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Cardiovascular System > Anatomy > Flashcards

Anatomy Flashcards

1
Q

How are the superior and inferior mediastinum separated?

A

at the sternal angle (T4/5)

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2
Q

The inferior mediastinum is further divided into _______________________.

A

Anterior, Middle (heart), posterior

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3
Q

What are the borders of the superior mediastinum?

A

Superior: 1st rib
Inferior: T4

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4
Q

What are 5 contents of the superior mediastinum?

A

1) Thymus
2) Trachea
3) Esophagus
4) Thoracic duct
5) Aortic arch
6) Veins (SVC, brachiocephalic)
7) Nerves (vagus, phrenic, L recurrent pharyngeal)

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5
Q

The thymus is found in both the _________ and ___________ mediastinum and is supplied by the ________________.

A

Thymus:
- both superior and anterior mediastinum
- Internal mammary artery

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6
Q

What are 5 contents of the middle mediastinum?

A

1) Heart
2) SVC
3) Ascending Aorta
4) Pulmonary trunk
5) R/L Pulmonary veins
6) R/L Phrenic veins
7) Cardiac plexus
8) Lymph nodes

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7
Q

Does the pericardium cover the aortic arch and descending aorta?

A

No

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8
Q

What are 2 layers of the pericardium?

A

1) Fibrous
- outer, tough, inelastic
- bound to central tendon of diaphragm by pericardiophrenic ligament

2) Serous
- Parietal
- Visceral

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9
Q

True or false:
The heart is located within a double-walled fibroserous sac known as the pericardium containing pericardial fluid to enable frictionless movement.

A

False.
The heart is not within but surrounded by the pericardial sac

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10
Q

Which layer(s) of the pericardium are supplied by the phrenic nerves and thus sensitive to pain?

A

Fibrous and parietal of serous

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11
Q

Pericarditis pain is:
exacerbated by ____________
alleviated by ______________

A

Pericarditis pain is:
exacerbated by deep breaths
alleviated by sitting up and leaning forward (↓P on parietal pericardium esp on inspiration)

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12
Q

What kind of pain fibres innervate the visceral layer of the pericardium?

A

Sympathetic and vagus (insensitive to pain)

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13
Q

What are the 2 sinuses of the pericardial cavity?

A

1) Transverse sinus
- behind ascending aorta and pulmonary trunk
- infront of SVC

2) Oblique sinus
- behind L/R pulmonary veins, SVC and IVC
- infront of anterior esophagus

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14
Q

Which pericardial sinus would mostly likely be penetrated by a ingested fish bone?

A

Oblique
- posteriorly bounded by anterior esophagus

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15
Q

What is pericarditis?

A

Inflammation of the pericardium

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16
Q

What is a pericardial effusion?

A

The passage of fluid from the pericardial capillaries into the pericardial cavity.

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17
Q

What is a hemopericardium?

A

Stab wounds that pierce the heart may cause blood enter into the pericardial cavity

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18
Q

What is a cardiac tamponade?

A

Extensive pericardial effusion, the excess fluid does not allow heart to expand fully, thereby limiting the inflow of blood to the ventricles.

  • potentially lethal condition, because the fibrous pericardium is tough & inelastic.
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19
Q

What is a perocardiocentesis?

A

drainage of fluid from the pericardial cavity

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20
Q

What are 4 contents of the posterior mediastinum?

A

1) esophagus
2) Thoracic (descending) aorta
3) Azygos vein
4) Thoracic duct
5) Sympathetic chain and splanchnic nerves

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21
Q

At which vetebral level does the esophagus begin?

A

From pharynx at C6

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22
Q

After entering the thoracic inlet, the esophagus lies anterior to ____________ and posterior to _____________.

A

Trachea < Esophagus < vertebra

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23
Q

At the level of the sternal angle, the esophagus is cross by:
i) the _______________ on the left
ii) the _____________ on the right
iii) the ______________ infront

A

@ Sternal angle, esophagus crossed by:
i) aortic arch on L
ii) arch of azygos vein on R
iii) L bronchus in front

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24
Q

Which chamber of the heart lies closest to the esophagus?

A

Left atrium

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25
Q

The esophagus pierces the diaphragm at which level?

A

T10

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26
Q

What are 3 physiological constrictions of the esophagus?

A

1) Junction of esophagus and pharynx

2) Crossing of arch of aorta (sternal angle) + compressed by L main bronchus

3) Enter diaphragm (T10)

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27
Q

What are 4 branches of the descending aorta?

A

1) Posterior intercostal
2) Esophageal
3) Bronchial
4) Pericardial
5) Subcostal
6) Mediastinal

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28
Q

Describe the lateral movement of the thoracic aorta inferiorly.

