CVR 2

Question 1

What divides the mediastinum

Answer 1

T4 angle of louie

Question 2

What is in the anterior mediastinum

Answer 2

very small space, thymus gland (produce T cells). As it grows it regresses, in a child it is big.
Sits behind the sternum thus retrosternal

Question 3

Middle mediastinum contains

Answer 3

Pericardium which sits between two lungs containing the heart.

Question 4

3 Layers of the pericardium

Answer 4

Fibrous pericardium (tough you need a blade)
Serous pericardium (made up of parietal and visceral inner part)
Parietal - adherent to the inner surface of fibrous pericardium
Visceral Pericardium - adherent to outer layer of heart. AKA epicardium.
Pericardial cavity - potential space, thin fluid - no friction

Question 5

What is the ligament between aorta and pulmonary trunk

Answer 5

ligamentum arteriosum which is a remnant of ductus arteriosus - which in fetal life because the lungs arent working the blood passes through this structure.

Question 6

What is the apex beat

Answer 6

The position most lateral and inferior point at which palpating fingers feel the beat.
5th ICS MCL left of sternum

Question 7

What is dextrocardia

Answer 7

Heart flipped other side.

Question 8

Name the valves of the heart

Answer 8

tricuspid - right atrium and right ven
pulmonary valve - 2 semi lunar cusps
(continue)

Question 9

Order of valves

Answer 9

PAMT
P= 3rd CC
A= 3 IC
M=4CC
T=4th IC
(3344 PAMT)

Question 10

How do we listen to the valves

Answer 10

A = 2nd ICS RIGHT of sternum
P= 2nd ICS left of sternum
(continue)

Question 11

How do we listen to the valves

Answer 11

A = 2nd ICS RIGHT of sternum
P= 2nd ICS left of sternum
(continue)

Question 12

Where does the pulmonary trunk bifurcate

Answer 12

behind the aorta

Question 13

Where does the arch of the aorta begin

Answer 13

T4

Question 14

Why are recurrent laryngeal nerves important and what is odd?

Answer 14

They look after the vocal cords and they come off the vagal branch
Right recurrent comes off vagus nerve and wraps areound right sublclavian artery
Left comes off vagus and wraps around the arch of the aorta. Compression of recurrent laryngeal nerves gives hoarseness.

Question 15

Why are recurrent laryngeal nerves important and what is odd?

Answer 15

They look after the vocal cords and they come off the vagal branch
Right recurrent comes off vagus nerve and wraps areound right sublclavian artery
Left comes off vagus and wraps around the arch of the aorta. Compression of recurrent laryngeal nerves gives hoarseness. Mediastinal tumours L and R.

Question 16

What level does the posterior mediastinum extend?

Answer 16

T4-T12

Question 17

What is in the anterior mediastinum?

Answer 17

Thymus gland. Regresses after childhood.

Question 18

What is in the middle mediastinum?

Answer 18

Pericardium, heart, roots of the great vessels.

Question 19

What nerve passes between the lung and heart to reach the diaphragm?

Answer 19

Left and right phrenic nerves

Question 20

Superficial to deep name the layers of the pericardium?

Answer 20

Fibrous (connective tiisue), Serious (parietal layer touching paricardial layer running over the heart).
Pericardial cavity is between the parietal layers and visceral layers for lubrication.

Question 21

Name the 2 sinuses in the pericardium

Answer 21

Transverse pericadial sinus across pericardium between roots of great vessels b/w aorta and pulmonary trunk). Anterior to SVC.

Oblique pericardial sinuse between the right pulmondary veins and IVC and between the righ pulmonary veins and left pulmonary veins

Question 22

Blood supply of pericardium

Answer 22

pericardiacophrenic arteries and internal thoracic arteries. Internal thoracic veins drain. Innervated by phrenic nerves.

Question 23

What is at level T4

Answer 23

bifurcation of the trachea.
Bifurcation of pulmonary trunk.
Azygos termination
Ligamentum arteriousum.
Ductus arteriosum.

Question 24

What is the ligamentum arteriosum?

Answer 24

remnant of ductus arteriosus.

Conveys blood in fetal life from pulmonary trunk to aorta bypassing lungs.

Question 25

Where is the apex beat

Answer 25

5th ICS MCL left of sternum

Question 26

What valve is between right ventricle and right atrium

Answer 26

Tricuspid

Question 27

How many cusps in the pulmonary valve

Answer 27

3 semilunar cusps

Question 28

What is between the left atrium and ventricle?

Answer 28

Mitral valve which is bicuspid

Question 29

Describe the aortic valve?

Answer 29

3 semilunar cusps (anterior, right posterior, left posterior)