Anatomy 1 Flashcards

1
Q

What are hilar lymph nodes the same as?

A

Bronchopulmonary lymph nodes

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2
Q

Where do phrenic nerves descend in the thorax?

A

Across lateral borders of the pericardium

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3
Q

How are phrenic nerve and vagus nerve differentiated?

A

* If anterior to hilum, phrenic nerve
* If posterior to hilum, vagus nerve

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4
Q

What are the 2 layers of the pericardium? (2)

A

* Fibrous pericardium
* Serous pericardium (further split into parietal and visceral layers)

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5
Q

What is visceral serous pericardium also known as?

A

Epicardium

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6
Q

What does epicardium do?

A

Secrete pericardial fluid

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7
Q

What exists between the 2 pericardial layers?

A

Pericardial cavity filled with pericardial fluid

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8
Q

What is fibrous pericardium line internally by?

A

Parietal serous pericardium

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9
Q

What can cause cardiac tamponade?

A

Haemopericardium - when pericardial cavity fills with blood and pressure around heart prevents cardiac contraction

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10
Q

What is cardiac tamponade?

A

Pressure around heart due to accumulation of fluid in pericardial cavity that can prevent cardiac contraction

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11
Q

What is the treatment for cardiac tamponade?

A

Pericardiocentesis

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12
Q

What is pericardiocentesis?

A

Drainage of fluid from pericardial cavity

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13
Q

Where is the needle inserted in pericardiocentesis?

A

Need to aim for “bare area” of pericardium by inserting needle via infrasternal (subcostal i.e. below costal angle) angle and directing it superoposteriorly

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14
Q

In pericardiocentesis, how do physicians know they are in pericardial cavity?

A

Continually aspirating with needle until it begins to fill up with blood - that is when you are in pericardial cavity

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15
Q

What is transverse pericardial sinus?

A

A space within pericardial cavity posterosuperiorly

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16
Q

Where is transverse pericardial sinus located?

A

Posterior to ascending aorta and pulmonary trunk, in front of SVC

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17
Q

Why is transverse pericardial sinus clinically important?

A

Cardiac surgeons use sinus to identify and isolate great vessels in order to commence cardiopulmonary bypass

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18
Q

Label the openings of the great vessels (pic)

A

A - Inferior vena cava
B - Superior vena cava
C - Aorta
D - Pulmonary trunk
E - Left pulmonary artery
F - Left pulmonary veins

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19
Q

What are the clinically important surfaces of the heart? (3) Why are they clinically important?

A

* Anterior (sternocostal) surface
* Base (posterior) surface
* Inferior (diaphragmatic surface)

* Used to describe type of heart attack they may have

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20
Q

What mainly comprises the inferior border?

A

Right ventricle

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21
Q

What are the clinically important borders of the heart? (2)

A

* Right border
* Left (lateral) border

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22
Q

What mainly comprises the left border?

A

Left ventricle

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23
Q

What mainly comprises the right border?

A

Right atrium

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24
Q

What is another clinically important area of the heart aside from borders and surfaces?

A

Apex

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25
Q

When can left atrium be visualised?

A

Cannot be visualised anteriorly like right atrium, can only really be seen posteriorly

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26
Q

Where is the apex beat of the heart palpated?

A

5th left intercostal space in the midclavicular line (mitral area)

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27
Q

What can an apex beat that is shifted to the left signify?

A

Cardiomegaly (cardiac enlargement) possibly caused by heart failure

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28
Q

Name the labelled structures on the anterior surface of the heart (pic)

A

A - right coronary artery (in coronary groove)
B - Right pulmonary veins (superior and inferior)
C - Right pulmonary arteries (superior and inferior)
D - Brachiocephalic trunk
E - Right subclavian vein
F - Right subclavian artery
G - Right common carotid artery
H - Left common carotid artery
I - Left vagus nerve
J - Left subclavian artery
K - Left phrenic nerve
L - left brachiocephalic vein (BCV)
M - Left pulmonary artery
N - Left pulmonary veins
O - branch of left coronary artery (in anterior inter ventricular groove)
P - Apex

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29
Q

What is the coronary groove?

A

Boundary between right atrium and right ventricle (also surface marking for tricuspid valve)

30
Q

What is the anterior inter ventricular groove?

A

Boundary between the 2 ventricles on anterior surface of heart

31
Q

What are other names for the branch of the left coronary artery that descends over anterior surface of the heart?

A

* Left anterior descending artery
* Anterior inter ventricular artery

32
Q

What does right coronary artery pass over anterior surface of the heart within? Branch of left coronary artery?

A

* Coronary groove
* Anterior inter ventricular groove

33
Q

What are right and left brachiocephalic veins formed from?

A

Joining of right/left internal jugular and subclavian veins (tributaries)

34
Q

How does oxygenated blood return to the heart?

A

Via right and left pulmonary veins

35
Q

What does brachiocephalic trunk (NOT vein) bifurcate into?

A

Right common carotid and right subclavian artery

36
Q

What are auricles? Function?

A

Extensions of the atria - allow atria to expand and fill with more blood

37
Q

Name the labelled structures on the base and diaphragmatic surfaces of the heart (pic)

A

A - Branch of right coronary artery with posterior inter ventricular vein (in posterior interventricular groove)
B - Left pulmonary veins
C - Left pulmonary artery
D - Azygous vein
E - Right pulmonary arteries
F - Right pulmonary veins
G - Interatrial groove

38
Q

What is the coronary sinus?

