CHAPTER 26

Question 1

definition
the cardiovascular system of the body is concerned with the _____ (cardio) and _____ (vascular); it is also referred to as the _____

Answer 1

heart
blood vessels
circulatory system

Question 2

heart

• the heart is a muscle that functions in pumping blood through vessels of the cardiovascular system
  1. it is composed of _____, _____ in type
  2. the heart has _____ internal cavities called _____: two _____ and two _____
• -the atria and ventricles are further differentiated by the _____ of the body; thus, we can speak of the four chambers as the right atrium, left atrium, right ventricle, and left ventricle
  3. the heart is positioned in such a way that the atria lie _____ (not _____) to the ventricles; thus, blood, when passing from atria to ventricles, moves _____ rather than _____
  4. the heart is located in the thorax between the _____, resting on the _____
  5. several structures protect the heart:
• anteriorly: _____
• laterally: _____, _____, _____
• posteriorly: _____
• in addition to the preceding structures, the heart is enclosed in a _____ called the _____

Answer 2

striated muscle 
cardiac
four
chambers
atria
ventricles 
side
posterior
superior
horizontally
vertically
lungs
diaphragm 
sternum
ribs
intercostal muscles 
lungs
thoracic vertebrae 
tough connective tissue sac
pericardium

Question 3

pericardium

• the pericardium is a _____ that encloses the heart
• its outer layer blends with the _____ of the _____ inferiorly
• superiorly and posteriorly, the _____ blends with the major blood vessels of the _____, _____, _____, and _____
• the cardiac muscle itself is referred to as _____
• the inner _____ of the chambers of the heart is referred to as _____

Answer 3

fibroserous sac
central tendon
diaphragm 
fibrous layer 
heart
vena cava
aorta
pulmonary trunk 
myocardium
epithelial lining 
endocardium

Question 4

external anatomy of the heart

• the heart is described as having an _____, a _____, and _____ surfaces:
  1. the _____ lies adjacent to the sternum and costal cartilages
  2. the _____ is adjacent to the diaphragm
  3. the _____ is adjacent to the medial surface of the _____ lung
• the apex, a rounded projection of the heart, points _____ and to the _____
• -it usually lies at the level of the _____
• the base is generally that area where the _____ attach tot he heart
• -these vessels are the _____, _____, and _____
• both the _____ and _____ have _____-like appendages attached to the _____ surface of the atria, and these are _____. the auricles allow for an increase in the _____ of the atrium
• -clinically, the term auricle is also referred to as the _____

Answer 4

apex
base
three
sternocostal surface 
diaphragmatic surface 
pulmonary surface 
left
inferiorly 
left
sixth costal cartilage 
great vessels
aorta 
pulmonary trunk
SVC
right
left atria
ear
lateral 
auricles
capacity 
appendage

Question 5

internal anatomy of the right side of the heart

• right atrium
• -a _____ ridge is seen on the _____ wall of the right atrium; this is called the _____
• -from the crista terminalis are muscular, ridge-like extensions called _____
• –these are found in the _____ and in the _____ and _____
• -three major venous openings enter into the right atrium:
  1. the _____ is for the main vein returning blood from the upper half of the body
  2. the _____ is for the main vein returning blood from the lower half of the body
• it is marked by a small flap of tissue called the _____, a valve that is _____
  3. the _____ leads to a venous chamber located on the posterior surface of the heart
• it receives the _____ that drain the _____ itself
• it opens into the right atrium just _____ and _____ to the _____
• -the partition between the right atrium and the left atrium is called the _____
• –on this septum in the right atrium lies an _____ depression, the _____
• –this fossa ovalis is a remnant of a foramen that in the _____ stage of development exited between the _____ and the _____
• –this opening was called the _____; it closes at _____ and remains in the adult as the fossa ovalis

–anteriorly, the right atrium opens into the right ventricle via the _____

Answer 5

vertical muscular ridge 
posterior
crista terminalis 
musculi pectinati
right atrium
right
left auricle 
superior vena caval opening 
inferior vena caval opening
valve of the inferior vena cava 
nonfunctional 
opening of the coronary sinus
veins
heart muscle 
anterior 
superior 
inferior vena cava 
interatrial septum
oval
fossa ovalis
fetal
right atrium 
left atrium
foramen ovale 
birth 
right atrioventricular opening

Question 6

internal anatomy of the right side of the heart
_____ (right atrioventricular) valve
-the right atrioventricular opening is guarded by the _____ or _____
-a valve is a mechanical device that allows flow of blood in _____ direction only, thus preventing _____ flow (flow in the wrong direction)
-the heart is composed of two types of valves, _____ and _____
-an atrioventricular valve is characteristically composed of three parts
1. _____ are flaps of connective tissue
2. _____ are connective tissue cords that attach to the lower surface of the cusps
3. _____ consist of internal folds of ventricular muscle that give attachment to the chordae tendineae

