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Right ventricle chordae tendineae are attached to adjacent sides of _________?
two cusps! "like cords on a parachute"
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The chordae tendineae of your right ventricle arise from?
apices of papillary muscles. these muscles contract BEFORE contraction of the right ventricle.
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Regurgitation of blood from the right ventricle back into the right atrium is blocked during ventricle systole by _______?
valve cusps.
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What three muscles in the right ventricle correspond to the cusps of the tricuspid valve? Which is the largest?**
- 1.) Anterior Papillary m (largest, most prominent)**
- 2.) Posterior Papillary m (smaller)
- 3.) Septal Papillary m
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The interventricular septum (IVS) is composed of __________ and __________ parts, is strong, obliquely placed partition between the right and left ventricles.
muscular and membranous parts!
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How many valves are at the apex of the conus arteriosus?
THREE pulmonary valves****
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_____________ is a curved muscular bundle that traverses the right ventricular chamber from the inferior part of the IVS to the base of the anterior papillary muscle. Why is it so important??
septomarginal trabecula (moderator band)
***this trabecula is impt. because it carries the right branch of the AV bundle, part of the conduction system of the heart to the anterior papillary muscle!
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The left atrium forms most of what part of the heart?
the BASE.
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The left atrium has two valveless vessels that enter the smooth-walled atrium, what are their names?
right and left pulmonary VEINS.
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The part of the wall of the left atrium that is smooth walled originated from what?
the embryonic pulmonary vein
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The tubular, muscular left auricle forms the superior part of the left border of the heart and overlaps the root of the _________ trunk
pulmonary
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The left auricle (tubular, muscular) represents the remains of the ______________.
left part of the primordial atrium
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The interior of the left atrium has a larger __________part and a ___________.
larger smooth-walled part and a smaller muscular auricle containing pectinate muscles.
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How many veins enter the left atrium (with oxy blood)?
- 4 VEINS, two superior/two inferior.
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The left atrium has a (thinner or thicker) wall than the right atrium?
THICKER!
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The interatrial septum of the left atrium slopes ________ and to the ______.
posteriorly and to the right!
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What occurs at the left AV orifice in the left atrium?
oxy blood the atrium received from the pulmonary veins leaves the left atrium/ discharges it into the left ventricle.
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The left ventricle forms what surfaces of the heart?
- apex
- pulmonary/left surface
- diaphragmatic surface
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How do the walls of the left ventricle compare to that of the right ventricle?
the walls are two to three times thicker in the left ventricle
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What are the walls of the left ventricle covered with?
covered with a mesh of trabeculae carneae that are finer and more numerous than those of the right ventricle.
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The interior of the left ventricle consists of a ________ that is longer than that of the right ventricle?
conical cavity
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The anterior and posterior papillary muscles of the left ventricle are _________ than the right ventricle.
larger!
****remember the papillary muscles are found in the ventricles of the heart and attach to cusps of the AV valves.
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The left ventricle has a smooth-walled, non-muscular superoanterior outflow part, the _________, leading to the aortic orifice and the aortic valave.
aortic vestibule
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The left ventricle has what that guards the left AV orifice?
MITRAL VALVE!
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How many cusps does the mitral valve have?
TWO! Anterior and Posterior
Mitral came from the fact that it looks like a bishop's miter
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Where is the mitral valve located anatomically? ***KNOW
Posterior to the sternum @ the level of 4th costal cartilage
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Each of the cusps of the mitral valve receive a tendinous cord from?
MORE that one papillary muscle.
*these muscles and their cords support the mitral valve allow the cusps to resist the pressure developed during contractions (pumping) of the left ventricle
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What is unique about the blood flow in the left ventricle?
As it comes into the left ventricle, the blood-stream undergoes two right angle turns, resulting in a 180-degree change in direction.
*this reversal of flow takes place around the anterior cusp of the mitral valve.
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What valve is placed obliquely between the left ventricle and the ascending aorta?
the semilunar aortic valve!
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the semilunar aortic valve is located where anatomically?
posterior to the left side of the sternum @ the level of the 3rd intercostal space!
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What is a completely revered position of the heart referred to? (where the heart is on the right side as opposed to the left)
Dextrocardia!
-normally during development the heart tube bends to the right, however in dextrocardia the tube bends to the left
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What is the most common heart positional abnormality?
Dextrocardia!
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Which is worse, isolated dextrocardia or dextrocardia associated with situs inversus?
dextrocardia assoc. with situs inversus (transposition of viscera, like liver) is more viable with life than dextrocardia alone.-->incidence of accompanying cardiac defects is low, heart usually functions normally!
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Ectopia cordis is what?
- rare condition when the heart is located in an abnormal location, in the thoracic form the hear is partly or completely exposed on the surface of the thorax
- Widely separated sternum (faulty development)
- Death within few days or prior to birth
- Can be fixed with surgery.
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Your heart valves consist of what 3 parts?
- valve: fold of lining membrane that prevents backflow of blood
- cusp: leaflet of the valve
- annular ring: fibrous connective tissue that surrounds the valve and cusp
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What are the 4 valves in your heart?