A

Begins @ L of T4 → moves medially to be anterior to lower thoracic vertebrae as it descends in posterior mediastinum

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29
Q

What are 4 tributaries of the azygos vein?

A

1) Posterior intercostal
2) Esophageal
3) Bronchial
4) Mediastinal

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30
Q

True or false:
The azygos vein drains blood from both the posterior wall of the thorax and the abdomen. It also forms a collateral pathway between the SVC and IVC.

A

True

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31
Q

The azygos vein ascends into the posterior mediastinum through the __________ of the diaphragm, on the (R/L) side of the vertebra and arches _________________ to join the SVC.

A

Ascends through aortic opening (T12) of diaphragm.

R of vetebrae

Arches on superior aspect of root of R lung to join SVC

32
Q

Describe the drainage of the 22 posterior intercostal veins.

A

1st posterior on both side → brachiocephalic

remaining 10 on R → azygos

remaining 10 on L → hemiazygos → azygos

33
Q

The thoracic duct originates from ________________, ascends through the diaphragm at ____________, emptying into the venous system at _____________.

A

Originates from cisternal chyli in abdomen

Ascend through diaphragm @ T12 (aortic opening)

Empty into venous system @ venous angle (union of L internal jugular and subclavian)

34
Q

In the posterior mediastinum, the thoracic duct lies between _____________________ and crosses (L/R) at (which level) to ascending into the superior mediastinum (posterior/anterior) to esophagus.

A

Posterior mediastinum:
- btwn thoracic aorta (L) and Azygos vein (R)

Cross L into superior mediastinum at sternal angle (T4/5)
- posterior to esophagus

35
Q

Which parts of the body does the thoracic duct drain and where does the rest go?

A

R Head, neck, upper limb and thorax → R lymphatic duct

Everything else → Thoracic duct

36
Q

The sympathetic trunk/ganglion lie on which side of the veterbrae?

A

Both sides

37
Q

What are splanchnic nerves?

A

Nerves containing both preganglionic sympathetic fibres and visceral afferent fibres

38
Q

What are 3 types of splanchic nerves arising from the sympathetic trunk?

A

1) Greater splanchnic nerve (T5-9)
2) Lesser splanchnic nerve (T10-11)
3) Least splanchnic nerve (T12)

39
Q

True or false:
The heart is shaped like a pyramid.

A

True lol

40
Q

The heart has 3 surfaces:
i) __________________________
ii) _________________________
iii) _________________________
and 4 walls:
____________________________

A

Surfaces
i) Pulmonary (left/LV)
ii) Sternocostal (anterior/RV)
iii) Diaphragmatic (inferior/LV/RV)

Walls:
Septal, Anterior, Lateral, Inferior

41
Q

Which heart chamber forms the apex of the heart?

A

Left ventricle

42
Q

Which heart chamber forms the base of the heart?

A

Left atrium

43
Q

What are the internal features of the right atrium (5)?

A

1) IVC
2) SVC
3) Tricuspid valve
4) Rough pectinate muscle
5) Interatrial septum (Fossa ovalis/where foramen ovale used to be)
6) Coronary sinus (between tricuspid valve and fossa ovalis)
7) SA node (near upper ends of crista terminalis: boundary of smooth and rough parts of RA)
8) AV node (between coronary sinus and tricuspid valve)

44
Q

Atrial septal defect involved the incomplete closure of what structure?

A

Foramen ovale

45
Q

What are the internal features of the right ventricle (5)?

A

1) Papillary muscles
2) Chordae tendinae
3) Tricuspid valve
4) Moderator band
5) Trabecular carnae
6) interventricular septum
7) Pulmonary valve

46
Q

True or false:
The left intraventricular pressure is 6x higher than the right and its wall is 3x thicker.

A

True

47
Q

What are the internal features of the left atrium (2)?

A

1) Pectinate muscle
2) Smooth and rough part of chamber
3) Pulmonary vein openings
4) Bicuspid (mitral) valve

48
Q

What are the internal features of the left ventricle (4)?

A

1) Papillary muscle
2) Chordae tendinae
3) Mitral valve
4) Interventricular septum
5) Aortic valve
6) Trabeculae carnae

49
Q

What structures does the left coronary artery supply (4)?

A

Left Anterior Descending (LAD):
1) RV
2) LV
3) AV bundle
4) 2/3 Interventricular septum

Left circumflex (LCx):
5) LA
2) LV

50
Q

What structures does the right coronary artery supply?

A

Marginal:
1) RV

Posterior descending:
2) 1/3 Interventricular septum
3) LV
4) RV

51
Q

What is coronary dominance?

A

The artery that suppled the posterior descending artery
- precisely which supply AV node

(TLDR: left dominant = bad coz then all supply to LV and AV node is from LCA)

52
Q

Majority of the population is (right/left) coronary dominant.

