Exam 2 Review: Cardiac Anatomy

Questions and Answers

Which valves are classified as semilunar valves?

Eustachian and Thebesian valves

Papillary and trabeculae carneae

Mitral and tricuspid valves

Aortic and pulmonic valves (correct)

What is the primary function of the papillary muscles?

To create trabeculations in the right ventricle

To contract the atria

To support the semilunar valves

To pull the AV valve leaflets together during ventricular contraction (correct)

During which phase of the cardiac cycle do the AV valves open?

Isovolumic relaxation

Isovolumic contraction

Atrial systole (correct)

Early diastolic filling

What defines hypertrophy in the context of the heart?

Increase in the size of heart muscles Signup and view all the answers

What condition is characterized by valves that do not open fully?

Stenosis Signup and view all the answers

Which characteristic describes an anechoic appearance in sonography?

Absence of echoes Signup and view all the answers

What happens during the isovolumic contraction phase of the cardiac cycle?

Ventricular volume remains unchanged while pressure increases Signup and view all the answers

What type of transducer is commonly used in cardiac sonography?

Phased array Signup and view all the answers

What structure drains blood from the anterior heart into the coronary sinus?

Great cardiac vein Signup and view all the answers

Which branch of the left coronary artery supplies blood to the anterior wall of the heart?

Left anterior descending artery Signup and view all the answers

What does the ejection fraction percentage represent?

Percentage of blood being ejected from the ventricle during systole Signup and view all the answers

What is the normal value range for stroke volume?

70-110 mL Signup and view all the answers

During which phase does the S1 heart sound occur?

End diastole Signup and view all the answers

What is the formula to calculate cardiac output?

CO = SV x HR / 1000 Signup and view all the answers

What is the normal range for the left ventricular peak systolic pressure?

120-140 mmHg Signup and view all the answers

Which of the following arteries is a branch of the right coronary artery?

Posterior descending artery Signup and view all the answers

What does fractional shortening measure?

Change in left ventricular internal dimension throughout the cardiac cycle Signup and view all the answers

The middle cardiac vein drains blood from which part of the heart?

Posterior heart Signup and view all the answers

Study Notes

Cardiac Anatomy

Semilunar valves include the aortic and pulmonic valves, responsible for directing blood out of the heart.
Atrioventricular valves consist of the mitral and tricuspid valves, located between the atria and ventricles.
Rudimentary valve locations: Thebesian valve in the superior vena cava and coronary sinus; Eustachian valve in the inferior vena cava.
Heart wall layers: Endocardium (inner), myocardium (middle, muscular layer), and epicardium (outer).
Hypertrophy refers to the thickening of heart muscle.
Myocardium comprises the major muscular structure of the heart wall.
Pectinate muscles are found in the atria, contributing to the formation of auricles.
Papillary muscles in the ventricles attach to atrioventricular valve leaflets via chordae tendineae, facilitating valve function during contraction.
Trabeculae carneae are muscular ridges in the ventricles, particularly prominent in the right ventricle.
Valve areas: Tricuspid valve (TV) - 7-9 cm², Mitral valve (MV) - 4-6 cm², Aortic valve (AoV) - 2-4 cm².

Cardiac Cycle

Diastole consists of three phases: early diastole (80% filling), diastasis (mid diastole with reduced filling), and atrial systole (20% late filling).
Atrial systole occurs at the end of ventricular diastole, characterized by open AV valves and closed semilunar valves, contributing to ventricular filling.
Systole begins after the QRS complex, with open semilunar valves and closed AV valves; it includes the contraction and ejection phase.
Isovolumic relaxation involves closed semilunar and AV valves with decreasing ventricular pressure but unchanged volume.
Isovolumic contraction features all valves closed as ventricular pressure rises without volume change.
Common pathologies:
- Valvular issues such as stenosis and regurgitation.
- Myocardial wall abnormalities: akinetic, hypokinetic, hyperkinetic, dyskinetic, paradoxical.
- Chamber dilation.

Sonographic Appearance

Anechoic refers to regions without echoes.
Hyperechoic denotes bright echo areas, often seen in calcifications or pericardial structures.
Homogeneous indicates evenly distributed echoes.
Use phased array transducer positioned to the right for optimal imaging.

Coronary Arteries

Main coronary arteries: right coronary artery (RCA) and left main coronary artery (LCA), originating from the sinus of Valsalva behind the aortic valve.
Coronary arteries fill with blood during diastole as the aortic valve closes.
RCA branches into acute marginal and posterior descending arteries.
LCA branches into left anterior descending (LAD) and left circumflex (LCx).
Great cardiac vein drains blood from the anterior heart; middle cardiac vein drains the posterior heart, both leading to the coronary sinus and then the right atrium.

Coronary Perfusion

LAD supplies the anterior and septal regions.
LCx supplies posterior and lateral areas.
RCA provides inferior blood supply.

Formulas

Stroke Volume (SV): Amount of blood pumped by the left ventricle per contraction; computed as SV = EDV - ESV (Normal: 70-110 mL).
Cardiac Output (CO): Blood volume ejected by the ventricle per minute; CO = SV x HR / 1000 (Normal: 4-8 liters/min).
Fractional Shortening (FS): Change in left ventricular dimension; FS% = (LVEDd - LVESd) / LVEDd x 100% (Normal: 30%-45%).
Ejection Fraction (EF): Percentage of blood ejected from the ventricle during systole; EF% = (LVEDV - LVESV) / LVEDV x 100% (Normal: >50% up to 75%).

Normal Cardiac Pressures

Right Atrium (RA): 0-5 mmHg
Right Ventricle (RV): 15-30 mmHg peak systole, 2-8 mmHg end diastole
Left Atrium (LA): 2-12 mmHg mean (10 mmHg mean)
Left Ventricle (LV): 120-140 mmHg peak systole, 3-12 mmHg end diastole
Aorta (systemic arterial): 100-140 mmHg peak systole (120 mean), 60-90 mmHg end diastole (80 mean)
Pulmonary Artery: 15-30 mmHg peak systole, 4-12 mmHg end diastole
Pulmonary Capillary Wedge: 2-12 mmHg (10 mmHg mean)

Heart Sounds

S1 (“Lub”): Occurs at the onset of QRS, indicates closure of mitral and tricuspid valves during ventricular contraction.
S2 (“Dub”): Happens at the end of systole when semilunar valves close, corresponding to the end of the T wave.
S3: A "gallop" sound during rapid filling phase in early diastole, indicative of decreased compliance or increased filling.
S4: Low-frequency sound before S1, occurs during late diastolic filling (atrial kick), suggests ventricular stress.

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Prepare for your Exam 2 with this detailed review on cardiac anatomy. Focus on the structure and function of semilunar and atrioventricular valves, as well as the layers of the heart wall and muscle types. This quiz will help reinforce your understanding of essential concepts in cardiology.