Download G06: Heart (Weyrich)

A patient is diagnosed with ischemia (i.e., lack of blood flow) in a
left lobar pulmonary vein. The attending physician determines that
the ischemia is due to a vasospastic episode. Constriction of this
left lobar pulmonary vein is controlled by ____________.
A.
B.
C.
D.
E.
Efferent fibers from the phrenic nerve.
Post-ganglionic fibers from T1-T4
sympathetic trunks
Post-ganglionic fibers from the vagus n.
Afferent fibers from the phrenic nerve
Sympathetic fibers from the vagus n.
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Heart
• Surface anatomy and heart sounds
-Dry lecture
-Gray’s 169, 203-205
• Heart
-Gray’s pp. 153-181
-Gray’s dissector pp. 84-101
1
Subdivisions of the Mediastinum
The Heart
2
The Heart
Pericardium
Pericardium
1. Fibrous pericardium (external sac)
2. Serous pericardium (internal sac)
(parietal layer– lines the inner surface of the fibrous)
(visceral layer [epicardium] – adheres to the heart)
Syllabus p. 41
3
Vessels and Nerves of the Pericardium
A patient is diagnosed with cardiac tamponade. Pericardiocentesis
is needed to drain fluid from the pericardial cavity to relieve
pressure on the heart. To remove fluid a wide bore needle is
inserted through the ________ intercostal space near the
____________ and passed superoposteriorly.
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5th or 6th, infrasternal angle
5th or 6th, mid-axillary line
2nd, sternal angle
2nd, jugular notch
5th or 6th, mid-vertebral line
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A.
B.
C.
D.
E.
4
Cardiac Tamponade
Walls of the Heart
Syllabus p. 41
5
General Features of the Heart
Arterial Supply of the Heart
Syllabus p. 42
6
Coronary Angiography
Arterial Supply of the Heart
Venous Drainage of the Heart
7
Chambers of the Heart
Right Atrium
Syllabus p. 44
8
Tricuspid Valve and Right Ventricle
Left Atrium and Ventricle
9
Heart Valves (Diastole)
Ventricular Filling
MV and TC valves close
Syllabus p. 45
Heart Valves (Systole)
Ventricular Contraction
Semilunar valves close
Syllabus p. 45
10
Sympathetic Innervation
of the Heart
Syllabus p. 46
Parasympathetic
Innervation of the Heart
11
Referred Pain
Innervation of the Heart
• Sympathetic Innervation
-Increases heart rate and force of contraction
-Dilates coronary arteries
• Parasympathetic Fibers
-Decreases heart rate and force of contraction
-Constricts coronary arteries
12
Conduction System of
the Heart
Syllabus p. 48
Blood Flow to and from the Heart
13
An aneurysm in the aortic arch compresses the left
vagus nerve and alters its activity. Stimulation of
parasympathetic vagus nerves __________.
40%
A.
B.
C.
D.
20% 20%
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Increases heart rate
Dilates coronary arteries
Constricts coronary arteries
Increases the force of the
heartbeat
Constricts pulmonary arteries
A thrombus develops in the right atrium of a patient and
eventually lodges itself in the sinuatrial nodal branch
artery. Identify the course of the thrombus from the
right atrium to the sinuatrial nodal branch artery.
D.
E.
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Right atrium, tricuspid valve, right ventricle, aortic
valve, right coronary artery, sinuatrial nodal branch
artery
Right atrium, mitral valve, right ventricle, aortic valve,
right coronary artery, sinuatrial nodal branch artery.
Right atrium, tricuspid valve, right ventricle, aortic
valve, left coronary artery, sinuatrial nodal branch
artery.
Right atrium, mitral valve, right ventricle, aortic valve,
left coronary artery, sinuatrial nodal branch artery
Right atrium, tricuspid valve, right ventricle, aortic
valve, right coronary artery, right marginal branch,
sinuatrial nodal branch artery
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14
SCREEN 2
Subdivisions of the Mediastinum
15
Pericardial Parts
16
Vessels and Nerves of the Pericardium
17
Cardiac Tamponade
Walls of the Heart
18
General Features of the Heart
Arterial Supply of the Heart
19
Venous Drainage of the Heart
20
Blood Flow to and from the Heart
Tricuspid Valve and Right Ventricle
21
Left Atrium and Ventricle
Heart Valves (Cardiac Cycle)
22
Sympathetic Innervation of the Heart
Sympathetic Innervation of the Heart
23
Parasympathetic Innervation of the Heart
Visceral Sensory Fibers from the Heart
Syllabus p. 47
24
Referred Pain
Conduction System of
the Heart
25
Blood Flow to and from the Heart
Syllabus p. 49
26