A

Right (85%)

(TLDR: left dominant = bad coz then all supply to LV and AV node is from LCA)

53
Q

What is an end artery and give 2 examples?

A

an artery that is the only supply of oxygenated blood to a portion of tissue.
Eg. splenic, renal

54
Q

Where is cardiac pain referred to?

A

T1-4 dermatomes: neck, and left shoulder

55
Q

Describe the venous drainage of coronary circulation.

A

Anterior cardiac vein → RA

Great, middle, small and posterolateral cardiac veins → Coronary sinus → RA

56
Q

What are the branches of the aorta from right to left?

A

1) Brachiocephalic trunk
2) L common carotid
3) L subclavian

57
Q

What are the branches of the brachiocephalic trunk?

A

1) R common carotid
2) R subclavian

58
Q

What are the tributaries of the SVC (4)?

A

1) R Subclavian
2) R Internal jugular
3) R lymphatic duct
→ R brachiocephalic

4) R subclavian
5) R Internal jugular vein
6) Thoracic duct
→ L brachiocephalic

59
Q

Injury to the phrenic nerve will cause (bi/ipsi/contralateral) paralysis of the diaphragm.

A

Ipsilateral paralysis of hemidiaphragm

60
Q

Which spinal segments does the phrenic nerve arise from?

A

C3-5

61
Q

The right phrenic nerve runs (anterior/posterior) to the root of the lungs and (lateral/in between) the R brachiocephalic vein and SVC.

A

Right Phrenic
Anterior to root of lung
Lateral to SVC and R Brachiocephalic vein

62
Q

The left phrenic nerve runs (anterior/posterior) to the root of the lungs and (lateral/in between) the L subclavian artery and L common carotid artery.

A

Left Phrenic:
Anterior to root of lung
In between L common carotid and subclavian artery

63
Q

Vagus nerves contains (para)sympathetic nerve fibres

A

Vagus: Parasympathetic

64
Q

The right vagus nerve runs (superficial/deep) to the R subclavian artery, hooking under it to form the _______________.

A

Superficial to R subclavian artery, hooks under to form R recurrent laryngeal nerve

65
Q

The left vagus nerve lies (anterior/posterior) to the L phrenic nerve, in between the L common carotid and subclavian artery. It wraps around the aortic arch below the ligamentum arteriosum to form the ______________________.

A

Posterior to phrenic

Forms the L recurrent laryngeal nerve

66
Q

Which recurrent laryngeal nerve is found in the superior mediastinum?

A

Left only (right hooks under R subclavian above)

67
Q

What is the ligamentum arteriosum?

A

Fibrous band passing from L pulmonary artery to aortic arch
- remnant of ductus arteriosus

68
Q

Describe the nervous supply of the heart?

A

Intrinsic: pacemaker cells in SA node

Modified rate:
1) Cardiac nerve (SNS)
2) Vagus nerve (PNS)

69
Q

The cardiac center, containing the cardioacceleratory and cardioinhibitory centers of the brain is located in the _____________.

A

Medulla oblongata

70
Q

What are the 4 areas of ausculation of the heart?

A

Aortic: R upper sternal border (2nd ICS)

Pulmonary: L upper sternal border (2nd ICS)

Tricuspid: 4th L ICS (next to sternum)

Mitral: 5th LICS (below nipple)

71
Q

Where is the apex beat normally felt?

A

5th ICS mid clavicular line

72
Q

What is a Coronary Artery Bypass Graft?

A

A segment of a long saphenous (from lower limb) vein is connected to the ascending aorta and then distal to the coronary artery stenosis.

73
Q

What are 3 functions of the lymphatic system?

A

1) Balance volume of interstitial fluid
2) Immune
3) Absorption of lipids and fat soluble-vitamines

74
Q

True or false: The flow of lymph is multidirectional depending on the presence of valves and presence of edema.

A

False. Unidirectional because of one way valves
(even when no valves, pressure gradient maintain by vascular smooth muscle, skeletal muscle, respiratory movements

75
Q

What are 2 difference between lymphatic capillaries and lymphatic vessels?

A

Lymphatic capillaries:
- highly permeable
- no continues basal lamina and smooth muscle
- thin

Lymphatic vessels:
- continuous tight junctions prevent leak
- continuous basal lamina and smooth muscle cells
- thick due to connective tissue and smooth muscle

76
Q

Lymphatic capillaries have (greater/lesser) permeability than blood capillaries and there (are/aren’t) pericytes.

A

Lymphatic > permeability
- no pericytes, no basement membrane

77
Q

True or false:
Lymphatic capillaries lack valves.

A

True

Cardiovascular System (12 decks)

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