• the three cusps of the tricuspid valve are named according to _____ position
• the _____ whose _____ support the cusps are named similarly
• the tricuspid valve functions in _____ during _____ of the ventricles
• -when closed, it prevents _____ of blood from the right _____ to the right _____
• -the valve is held in a _____ position via the _____ that are attached to the _____ surface of the _____ and are thus not everted into the atrium

Answer 6

tricuspid 
tricuspid 
right atrioventricular valve
one
retrograde
atrioventricular valves
semilunar valves
cusps
chordae tendineae
papillary muscles 
anatomical 
papillary muscles 
chordae tendineae
closing
contraction
backflow
ventricle 
atrium
closed
chordae tendineae
lower
cusps

Question 7

internal anatomy of the right side of the heart
right ventricle
-the internal surface of the ventricle consists of irregular, _____-like projections of muscle called _____
-_____ are a type of _____
-another special type of trabeculae carne is one band that attaches to the _____ (the wall between the right and left ventricles) and to the _____
–this band is called the _____ or _____
–it contains the right branch of the _____, which is part of the collection of fibers making up the _____ system of the heart

• the only openings of the right ventricle are the following:
• -_____, guarded by the _____
• -_____ opening
• blood leaves the right ventricle and enters the _____ by passing through the pulmonary trunk opening
• -this opening is guarded by a valve, the _____
• a semilunar valve, unlike the atrioventricular valves, does not posses _____ and _____
• -rather, it exists merely as _____ surrounding an opening
• -for each semilunar valve, there are _____ flaps or cusps
  1. the free edge of each cusp has a small central thickening of _____, the _____; this fills the small gap left at closure of the three flaps
  2. extending from each side of the nodule is a narrow, thin lip termed the _____
  3. the spaces between he cusps and the wall of the vessels are termed _____, and each is named for its corresponding cusp
• in the pulmonary semilunar valve, there are _____ such flaps
• between these cusps and the wall of the pulmonary trunk, there are _____ sinuses
• when flow of blood is from the right ventricle into the pulmonary trunk, the valve _____; if flow is _____, it closes

Answer 7

ridge
trabeculae carneae
papillary muscles 
trabeculae carneae
interventricular septum 
anterior papillary muscles 
moderator band 
septomarginal trabecula
atrioventricular bundle 
conduction 
right atrioventricular opening 
tricuspid valve
pulmonary trunk
pulmonary trunk 
pulmonary semilunar valve
papillary muscles 
chordae tenineae
pocket-like flaps 
3
fibrous tissue
nodule 
lunula 
sinuses
three
three
opens
retorgrade

Question 8

pulmonary circulation

• blood flows through the pulmonary trunk into the _____ and _____, to the _____ and _____
• in the lungs, blood gives off _____ and receives _____
• _____ returns to the heart via four _____, _____ from the right lung and _____ from the left lung
• all four pulmonary veins enter the _____

Answer 8

right 
left pulmonary arteries 
right 
left lungs 
carbon dioxide 
oxygen 
oxygenated blood 
pulmonary veins 
two
two
left atrium

Question 9

internal anatomy of the left side of the heart
left atrium
-the left atrium has its _____ located within the _____ only
-the main part of the left atrium is taken up by the _____ separate openings of the _____
-the only other opening of the left atrium is the _____

Answer 9

musculi pectinati
left auricle 
4
pulmonary veins 
left atrioventricular opening

Question 10

internal anatomy of the left side of the lung
_____ (_____, left atrioventricular) valve
-the left atrioventricular opening is guarded by the bicuspid valve
-being an atrioventricular valve, it consists of _____, _____, and _____
-it contains _____ cusps
-supporting papillary muscles connect to the cusps via the _____
-blood flows from the _____ into the _____ through the bicuspid valve

Answer 10

bicuspid 
mitral 
cusps
chordae tendineae
papillary muscles 
two
chordae tendineae
left atrium
left ventricle

