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Where does the right atrium receive blood from?
- superior vena cavae
- inferior vena cavae
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What internal features are found in the right atrium?
- crista terminalis
- valve of inferior vena cava
- orifice of coronary sinus
- fossa ovalis
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Is the valve of inferior vena cava a functional structure?
no
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What is the fossa ovalis?
remnant from a whole in the heart during fetal development
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What type of surface does the internal part of the left atrium have?
smooth
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Where does the left atrium receive blood from?
pulmonary veins
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What are the internal features of the left atrium?
orifices of pulmonary veins (usually 4 in number)
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Which ventricle has lower pressure?
right ventricle
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What is the shape of the right ventricle?
triangular
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What is the shape of the left ventricle?
conical
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Does the right ventricle have trabeculae carneae?
yes
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Does the left ventricle have trabeculae carneae?
yes
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What is the function of papillary muscles?
- contract at same time as ventricles
- prevents valves from opening (backward) during ventricle contraction
- maintains competency of valves
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How many papillary muscles does the right ventricle have?
3 (ant, post, septal)
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How many papillary muscles does the left ventricle have?
2 (ant, post)
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What is another name for septomarginal band?
moderator band
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Does the right ventricle have a septomarginal band?
in 57% of population
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Does the left ventricle have a septomarginal band?
no
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Does the right ventricle have a conus arteriosus?
yes
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What is the conus arteriosus?
smooth area in right ventricle
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Does the left ventricle have a conus arteriosus?
no
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Which ventricle has the aortic semilunar valve?
left ventricle
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Does the right ventricle have an aortic vestibule?
no
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Where is the pulmonary valve?
in right ventricle
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Does the left ventricle have an aortic vestibule?
yes
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Which ventricle has the tricuspid valve?
right ventricle
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Which ventricle has the bicuspid (mitral) valve?
left ventricle
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Which ventricle has chordae tendineae?
both right and left
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Why is the left ventricle larger (more muscular) than the right ventricle?
left ventricle has to pump blood to entire body, not just to the lungs like the right ventricle
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What is the cardiac skeleton?
- fibrous framework
- maintains competency of valves
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What makes up the cardiac skeleton?
- semilunar valves
- annulus fibrosis
- right fibrous trigone
- left fibrous trigone
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What connects the semilunar valves?
conus tendon
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Where is the annulus fibrosis?
surrounds base of tricuspid and bicuspid valves
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What is the annulus fibrosis?
provides attachment point for muscles in ventricle
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Where is the right fibrous trigone?
- between aortic, bicuspid and tricuspid valves
- connects two annulus fibrosis
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Where is the left fibrous trigone?
between aortic and bicuspid valves
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How many layers of myocardium is there?
3
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All 3 muscle layers of the heart are attached to what?
cardiac skeleton
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The superficial layer of the myocardium is continuous with what?
deep layer
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The superficial and deep layer of myocardium are arranged in what type of configuration?
figure 8
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The middle layer of myocardium is arranged in what type of configuration?
circular
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What is the action of the superficial and deep layers of myocardium?
- wringer-like action
- ventricles shorten upon contraction
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What is the function of the middle layer of myocardium?
decreases size of chamber (diameter) upon contraction
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What is the function of all three layers of myocardium?
to empty chamber and eject blood into great vessels
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What is the cardiac conduction system composed of?
purkinje fibers
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What are Purkinje fibers?
specialized cardiac muscle fibers
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What is the function of the Purkinje fibers?
transmit electrical impulses to myocardium
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What are the components of the cardiac conduction system?
- sino-atrial node (pacemaker)
- internodal tracts
- atrio-ventricular node
- bundle of His
- right/left bundle branches
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What is another name for the sino-atrial node?
pacemaker
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Where is the sino-atrial node located?
at junction of superior vena cava and right atrium
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Does the sino-atrial node produce its own electrical impulses?
yes
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How many internodal tracts are there?
3
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What are the internodal tracts?
consists of Purkinje fibers that connect SA node with AV node
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Where are the internodal tracts?
contained in walls of atria
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Where is the atrio-ventricular node?
in interatrial septum, just above ventricles
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What happens at the atrio-ventricular node?
electrical impulse is re-enforced
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What is another name for the Bundle of His?
- atrio-ventricular bundle
- common bundle branch
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Where is the Bundle of His?
in interventricular septum
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What does the Bundle of His split into?
right and left bundle branches
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Where are right and left bundle branches?
lead from the AV bundle to their respective ventricles
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What does the moderator band have a portion of to help send electrical impulses to the ventricle?
has a portion of right bundle branch with Purkinje cell sending electrical impulses to ventricle
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What is the cardiac plexuses?
nerve networks comprised of autonomic fibers
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Where is the superficial cardiac plexus located?
in concavity of aortic arch
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Where is the deep cardiac plexus located?
in fibrous pericardium anterior to tracheal bifurcation
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The superficial cardiac plexus receives the left superior sympathetic cardiac nerve from which ganglion?
left superior cervical ganglion
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Where does the deep cardiac plexus receive bilateral branches from?
all cervical sympathetic chain ganglia, except left superior cervical ganglion and thoracic sympathetic chain ganglia T1-4
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The thoracic sympathetic chain ganglia T1-4 send branches to which cardiac plexus?
deep cardiac plexus
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Which cardiac plexus contains postganglionic sympathetic fibers?
both
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Where do postganglionic sympathetic fibers of the cardiac plexuses terminate?
sino-atrial node
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What actions result from sympathetic stimulation?
- increased heart rate
- increased force of contraction
- vasodilation of coronary arteries (increase blood flow to heart muscles -- increase cardiac output
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In parasympathetic contribution, the deep cardiac plexus receives which branches from the vagus nerves?
- left superior cardiac branch
- right superior cardiac branch
- right inferior cardiac branch
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In parasympathetic contribution, the deep cardiac plexus receives numerous recurrent branches from which nerves?
both recurrent laryngeal nerves
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In parasympathetic contribution, the superficial cardiac plexus receives which branch of the left vagus nerve?
left inferior cardiac branch
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Pre-ganglionic parasympathetic fibers pass through which cardiac plexus to synapse with post-ganglionic parasympathetic fibers?
both cardiac plexuses
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Where do pre/post-ganglionic parasympathetic fibers synapse?
adjacent to sino-atrial node (on the surface)
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Where do the post-ganglionic parasympathetic fibers terminate?
at sino-atrial node
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What actions result from parasympathetic stimulation?
- decreased heart rate
- decreased force of contraction
- vasoconstric coronary AA
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What structures pass through the superior thoracic aperture?
- cervial parietal pleura
- trachea
- vagus N
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