0071509674.pdf

Note: Left and right are the patient’s left and right. As you “read” from left
to right and down the patient’s chest the valves order is the same as, “All
Physicians Take Money.”

• The atrioventricular bundlepasses through the annulus fibrosus and
  descends along the posterior border of the membranous part of the
  interventricular septum to enter the muscular portion of the septum. It
  transmits electrical activity to the ventricles.

High-Yield Facts 51

Aortic Right of sternum over Stenosiswill tend to be auscultated as a

second intercostal space high-pitched systolic murmur with possible

radiation to the carotid arteries

Pulmonary Left of sternum over

second intercostal space

Tricuspid Left of sternum in

fifth intercostal space

Mitral Apex of heart in fifth Insufficiencyproduces a low-pitched,

intercostal space in left late systolic blowing murmur

midclavicular line

HEART VALVES

Valve Auscultation Comment

Sinoatrial In myocardium Initiates contractile Nodal branch

between crista event with electrical of the right

terminalis and depolarization coronary artery

opening of spreading throughout

superior vena cava atrial musculature

Atrioventricular In right atrial floor Stimulated by atrial Branch of right

in the interatrial depolarization; it coronary artery

septum near the leads into the near the

opening of the atrioventricular (A-V) posterior inter-

coronary sinus bundle to synchronize ventricular

ventricular branch

depolarization

CARDIAC NODAL TISSUE

Node Location Function Vasculature

• Autonomic pathwaysconsist of two motor neurons, a myelinated pre-
  ganglionic (presynaptic) neuron and an unmyelinated postganglionic
  (postsynaptic) neuron.