Tamponade
What does an anechoic appearance in an echocardiogram indicate?
Accumulated pericardial fluid.
p.25
Venous Return from the Heart
Which artery does the small cardiac vein accompany?
The right marginal artery and then the right coronary artery in the coronary sulcus.
p.16
Anatomy of the Mediastinum
Where is the pulmonary trunk located?
Deep to the second intercostal space at the left parasternal border.
p.6
Pericardial Effusion and Cardiac Tamponade
What is pericarditis?
An inflammatory condition of the pericardium that may result in pain.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
What do blue and red vessels indicate in diagrams of the pulmonary system?
Blue indicates oxygen-poor blood, while red indicates oxygen-rich blood.
p.12
Structure and Function of the Heart
What two major borders of the heart come together at the apex?
The inferior (acute) margin and the obtuse margin.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
What valve allows blood to pass from the left atrium to the left ventricle?
The bicuspid (or mitral or left atrioventricular) valve.
p.26
Venous Return from the Heart
What artery is the small cardiac vein associated with?
The right coronary artery in the coronary sulcus.
p.14
Anatomy of the Mediastinum
What structures are located in the coronary sulcus?
Coronary arteries, great cardiac vein, and coronary sinus.
p.14
Anatomy of the Mediastinum
What does the posterior interventricular sulcus house?
The posterior interventricular artery and middle cardiac vein.
p.17
Coronary Arteries and Myocardial Infarction
Where do the coronary arteries branch off from?
Immediately after blood passes through the aortic semilunar valve into the ascending aorta.
p.9
Pericardial Effusion and Cardiac Tamponade
What happens to the pericardial cavity under pathological conditions?
It can fill with excess fluid, blood, or pus, leading to pericardial effusion.
p.9
Pericardial Effusion and Cardiac Tamponade
Why can't the fibrous pericardium expand?
Because it has little to no elasticity.
p.9
Pericardial Effusion and Cardiac Tamponade
What is the 'Oreo cookie sign' in a CT scan?
It refers to the radiolucent line of paracardial fat, followed by the radiopaque line of pericardial fluid, and then the radiolucent line of epicardial fat.
p.6
Innervation and Blood Supply of the Pericardium
What nerve innervates the pericardium?
The phrenic nerve (C3 - 5).
p.1
Pericardium: Structure and Function
What defines the space of the middle mediastinum?
The borders of the fibrous pericardium.
p.5
Pericardium: Structure and Function
What does the fibrous pericardium attach to inferiorly?
The diaphragm via the pericardiacophrenic ligament.
p.18
Coronary Arteries and Myocardial Infarction
What is the path of the right coronary artery?
It continues along the coronary sulcus both anteriorly and posteriorly.
p.18
Coronary Arteries and Myocardial Infarction
What does the posterior interventricular artery supply?
The posterior one-third of the interventricular septum and right and left ventricles.
p.4
Pericardium: Structure and Function
What are the pericardial membranes?
The fibrous pericardium and serous pericardium.
p.23
Coronary Arteries and Myocardial Infarction
What does Image B illustrate regarding the coronary arteries?
A posterior interventricular artery branching from the left coronary artery instead of the right.
p.15
Anatomy of the Mediastinum
What is the position of the heart's apex in relation to the diaphragm?
The heart's apex sits superior to the diaphragm.
p.16
Anatomy of the Mediastinum
What is the location of the right border of the heart?
Extends between the third and sixth costal cartilage just to the right of the parasternal border.
p.19
Coronary Arteries and Myocardial Infarction
What does the anterior interventricular artery supply?
The anterior surfaces of the ventricles, the anterior 2/3 of the interventricular septum, and the right and left atrioventricular bundles.
p.1
Divisions of the Mediastinum
What divides the superior and inferior mediastinum?
The transverse thoracic plane.
p.16
Anatomy of the Mediastinum
Where can the apex of the heart be found?
Deep to the left fifth intercostal space at the mid-clavicular line.
p.12
Structure and Function of the Heart
What is the anterior surface of the heart also known as?
