Post on 19-Jul-2020
transcript
1
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 ____________.
effe
rent f
iber
s from
t..
sym
pathet
ic fi
bers
fr..
par
asym
pathet
ic fi
ber...
affe
rent f
iber
s from
th...
sym
pathet
ic fi
bers
fr..
0% 0% 0%0%0%
0
of
5
A. Efferent fibers from the phrenic nerve.
B. Post-ganglionic fibers from T1-T4sympathetic trunks
C. Post-ganglionic fibers from the vagus n.
D. Afferent fibers from the phrenic nerve
E. Sympathetic fibers from the vagus n.
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
2
Subdivisions of the Mediastinum
The Heart
3
The Heart
Pericardium
Pericardium1. 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
4
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.
5th
or 6
th, s
tern
um, i
n...
5th
or 6
th, m
id-a
xilla
ry...
C. 2
nd, ste
rnal
angle
, ...
D. 2
nd, ste
rnal
angle
, ...
E. 5
th o
r 6th
, mid
-ver
...
0% 0% 0%0%0%
0
of
5
A. 5th or 6th, infrasternal angle
B. 5th or 6th, mid-axillary line
C. 2nd, sternal angle
D. 2nd, jugular notch
E. 5th or 6th, mid-vertebral line
5
Cardiac Tamponade
Walls of the Heart
Syllabus p. 41
6
General Features of the Heart
Arterial Supply of the Heart
Syllabus p. 42
7
Coronary AngiographyArterial Supply of the Heart
Venous Drainage of the Heart
8
Chambers of the Heart
Right Atrium
Syllabus p. 44
9
Tricuspid Valve and Right Ventricle
Left Atrium and Ventricle
10
Syllabus p. 45
Ventricular Filling MV and TC valves close
Heart Valves (Diastole)
Syllabus p. 45
Ventricular Contraction Semilunar valves close
Heart Valves (Systole)
11
Sympathetic Innervationof the Heart
Syllabus p. 46
ParasympatheticInnervation of the Heart
12
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
13
Conduction System ofthe Heart
Syllabus p. 48
Blood Flow to and from the Heart
14
An aneurysm in the aortic arch compresses the left
vagus nerve and alters its activity. Stimulation of
parasympathetic vagus nerves __________.
Incr
ease
s hea
rt ra
te
Dila
tes
coro
nary
arte
ries
C. C
onstric
ts c
oronar
...
D. I
ncrea
ses
the
forc
e ..
E. C
onstric
ts p
ulmon...
40%
20% 20%
0%
20%A. Increases heart rate
B. Dilates coronary arteries
C. Constricts coronary arteries
D. Increases the force of theheartbeat
E. 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.
Rig
ht atriu
m, t
ricusp
i...
Rig
ht atriu
m, m
itral
va.
..
C. R
ight a
triu
m, t
ricu...
D. R
ight a
triu
m, m
itral
...
E. R
ight a
triu
m, t
ricus.
..
0% 0% 0%0%0%
0
of
5
A. Right atrium, tricuspid valve, right ventricle, aorticvalve, right coronary artery, sinuatrial nodal branchartery
B. Right atrium, mitral valve, right ventricle, aortic valve,right coronary artery, sinuatrial nodal branch artery.
C. Right atrium, tricuspid valve, right ventricle, aorticvalve, left coronary artery, sinuatrial nodal branchartery.
D. Right atrium, mitral valve, right ventricle, aortic valve,left coronary artery, sinuatrial nodal branch artery
E. Right atrium, tricuspid valve, right ventricle, aorticvalve, right coronary artery, right marginal branch,sinuatrial nodal branch artery
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SCREEN 2
Subdivisions of the Mediastinum
16
Pericardial Parts
17
Vessels and Nerves of the Pericardium
18
Cardiac Tamponade
Walls of the Heart
19
General Features of the Heart
Arterial Supply of the Heart
20
Venous Drainage of the Heart
21
Blood Flow to and from the Heart
Tricuspid Valve and Right Ventricle
22
Left Atrium and Ventricle
Heart Valves (Cardiac Cycle)
23
Sympathetic Innervation of the Heart
Sympathetic Innervation of the Heart
24
Parasympathetic Innervation of the Heart
Visceral Sensory Fibers from the Heart
Syllabus p. 47
25
Referred Pain
Conduction System ofthe Heart
26
Syllabus p. 49
Blood Flow to and from the Heart