* think of where they are located and what part of the cardiac cycle they act!
- Aortic
- Pulmonary
- Tricuspid
- Bicuspid (mitral = think miter!)
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Aortic valve has how many cusps (leaflets of a valve)? 
3 cusps (posterior, anterior right and left)
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The pulmonary valve has how many cusps?
THREE CUSPS! anterior, posterior right and left
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Tricuspid valve has how many cusps and is located where?
- Located between right atrium and right ventricle,
- 3 cusps : septal, anterior and posterior.
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Where is your bicuspid (mitral) valve located and how many cusps does it have?
between the left atrium and left ventricle and has two cusps (anterior and posterior)
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Anatomically where is your pulmonary valve located?
- Medial aspect of the left 3rd costal cartilage
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Anatomically where is your aortic valve located?
Medial aspect of the left 3 rd intercostal space behind the left side of the sternum. #2 on picture***
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Anatomically where is the tricuspid valve located?
medial aspect of the right 5th costal cartilage behind the right side of the sternum (#3 on picture)
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Anatomically where is you mitral valve located?
In medial 3rd left intercostal space (medial aspect) #4 in picture
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Valvular Heart Disease pertains to what?
disorders involving the valves of your heart that disturb the pumping of efficiency of the heart
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Valvular heart disease can produce two things, what are they?
stenosis (narrowing) or insufficiency (regurgitation)
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Stenosis is what?
failure of a valve to open fully, slowing blood flow in a chamber!
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What is insufficiency or regurgitation?***
- failure of the a heart valve to close completely!
- usually caused by nodule formation on the cusps so the edges of the valve do not meet or align
- leads to a variable amount of blood flowing BACK into the chamber.
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Turbulence in the heart is caused by what two things?
- restriction of high flow blood (stenosis) or passage of blood through a narrow opening into a larger vessel or chamber (stenosis or regurgitation)
- Turbulence causes eddies (small) whirlpools to form that produce vibrations that are audible called murmurs
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Turbulence due to stenosis or regurgitation causes what two easy things to remember?
- Eddies (whirlpools) that cause audible sounds called murmurs
- **Also Thrills may be felt on the skin over an area of turbulence
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**Valvular heart disorders can be both ACQUIRED and CONGENITAL
**They can range in SEVERITY from physiologically insignificant to FATAL :(
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Valvular stenosis is almost always a _______ condition
CHRONIC, because it is almost always due to the valve abnormality
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What is the name of the procedure that involves the replacement of the valves of the heart?
valvuloplasty
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The framework of the heart consists of what?
- four dense, fibrous collagen rings
- surround the orifices of the valves, a right and left fibrous trigone and the membranous parts of the interatrial and interventricular septa.
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Marfan syndrom and endocarditis can affect the fibrous rings of the heart valves which can lead to mitral/aortic valve prolapse, which can lead to what?
Prolapse can cause mitral/aortic valve regurgitation!
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Mitral valve and Aortic valve calcification can be caused by what? and affects the heart how so?
- caused by degenerative processes in the cardiovascular fibrous skeleton
- cause enhanced stress and abnormal valve motion which ACCELERATES the degenerative process, leading to premature calcium deposition.
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Tricuspid and pulmonary valve calcification are .....
NOT COMMON, RARE!
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Valvular Thickening/Sclerosis
- most commonly involves aortic/mitral valves.
- can progress gradually to stenosis that is SIGNIFICANT!
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Valvular Thickening/Sclerosis involves what structures normally?
- chordae tendineae
- valve cusps
- leaflets
- **can be caused by the presence of abnormal annular tissue and subclinical infection
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What is the most frequent valve abnormality?
- Aortic Stenosis!caused by the degenerative calcification of valve
- typically seen in the 50s or 60s yr olds
- causes the heart to have to work harder, can lead to left ventricle hypertrophy.
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Aortic Stenosis can cause what?
causes the heart to have to work harder, leading the left ventricular hypertrophy.
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Atresia of the aortic valves is what?
- Fusion of the aortic valves completely! uh oh!
- Left ventricle and left atrium are remarkably underdeveloped
- patent ductus arteriosus delivers blood to the aorta!!!!
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In pulmonary valve stenosis the ________are fused, forming a dome with a narrow central opening
valve cusps!
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Pulmonary valve atresia + stenosis?
- Semilunar valves are fused
- Trunk of pulmonary artery is narrow
- Ductus arteriosus is patent and is only access route for the pulmonary circulation
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Transposition of Great Vessels
aorta originates from right ventricle and pulmonary trunk originates from the left ventricle due to failure of spiral conotruncal septum to follow its course!
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Persistent Truncus Arteriosus
- Conotruncal ridges fail to fuse/ fail to descend toward venticles
- Pulmonary artery arises from the truncus arteriosus
- Inteventricular septal defect present
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Tetralogy of Fallot
- Most frequent abnormality of conotruncal region****1) narrow right ventricular outflow
- 2) defect of interventricular septum
- 3) Overriding aorta arising directly above septal defect4) Hypertrophy of the right ventricular wall
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