10: Clinically relevant anatomy of the heart

Question 1

A bit off topic, but what are the components of the hilum (root) of the lung?

Answer 1

Pulmonary artery

Main bronchus

Pulmonary veins

Pulmonary lymphatics and bronchopulmonary lymph nodes

Pulmonary visceral afferents & autonomic motor nerves

Question 2

What do pulmonary visceral afferents do?

Answer 2

Refer pain signals from the lungs BACK to the central nervous system

Question 3

Where in the mediastinum is the heart found?

Answer 3

Middle mediastinum

Question 4

Where, relative to the roots of the lung, are the phrenic nerves found?

Answer 4

Anterior to the roots of the lung

Question 5

Where, relative to the pericardium, are the phrenic nerves found?

Answer 5

Descending across the lateral borders of the pericardium

Question 6

The phrenic nerves are commonly confused with the ___ ___.

Answer 6

vagus nerves.

Question 7

Relative to the roots of the lungs, where are the vagus nerves found?

Answer 7

Posterior to the roots of the lungs

Question 8

The phrenic nerves are branches of which spinal nerve(s)?

Answer 8

C3, C4 and C5

(Remember - C345 keep the diaphraghm alive.)

Question 9

Parietal serous pericardium

Parietal visceral pericardium

Fibrous pericardium

Arrange in the correct order (superficial to deep).

Question 10

What is the name of the space between the two layers of serous pericardium?

Answer 10

Pericardial cavity

Question 11

What is another name for the visceral serous pericardium?

Answer 11

Epicardium

Question 12

What does the visceral serous pericardium / epicardium secrete? What is its function?

Answer 12

Pericardial fluid

Acts as a lubricant.

Question 13

What is the name given to the clinical condition in which the pericardial cavity fills with blood?

Answer 13

Haemopericardium

Question 14

What is the consequence of haemopericardium on heart contraction?

Answer 14

Cardiac contraction is prevented

Question 15

Haemopericardium can prevent cardiac contraction. What is this condition called?

Answer 15

Cardiac tamponade

Question 16

What is pericardiocentesis?

Answer 16

Drainage of fluid from the pericardial cavity

Question 17

What is the “bare area” of pericardium?

Answer 17

Area in which there is no overlying pleura, reducing the possibility of accidently causing a pneumothorax during pericardiocentesis

Question 18

What name is given to the space within the pericardial cavity, found posterosuperiorly?

Answer 18

Transverse pericardial sinus

Question 19

Describe the position of the transverse pericardial sinus in relation to the ascending aorta, pulmonary trunkandsuperior vena cava.

Answer 19

Posterior to ascending aorta and pulmonary trunk

Anterior to SVC

Question 20

How many pulmonary veins emerge from the right and left posterior surfaces of the heart?

Answer 20

2 at each side

Question 21

Name the three surfaces of the heart.

Answer 21

Anterior (sternocostal) surface

Base (posterior) surface

Inferior (diaphragmatic) surface

Question 22

Name the two borders of the heart.

Answer 22

Right border

Left (lateral) border

Question 23

Where is the apex of the heart usually found?

Answer 23

Left side, 5th intercostal space, mid-clavicular line

Question 24

What is the clinical name given to cardiac enlargement?

Answer 24

Cardiomegaly

Question 25

What is **cardiomegaly**?

Answer 25

**Cardiac enlargement**

Question 26

Cardiomegaly often shifts the **apex beat** in which direction?

Answer 26

Further to the left

Question 27

Name the veins (blue structures) on the left-hand side of this picture.

Answer 27

**Right internal jugular vein** **Right subclavian vein** **Right brachiocephalic vein** **Left brachiocephalic vein** **Superior vena cava** Remember the **coronary sinus** drains into the SVC just before it enters the right atrium

Question 28

The **jugular** veins are found in the neck. What are their arterial equivalents?

Answer 28

**Carotid arteries**

Question 29

What are the "ear-like" structures found on the right and left atrial surfaces of the heart?

Answer 29

Auricles

Question 30

Where is the **right coronary artery** found?

Answer 30

In the **coronary groove** (Boundary between right atrium and right atrium, surface marking for the tricuspid valve)

Question 31

Almost as soon as it comes off the ascending aorta, the **left coronary artery** bifurcates - what branch is found on the **anterior surface** of the heart?

Answer 31

**Left anterior descending artery (LAD)** / anterior interventricular artery

Question 32

Where on the anterior surface of the heart, is the **left anterior descending artery** found?

Answer 32

**Anterior interventricular groove**

Question 33

Where is the **posterior interventricular groove** found?

Answer 33

**Base of the heart, separating the left and right ventricles** Carries the **posterior interventricular artery**, a branch of the **left coronary artery**

Question 34

What is the **coronary sinus**?

Answer 34

**Short venous conduit** **Returns** deoxygenated blood from the **cardiac veins** to the **right atrium**

Question 35

What is the **azygous vein**?

Answer 35

Carries deoxygenated blood from the **posterior chest wall** to the **superior vena cava**

Question 36

What are the first branches to come off the **aorta**?

Answer 36

**Right and left coronary arteries**

Question 37

What are the coronary arteries?

Answer 37

**Arterial blood supply** to the **epicardium** and **myocardium**

Question 38

Name a branch of the right coronary artery.

Answer 38

**Right marginal artery**

Question 39

Which branch of the left coronary artery **anastomoses** and joins the right and left coronary arteries?

Answer 39

**Circumflex artery**

Question 40

A ___ divides the heart into a right and left side.

Answer 40

**septum**

Question 41

Name the two components of the septum which splits the heart in two.

Answer 41

**Interatrial septum** **Interventricular septum**

Question 42

\_\_\_ ___ allow mixing of arterial and venous blood in the heart.

Answer 42

**Septal defects**

Question 43

Mixing arterial and venous blood reduces the **oxygen content** of **systemic arterial blood** - what is this condition called?

Answer 43

**Hypoxaemia**

Question 44

The right atrium has holes for **three vessels** - what are these vessels called?

Answer 44

**Superior vena cava** **Inferior vena cava** **Coronary sinus**

Question 45

During normal embryological development, the ___ \_\_\_ should close to form the ___ \_\_\_.

Answer 45

**foramen ovale** , **oval fossa**

Question 46

What is the name of the differentiation tissue between the rough, muscular **auricle** and the smooth atrial wall?

Answer 46

**Crista terminalis**

Question 47

The tricuspid and mitral valves have a different design to the pulmonary and aortic valves. What are these two designs called?

Answer 47

**Leaflet design** (AV valves) **Semilunar valve** (pulmonary & aortic valves)

Question 48

Which muscles pull the tendinous cords resulting in the closure of valves?

Answer 48

**Papillary muscles**