The sternocostal surface.
p.5
Pericardium: Structure and Function
What covers the heart within the middle mediastinum?
The pericardium, a fibroserous membrane.
p.21
Coronary Arteries and Myocardial Infarction
What happens if a coronary artery becomes occluded?
The myocardium supplied by that artery may receive inadequate oxygen, leading to ischemia and potentially cell death (necrosis).
p.5
Pericardium: Structure and Function
What are the two layers of the serous pericardium?
The parietal layer and the visceral layer (epicardium).
p.21
Coronary Arteries and Myocardial Infarction
What is atherosclerosis?
The progressive narrowing of the arteries caused by the accumulation of fatty deposits in the arterial walls.
p.18
Coronary Arteries and Myocardial Infarction
What does the atrioventricular nodal artery supply?
The atrioventricular node (AV node).
p.26
Venous Return from the Heart
What does the great cardiac vein travel with?
The anterior interventricular artery in the anterior interventricular sulcus.
p.4
Pericardium: Structure and Function
What is the function of the pericardial cavity?
To reduce friction between the heart and surrounding structures during heartbeats.
p.22
Coronary Arteries and Myocardial Infarction
What is a significant limitation of the heart regarding collateral circulation?
The heart has very little protection in terms of collateral circulation.
p.16
Anatomy of the Mediastinum
Where is the superior vena cava formed?
Deep to the junction of the first costal cartilage and the manubrium of the sternum.
p.19
Coronary Arteries and Myocardial Infarction
What is another name for the anterior interventricular artery?
Left anterior descending (LAD) artery.
p.7
Pericardial Sinuses and Clinical Relevance
Where is the oblique pericardial sinus located?
Posterior to the heart between the left and right pulmonary veins.
p.2
Blood Circulation: Pulmonary and Systemic Circuits
What is the pulmonary circuit?
The circulation between the heart and lungs.
p.1
Divisions of the Mediastinum
What anatomical landmarks define the transverse thoracic plane?
The sternal angle anteriorly and the intervertebral disc between thoracic vertebrae 4 and 5 posteriorly.
p.12
Structure and Function of the Heart
What comprises the base of the heart?
The left atrium and part of the right atrium.
p.21
Coronary Arteries and Myocardial Infarction
What factors influence the severity of a myocardial infarction?
The size and location of the artery involved, whether the blockage is complete, and the presence of collateral vessels.
p.5
Pericardial Effusion and Cardiac Tamponade
What can cause pressure to build up in the pericardial cavity?
Excess fluid accumulation due to pathological conditions, leading to cardiac tamponade.
p.8
Pericardial Sinuses and Clinical Relevance
What are the two types of pericardial sinuses mentioned?
Transverse Pericardial Sinus and Oblique Pericardial Sinus.
p.22
Coronary Arteries and Myocardial Infarction
What are anatomical anastomoses in the heart?
They are connections between blood vessels, but usually insufficient to replace coronary arteries.
p.13
Structure and Function of the Heart
Which chambers of the heart are more anteriorly placed?
The right atrium and right ventricle.
p.24
Coronary Arteries and Myocardial Infarction
What is codominance in coronary dominance?
When both the right and left coronary arteries contribute to the posterior interventricular artery.
p.22
Coronary Arteries and Myocardial Infarction
What is the purpose of using vessels from other regions of the body in CABG?
To bypass the occluded coronary artery.
p.17
Blood Circulation: Pulmonary and Systemic Circuits
When does blood flow into the coronary arteries?
During atrial contraction when the aortic semilunar valve is closed.
p.1
Structure and Function of the Heart
What structures are located in the middle mediastinum?
The heart and its pericardium, as well as the beginnings/endings of the great vessels.
p.21
Coronary Arteries and Myocardial Infarction
What is a myocardial infarction?
A condition where blood flow is completely cut off from an area of tissue, resulting in a heart attack.
p.21
Coronary Arteries and Myocardial Infarction
Which coronary artery is known as the 'widow-maker'?