A

Short venous conduit that receives deoxygenated blood from cardiac veins and drains into RIGHT atrium

39
Q

Where is coronary sinus located?

A

In atrioventricular groove posteriorly (separates atria and ventricles)

40
Q

What is the posterior inter ventricular groove? What is located within groove?

A

* Boundary between 2 ventricles on diaphragmatic surface of heart
* Branch of right coronary artery (posterior inter ventricular artery) with posterior inter ventricular vein

41
Q

What is the branch of the right coronary artery that passes through posterior interventricular groove known as?

A

Posterior interventricular artery

42
Q

What do most cardiac veins drain into?

A

Coronary sinus

43
Q

What is the function of the azygous vein?

A

Intercostal veins drain into azygous vein which drains into SVC

44
Q

What is the function of the coronary arteries and their branches?

A

Arterial blood supply to epicardium and myocardium

45
Q

Where do coronary arteries and their branches course?

A

Deep to the epicardium usually embedded in adipose tissue

46
Q

Where do the coronary arteries branch from?

A

The ascending aorta (first branches of the aorta)

47
Q

Name structures labelled on anterior surface of the heart

A

A - Right marginal artery
B - Right coronary artery
C - Coronary arteries arise from ascending aorta
D - Left coronary artery
E - Circumflex artery
F - Left anterior descending (LAD)/anterior interventricular artery
G - Left marginal artery
H - Lateral (diagonal) branch
I - Posterior interventricular artery

48
Q

What do right and left marginal branches follow?

A

The margins of the heart

49
Q

What artery anastomoses with right coronary artery in the atrioventricular groove?

A

Circumflex artery

50
Q

What divides heart into a right side and left side?

A

Septum (internal wall)

51
Q

What are the 2 parts of the septum? (2)

A

* Interatrial septum (between the 2 atria)
* Interventricular septum (between the 2 ventricles)

52
Q

Where are the 2 parts of the septum positioned? (2)

A

* Interatrial septum - interatrial groove
* Interventricular septum - interventricular groove

53
Q

What is an atrial septal defect (ASD)? Ventricular septal defect (VSD)?

A

* Hole in the interatrial septum
* Hole in the interventricular septum

54
Q

Why are atrial and ventricular septal defects an issue?

A

Get mixing of oxygenated and deoxygenated blood so blood transported around body that isn’t fully oxygenated - HYPOXAEMIA

55
Q

What does mixing of venous and arterial blood do?

A

Reduces oxygen content of systemic arterial blood in the aorta - HYPOXAEMIA

56
Q

Name structures labelled on anterior surface of heart (pic)

A

A - Opening of IVC
B - Opening of coronary sinus
C - Oval fossa
D - Crista terminalis
E - Location of SA node
F - Opening of SVC
G - Muscle bands of auricle wall
H - Anterior interventricular groove
I - Coronary groove

57
Q

What are the 3 openings in the right atrium?

A

* Superior vena cava
* Inferior vena cava
* Coronary sinus

58
Q

What separates the muscular bands of the auricle wall?

A

Crista terminalis

59
Q

What is oval fossa/fossa ovalis?

A

Embryological remnant of foramen ovale

60
Q

How does heart ensure unidirectional flow?

A

4 cardiac valves (tricuspid, bicuspid (mitral), pulmonary valve and aortic valve)

61
Q

What are the cusps of the pulmonary valve? Aortic valve? Tricuspid valve? Mitral valve?

A

* Pulmonary valve - anterior, right and left cusp
* Aortic valve - posterior, right and left cusp and sinuses
* Tricuspid valve - anterior, posterior and septal cusp
* Mitral valve - anterior and posterior cusp

62
Q

What is significant about the sinuses (spaces within cusps) in aortic valve?

A

Coronary arteries arise from the right & left aortic sinuses respectively

63
Q

What is the design of pulmonary and aortic valves? Tricuspid and mitral valves?

A

* Semilunar design
* Leaflet design

64
Q

What are leaflets of tricuspid and mitral valves connected to?

A

Connected to papillary muscles (cardiac muscle attached to chamber walls) via tendinous chords

65
Q

Why is leaflet attachment to papillary muscles important?

A

To prevent reflux of of leaflets during ventricular contraction

66
Q

What is the function of the cardiac skeleton? (2)

A

* Gives valves structural integrity, anchor and structure
* Assists electrical conduction through heart

67
Q

What valves are surrounded by fibrous cardiac skeleton?

A

…?????

68
Q

What is the moderator band? Function?

A

* Moderator band (septomarginal trabecula) is muscular band of heart tissue found in right ventricle of the heart
* Shortcut for electrical activity reaching anterior cusps of tricuspid valve (need shortcut cause anterior cusp is further away from other 2 cusps but still has to contract at same time as other 2)

69
Q

Name structures in interior of left atrium (and 1 structure on posterior surface on heart)

A

A - Interatrial groove
B - Cusps of mitral valve
C - Remains of foramen ovale (oval fossa)
D - bilateral openings of superior and inferior pulmonary veins
E - left auricle

70
Q

What are the positions for auscultation of the heart valves?

A

* Aortic - 2nd ICS, right sternal edge
* Pulmonary - 2nd ICS, left sternal edge
* Tricuspid - 4th ICS, left sternal edge
* Mitral - 5th left ICS, mid-clavicular line

DO NOT GET CONFUSED WITH PRECORDIAL ECG POSITIONS

71
Q

What is the purpose of auscultating heart valves?

A

Listening for heart sounds and murmurs