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Borders
- Right-SVC and right atrium
- Diaphragmatic-Right ventricle and small portion of left ventricle
- Apex-Left ventricle
- Left-Aortic arch, pulmonary artery, left auricle, left ventricle
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visceral pericardium
outer layer of epicardium
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parietal pericardium
inside lining
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fibrous pericardium
- outer reinforcing layer, fused with diaphragm
- collagen fibers and fascia
- moves up and down with diaphragm
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transverse sinus
seperates arteries (ant.) from veins (post.)
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oblique sinus
cul-de-sac of venous reflections
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Cardiac tamponade/Pericarditis
- excess of 50 cc
- arterial presssure increases
- shut down venous return and decrease CO to lungs, then brain and body
- could die if not treated
- serenge-pull out blood-quick recovery
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Left main coronary artery
- Left anterior sinus of Valsalva
- 1-2 cm
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Left anterior descending (LAD)
Left interventricular, ant. 2/3 of septum
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Left circumflex (LC)
- origin of nodal br. to SA node (45%)
- in AV groove to back of heart
- divide into marginal
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Left diagnoal branch
origin from either LAD, LC or trifurcation of lt. main a.
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Right nodal branch
1st branch to SA node (55%)
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right conus branch
infundibulum region to anastomose with br. of lt. main
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Right marginal branch
descends along acute margin of rt. ventricle
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Right posterior descending (PD)
- Post. interventricular, post. 1/3 septum
- anastomose with LAD
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Crux
- Intersection of AV groove and post. interventricular sulci, vessel which crosses this is considered dominant (right 90%) and supplies AV node
- 90%-right coronary artery
- 10%-left circumflex artery
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How do you treat myocardial infarction?
- Put a stint in with balloon
- Expand balloon to expand stint
- Take balloon out and stint stays expanded
- If doesn't work-bypass vessels
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Great cardiac vein
accompanies LAD and then LC
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Middle cardiac vein
accompanies PD
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Small cardiac vein
accompanies rt. marginal and then RC
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Which veins drain into coronary sinus?
Great cardiac vein, Middle cardiac vein, Small cardiac Vein
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Oblique vein
small vessel joins great cardiac v. to form coronary sinus (remnant of lt. superior cardinal and left SVC)
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Anterior cardiac vein
open directly into rt. atrium
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Thebasian veins (venae minimae cordis)
empty directly into all 4 chambers
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Crista terminalis
- SVC to IVC
- boundary between primitive rt. atrium and sinus venosus
- between pectinate muscles and interatrial septum
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Auricle (Auricular appendage)
- left-flap over pulmonary artery
- right-flap over aorta
- holds blood
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Pectinate muscle
auricle and primitive rt. atrium
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Atrium
- Crista terminalis
- auricle
- pectinate muscle
- fossa ovalis
- coronary sinus
- annulus fibrosus
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Ventricle
- Trabeculae carneae
- Tricuspid valve
- Chordae tendineae
- Papillary muscles (Ant., post. and septal)-keep valves from flapping back into atrium
- Moderator band-Trabeculae carneae with bundle of conduction fibers
- infundibulum (conus arteriosus)-Smooth-walled outflow tract
- Crista supraventricularis-Boundary between primitive Rt. Vent and conus outflow
- Membranous septum
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Conduction System
- Sinoatrial node (SA)-SVC with rt. atrium, beginning of crista terminalis (ridge in RA)
- Internodal pathways-Includes Bachmann's bundle to lt. atrium
- Atrioventricular node (AV)-Between coronary sinus and annulus fibrosi
- Common bundle of His-Top of interventricular septum
- Bundle branches-Ant. & post. divisions (Lt.), moderator band (Rt.)-short cut
- Purkinje fibers-Subendocardium into myocardium-looks closest to cardiac muscle
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Anastomoses
- Right coronary artery and Left circumflex artery
- right posterior descending artery and left anterior descending artery
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