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Exam 2 Anatomy
Heart
| Question | Answer |
|---|---|
| what can the RA be divided into? | the sinus venarum and pectinate muscles |
| what divides the sinus venarum from the pectinate muscles? | the crista terminalis |
| what is the remnant of the foramen ovale? | fossa ovalis |
| 25% of people have an atrial septal defect. What problems do these people experience? | oxygenated blood might be shunted from the L heart to the Right (which increases pressure on the R side of the heart, bc the pulmonary system is overloaded) |
| what is increased pressure in the right heart point to? | an atrial septal defect (which occurs in 25% of people). |
| If a person has an atrial septal defect, what vessels, etc are enlarged? | RA, RV, and pulmonary trunk |
| where do the pectinate muscles from the RA branch? | from the crista terminalis |
| where is the tricuspid valve? | at the atrioventricular orifice between the RA and RV |
| what is the composition of the RV? | it has thick layers of trebeculae carnae |
| what is the composition of the interventricular septum? | it has a membranous part (inovled in defect) and a muscular part |
| Where does an interventricular defect most likely occur? | in the membranous part of the septum, not the muscular |
| what is the area called that leads to the pulmonary trunk>? | the conus arteriosus |
| explain the structure/function of the tricuspid valve? | it's made of three cusps (anterior/posterior/septal) which are attached to anterior/posterior/septal papillary muscle by chordinae tendinae, gaurding passage from RA to RV (right AV valve) |
| explain the structure/function/anatomy of the three cusps of the tricuspid AV valve? | the anterior (attached to the septomarginal trebeculum, carring the R branch of the AV bundle); posterior, and septal |
| what is associated with the R ventricular (anterior) cusp? | the septomarginal trebeculum carrying the R branch of the AV bundle to the anterior papillary muscle |
| How does the right branch of the AV bundle target the right ventricle? | it runs from the interventricular septum thru the septomarginal trebeculum to the anterior papillary muscle). |
| what is another name for the septomarginal trebeculum? | the moderator band |
| What is the composition of the interior of the LA? | it has a smooth wall except for the L auricle (that has muscular pectinate muscles) |
| why is the L AV valve called the mitral valve? | because it doesn't always have 2 cusps (bicuspid) however it normally does |
| what is the composition of the LV? | the LV has trebeculae carnae but they are much finer but more numerous |
| explain the main differences between the RV and LV? | the RV is crescent shaped, the LV is conical; the RV has thick tr. carnae, the LV has finer and more trebeculae carnae; and the LV wall is 2x thicker (in healthy heart) |
| what is the difference between the AV valves (tri and bicuspid) and the semilunar valves (the aortic and pulmonary) | the AV valves have chordae tendinae and papillary muscle associated, and semilunar valves don't |
| Explain the mitral valve anatomically? | the mitral valve has 2 cusps: anterior/posterior with corresponding ant/post papillary muscle and chordae tendinae |
| what is the most commonly diseased valve of the heart? | the mitral (L AV valve) |
| what happens if nodules form on the mitral valve? | it can become diseased and create turbulent flow |
| Why is valvular prolapse bad for more than just regurgitation? | bc if there's regurgitation the turbulent airflow can erode and predispose the valve to endocardial infections (where bacteremias seed) |
| what is a common cause of endocarditis fo the mitral valve? | bactemic colonization of the prolapsed, eroded valve |
| what is the makeup of the pulmonary and aortic valves? | they are semilunar tricuspid valves that are NOT associated with chordae tendinae or papillary muscle |
| What is the composition of the semilunar valves (cusps)? | they are tricuspid valves: anterior, left and right (that are named based on their embryolgical origins) which don't reflect their actual orientation |
| explain the anatomy of the semilunar valve? | tricuspid valve with a fibrous nodule on the free edge in the middle of the lunule (a thin CT on either side of the nodule) |
| what is located on either side of the nodule, on the free edge of the semilunar valves? | the lunule (a thin CT) |
| Where do the coronary arteries arise from? | the ascending aorta from the coronary sinuses on the respective side |
| when do the coronary arteries fill? | after ventricular contraction |
