Mediastinum and the Heart Flashcards

1
Q

Where is the mediastinum

A

Between right and left lungs, Superior thoracic aperture and diaphragm

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2
Q

Divisions of mediastinum?

A

Superior and inferior

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3
Q

Where does the mediastinum divide?

A

Transverse sternal angle plane

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4
Q

What does the mediastinum contain?

A

Thymus, heart, great vessels, trachea/bronchi, esophagus, thoracic duct, etc.

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5
Q

Where is the transverse thoracic plane at the sternal angle?

A

T4 disc

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6
Q

Somatic pericardial cavity does what?

A

fixes heart to central tendon of diaphragm

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7
Q

visceral pericardium is also known as what?

A

epicardium

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8
Q

What do the pericardium do?

A

lubricate for smooth movement of heart in the cavity

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9
Q

What are the somatic pericardiums?

A

fiberous pericardium and parietal pericardium

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10
Q

Cardiac wall has what three layers?

A

Epicardium, myocardium, endocardium

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11
Q

Epicardium is somatic. True or false?

A

False. This is a visceral pericardium.

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12
Q

Myocardium is for what?

A

cardiac muscles

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13
Q

The heart is shaped like a _____

A

cone

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14
Q

Where is the apex of the heart in relation to ribs?

A

The left 5th intercostal space

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15
Q

What is the base of the heart?

A

Left atrium

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16
Q

What is the right pulmonary surface of the heart?

A

right atrium

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17
Q

What is the left pulmonary surface of the heart?

A

Left ventricle

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18
Q

Right heart (right ventricle and atrium) has ____ oxygen blood

A

low oxygen blood

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19
Q

Left atrium and ventricle have _____ oxygen blood

A

high oxygen blood

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20
Q

Which two sinuses are important surgical landmarks?

A

The oblique pericardial sinus and the transverse pericardial sinus

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21
Q

What are the two veins that are great cardiac vessels?

A

Superior vena cava, pulmonary veins

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22
Q

What two arteries are great cardiac vessels?

A

Pulmonary trunk and ascending aorta to aortic arch

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23
Q

Which of the following structures can be seen on transverse CT scans at the sternal angle?

A

T4 disc

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24
Q

What does the right atrium contain?

A

Auricle, crista terminalis, fossa ovalis, openings of SVC and IVC, opening of coronary sinus, tricuspid valve

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25
Q

What does the right ventricle contain?

A

Trabeculae carneae, papillary muscles, Anterior/Posterior/Septal valve, Pulmonary valves

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26
Q

What does the left atrium contain?

A

Auricle, 4 or more pulmonary veins, fossa ovalis, left AV valve (bicuspid)

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27
Q

Which intercostal space does the apex of the heart point to?

A

Left 5th intercostal space

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28
Q

What does the left ventricle contain?

A

Trabeculae carneae, papillary muscles, Anterior/posterior valve (bicuspid), aortic valves

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29
Q

Where are the pulmonary and aortic valves located?

A

Between the ventricles and the great arteries

30
Q

What are the AV valves?

A

Tricuspid and bicuspid

31
Q

What is the function of the valves in the heart?

A

Prevention of blood backflow

32
Q

where do you auscultate for the aortic valve?

A

right second intercostal space

33
Q

where do you auscultate for the pulmonary valve?

A

Left 2nd intercostal space

34
Q

Where do you auscultate for the tricuspid valve?

A

5h intercostal space lateral to sternum

35
Q

Where do you auscultate for the mitral valve?

A

5th intercostal space, mid-clavicular line

36
Q

Where does moderate/septomarginal band locate and connect which structures? Why is it important?

A

right ventricle connects to papillary muscles, assists in valve opening and closure at same time

37
Q

What is the goal of pulmonary circulation

A

exchange of CO2 and O2

38
Q

Where does pulmonary circulation flow?

A

Right atrium
Right ventricle
Pulmonary trunk
Right and left pulmonary arteries
Right and left lungs
Right and left pulmonary veins
Left atrium: high oxygen

39
Q

what is the goal of systemic circulation?

A

delivery of O2 and nutrition to whole body

40
Q

Do pulmonary and systemic circulation take place simultaneously?

A

yes

41
Q

Does systemic circulation include the lungs?

A

Yes

42
Q

what structure in systemic circulation is in charge of nutrition?

A

Liver

43
Q

What structure in systemic circulation is in charge of waste?

A

Kidneys

44
Q

What are the right Coronary arteries?

A

Nodal branch, marginal branch, posterior interventricular artery

45
Q

What are the left coronary arteries?

A

Anterior interventricular arteru/ left anterior descending artery
circumflex branch

46
Q

Venous drainage follows which pathway?

A

Great cardiac vein to middle cardiac vein to small cardia vein to coronary sinus to right artium

47
Q

What veins directly drain into right atrium?

A

anterior cardiac veins

48
Q

What is the cardiac cycle?

A

beginning one one heartbeat to beginning of next

49
Q

What happens in diastole?

A

Open AV valves, close pulmonary/aortic valves

negative pressure causes blood to drain into ventricles

50
Q

What happens in systole?

A

Open pulmonary/aortic valves, close AV valves

atria contact to drain more blood into the ventricles, then ventricular contraction to project blood to lungs and whole body

51
Q

SA node base heart rate?

A

80~100 BPM

52
Q

AV node base heart rate?

A

40~60 BPM

53
Q

Conduction system of heart:

A

SA node to AV node to Bundle of His to right and left bundle branches to purkinje fibers to cardiac muscles

54
Q

Sympathetic intrinsic innervation of the heart does what?

A

Increases heart rate.

55
Q

What are the sympathetic nerves of the heart?

A

Cervical cardiac sympathetic nerves and thoracic cardiac sympathetic nerve

56
Q

What provides parasympathetic innervation of the heart?

A

Vagus nerve

57
Q

Vagus nerve does what to heart rate?

A

Decreases

58
Q

What are the branches of the vagus nerve?

A

Cervical cardiac, thoracic cardiac, left vagus nerve, and right vagus nerve

59
Q

What is the left vagus nerve responsible for?

A

Recurrent laryngeal nerve = why we are able to speak

60
Q

Where can patients sometimes feel referred pain after heart surgery?

A

Right shoulder from the c4 dermatome

61
Q

How many patients have right bicipital groove pain

A

1 in 1000

62
Q

What does the umbilical vein do?

A

takes high oxygen blood from placenta through liver for nutrient stoarge and detoxification

63
Q

What forms when umbilical vein closes after birth?

A

Ligamentum teres/ round ligament

64
Q

Which nerve provides parasympathetic support for the heart?

A

Vagus nerve

65
Q

What causes heart burn?

A

Gastroesophogeal reful, cardiac notch of stomach causes us to feel it in heart area

66
Q

What structure has impressions on both lungs?

A

Esophagus

67
Q

What is the largest lymphatic channel?

A

Between azygos vein and esophagus

68
Q

What percentage does the thoracic duct drain?

A

75% of body lymph fluid

69
Q

What provides the innervation for the three cavities?

A

Splanchnic nerve: preganglionic axons to form synapses in prevertebral ganglion
Greater splanchnic nerve: T5~T9
Lesser splanchnic nerve: T10~T11
Least splanchnic nerve: T12
Lumbar/sacral splanchnic nerve: L1~L2

70
Q

Which fetal structures degenerate to form the ligamentum arteriosum and ligamentum venosum?

A

ductus venosus and ductus arteriosus

71
Q

Where does thoracic duct deliver the contents into blood circulating system?

A

left subclavian and internal jugular veins