The anterior interventricular artery (LAD).
p.3
Blood Circulation: Pulmonary and Systemic Circuits
What happens to oxygen-poor blood in the lungs?
It exchanges carbon dioxide for oxygen and becomes oxygen-rich.
p.18
Coronary Arteries and Myocardial Infarction
What is the left coronary artery also known as?
LCA (Left Coronary Artery).
p.14
Anatomy of the Mediastinum
What do the anterior and posterior interventricular sulci demarcate?
The separation between the ventricles.
p.17
Coronary Arteries and Myocardial Infarction
What are the two major arteries supplying the myocardium of the heart?
The right and left coronary arteries.
p.24
Coronary Arteries and Myocardial Infarction
What characterizes left dominant hearts?
The posterior interventricular artery stems from the left coronary artery (LCA).
p.13
Structure and Function of the Heart
Where is the right atrium located in relation to the vena cavae?
Between the superior and inferior vena cavae.
p.25
Venous Return from the Heart
Where does the great cardiac vein travel?
In the anterior interventricular sulcus with the anterior interventricular artery, then to the coronary sulcus with the circumflex artery.
p.19
Coronary Arteries and Myocardial Infarction
What is the function of the posterior left ventricular branch?
It is a termination of the circumflex branch supplying the posterior left ventricle.
p.25
Venous Return from the Heart
Into which chamber does the coronary sinus empty its blood?
The right atrium of the heart.
p.6
Innervation and Blood Supply of the Pericardium
What is the primary blood supply to the pericardium?
Pericardiacophrenic arteries and veins.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
How does blood enter the right atrium of the heart?
Via the superior and inferior vena cava.
p.3
Structure and Function of the Heart
What controls blood flow through the heart?
Pressure gradients and the function of the atrioventricular and semilunar valves.
p.19
Coronary Arteries and Myocardial Infarction
What are the two terminal branches of the left coronary artery?
The anterior interventricular artery (LAD) and the circumflex branch.
p.17
Structure and Function of the Heart
What is the function of the aortic semilunar valve?
It allows blood to flow from the heart into the ascending aorta and prevents backflow.
p.23
Coronary Arteries and Myocardial Infarction
What is the significance of variations in blood supply to the heart?
They demonstrate the variability in human anatomy and how it affects myocardial supply.
p.7
Pericardial Sinuses and Clinical Relevance
What separates the oblique sinus from the transverse sinus?
Two layers of visceral pericardium.
p.13
Structure and Function of the Heart
What is the orientation of the left atrium and left ventricle?
More posteriorly oriented.
p.17
Coronary Arteries and Myocardial Infarction
What is the coronary sulcus?
The groove along which the coronary arteries continue after exiting the ascending aorta.
p.20
Coronary Arteries and Myocardial Infarction
What is the function of the right coronary artery?
It supplies blood to the right side of the heart.
p.6
Innervation and Blood Supply of the Pericardium
Where does the pericardiacophrenic vein drain?
Into the internal thoracic vein and subsequently the subclavian vein.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
Where does blood go after being pumped from the right ventricle?
Through the pulmonary semilunar valve into the pulmonary trunk and then to the pulmonary arteries.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
What is the pathway of blood after it leaves the left ventricle?
It is pumped through the aortic semilunar valve into the ascending aorta and then to the body.
p.20
Coronary Arteries and Myocardial Infarction
What are some branches of the left coronary artery mentioned?
Anterior interventricular artery and left circumflex artery.
p.3
Blood Circulation: Pulmonary and Systemic Circuits
What valve allows blood to pass from the right atrium to the right ventricle?
The tricuspid (or right atrioventricular) valve.
p.18
Coronary Arteries and Myocardial Infarction
What does the right marginal artery supply?
The right margin of the right ventricle.
p.18
Coronary Arteries and Myocardial Infarction
What does the circumflex branch of the left coronary artery supply?
The posterior aspect of the heart.