| what supplies the myocardium and epicardium? | the coronary arteries |
| the coronary arteries supply what? | the epicardium and myocardium of the pericardium |
| where are the blood vessels of the heart located? | in the fat beneath the epicardium |
| which artery gives off the sinuatrial nodal artery 60% of the time? | the right coronary artery |
| what coronary artery gives off the sinoatrial nodal artery 40% of the time? | the left coronary artery |
| the right coronary artery gives off the SA nodal artery ____% of the time? | 60% |
| what arteries branch from the right coronary artery, for the majority of the time? | the sinoatrial nodal artery, right marginal artery, posterior interventricular artery (aka posterior descending artery), and the AV nodal artery |
| what are the branches of the left coronary artery? | circumflex artery, and the anterior interventricular artery (left anterior descending: LAD) |
| why are coronary arteries known as "functionally" end arteries (or physiological end arteries) what are end arteries? | end arteries are arteries that don't anastomose. cor. arteries are "funct." end arteries bc they do anastomose, but the collateral circ isn't good enough really so they're just functional (not the real deal) |
| where do the anastomoses occur in the coronary arteries? | the LAD (anterior IV) and the posterior descending (posterior IV) at the apex; and the L circumflex witht with the RCA |
| how do you determine coronary dominance? | by seeing with coronary artery (L or R) gives off the posterior interventricular artery (posterior descending) |
| Which coronary artery is more likely to be dominant? % | the R 85-90% of the time |
| In the case of L sided dominance of the coronary arteries which only occurs in 10-15% of people, what branch gives off the posterior desceding (posterior invertentricular) | the Left coronary artery at the L. circumflex gives off the posterior descending (posterior interventricular artery) |
| Give the order of frequencies in terms of dominance of the coronary vasculature? | Right dominace > Equal dominance > Left dominance |
| what are the three most common sites of coronary occlusion (and in order of most likely --> least likely) | LAD (anterior descending/anterior interventricular), Right Coronary Artery, L circumflex artery |
| where are the cardiac coronary veins? | running alongside the coronary arteries |
| what is the ultimate destination of the cardiac coronary veins? | the coronary sinus, which empties into the right atrium |
| what are the types of cardiac coronary veins? | great cardiac vein, middle cardiac vein, small cardiac vein |
| what cardiac vein runs parallel to the circumflex? | the coronary sinus |
| from R-->L give the order of the cardiac veins | small cardiac vein, middle cardiac vein, great cardiac vein (all connected to the coronary sinus which runs perpindicular to them) |
| which cardiac vein makes the tail of the coronary sinus? | the great cardiac vein |
| which cardiac vein drains the right ventricle? | the small cardiac vein |
| what does the right coronary artery run in? | the AV groove/sulcus (coronary groove) |
| which branches of the right coronary artery are directed toward (not necessary touching) the apex of the heart? | the posterior descending (post. IV art) and the right marginal artery |
| what does the RCA supply? | the RA, most of RV, some of the AV septum, the SA and AV node (in most cases) and some of the LV |
| where does the LCA travel after coming off of the ascending aorta from the aortic sinus? | it travels between the pulmonary trunk and the L auricle |
| where does the LAD (anterior descending/ant IV art) travel? | in the interventricular groove |
| in the normal heart what is in the coronary groove (ant/post) | the RCA, the circumflex, and the coronary sinus |
| where can the veins of the heart drain? | into the coronary sinus, or via small veins to the right atrium |
| what drains the areas supplied by the LCA? | the great cardiac vein |
| what veins drain the areas supplied by the RCA? | the small and middle cardiac vein |
| How many vessels does the umbilical cord have? | 3 vessels (2 umbilical arteries and 1 umbilical vein) |
| Explain the following for all the vessels of the umbilical cord: where they branch from, what they carry, and what they turn into? | (2) umbilical arteries: internal iliac arteries/unoxygenated blood away from the fetus/medial umbilical ligaments of the ant abdominal wall (1) umbilical vein: ?/carries oxygenated blood to the fetus |
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