Question 11

internal anatomy of the left side of the heart

• the left ventricle contains internal muscular ridge-like folds, the _____
• _____ of the bicuspid valve are a type of trabecula carneae
• one major difference between the right ventricle and the left ventricle is the _____ of the wall itself
• -the wall of the left ventricle is usually _____ as thick as that of the right
• -the reason for this is the right ventricle must pump blood to only _____, the _____
• -the left ventricle must pump blood to _____ in the body and thus performs more work and is larger
• the only openings of the left ventricle are the following:
• -_____ opening
• -opening of the _____
• when the left ventricle contracts, blood _____ and enters the _____
• -the opening of the aorta is guarded by a valve, the _____
• –this valve possesses _____ located at the opening of the _____
• –these cusps posses _____ and _____, as do pulmonary semilunar valves
• –similarly, the spaces between the cusps and the wall of the aorta are termed _____ and differ from the pulmonary sinuses in that the right aortic sinus and left aortic sinus are the sites of _____ of the _____ and _____, respectively

-blood then leaves the left ventricle, enters the _____, and then passes to all parts of the body

Answer 11

trabeculae carneae
papillary muscles 
thickness
more than twice
one organ
lungs
every other organ
left atrioventricular 
aorta 
leaves
aorta
aortic semilunar valve
three cusps
aorta
nodules
lanulae
aortic sinuses
origins
right 
left coronary arteries 
aorta

Question 12

remnant of fetal circulation

-in addition to the fossa ovalis in the right atrium, note the _____ connecting the _____ and the _____ called the _____

Answer 12

cord-like band
pulmonary trunk
aortic arch
ligamentum arteriosum

Question 13

conduction system of the heart

• to work efficiently, certain events of the heart must follow one another in an orderly sequence
  1. this is carried out by the conducting system of the heart
  2. the conducting system is made up of specialized muscle fibers, specialized in that they can _____
  3. it consists of three parts:
• sinoatrial node
• -the sinoatrial node is also referred to as the _____ of the heart
• -it is located at the junction of the _____ and the _____
• -an impulse is initiated at the sinoatrial node and spreads from the node directly through the _____ to all parts of both _____, causing them to _____
• -this impulse also reaches the _____
• atrioventricular node
• -the atrioventricular node is located in the _____ part of the _____
• -it receives the impulse that is coursing through the wall of the _____, holds it for a _____ time (while the _____ are _____), and then sends the impulse to the _____
• atrioventricular bundle
• -the atrioventricular bundle is also referred to as the _____
• -it extends down the _____ and divides into the _____ and the _____
• –the right branch courses through the _____ (_____) to the wall of the right ventricle
• –the left branch courses directly to the _____

–the impulse is conducted along the _____ and through its branches to the _____, causing both ventricles to _____

Answer 13

conduct impulses 
pacemaker 
SVC
right atrium 
atrial muscle 
atria
contract
atrioventricular node 
upper
interventricular septum 
atria
short time
atria
contracting 
atrioventricular bundle 
bundle of his 
interventricular septum 
right branch
left branch 
septomarginal trabecula (moderator band)
left ventricle 
atrioventricular bundle 
ventricles 
contract

Question 14

external vessels supplying the heart

• right coronary artery
• -the right coronary artery arises from the _____
• -it emerges between the _____ and the _____
• -it courses inferiorly along the heart, gives off a _____, and then courses to the _____ of the heart
• -it ends by _____ with a branch of the _____
• -just before it ends, it gives off the _____, which courses to the _____ of the heart
• left coronary artery
• -the left coronary artery arises from the _____
• -it courses between the _____ and the _____
• -it immediately divides into
• –the _____ or _____ (_____), which courses toward the _____ and ends by anastomosing with the _____
• –the _____, which courses around the heart and anastomoses with the _____
• venous drainage
• -the veins draining the heart are all called _____
• -there are _____ major veins, all of which drain into the _____:
• –the _____ courses with the anterior inter ventricular artery and the circumflex branch
• —it continues on the back of the heart as the _____
• –the _____ courses with the posterior inter ventricular artery and ends in the coronary sinus
• –the _____ courses with the marginal artery and ends in the coronary sinus
• -the _____ is a short, wide vessel that receives all three _____
• –it empties directly into the _____
• -_____ are two or three small vessels that drain the right ventricle and end directly in the right atrium
• -_____ are numerous small veins that drain the myocardium itself and empty separately into all four chambers

Answer 14

aortic sinus 
pulmonary trunk
right auricle 
marginal branch
back
anastomosing 
left coronary artery 
posterior interventricular artery 
apex
left aortic sinus
left auricle 
pulmonary trunk 
anterior interventricular artery 
left anterior descending artery (LAD)
apex
posterior interventricular artery 
circumflex branch 
right coronary artery 
cardiac veins
three
coronary sinus
great cardiac vein 
coronary sinus
middle cardiac vein 
small cardiac vein 
coronary sinus
cardiac veins 
right atrium 
anterior cardiac veins 
venae cordis minimae