L1, 11 Heart anatomy and central lines Flashcards
What is the purpose of central lines
To deliver medicine, blood, fluids quickly. Can also be used to measure pressure in the heart.
What is the advantage and disadvantage of lines in the ext. jugular vein
Ad:
easy to access, reduced risk of pneumothorax
Dis:
Small, difficult to insert. uncomfortable for long periods
What is the advantage and disadvantage of lines in the int jugular vein (most common)
Ad. easy to find and thread
Dis: Puncture carotid artery/pneumothorax
-Difficult if CPR is required
-Patient uncomfortable
What is the advantage and disadvantage of lines in the subclavian vein
Ad: comfortable for long term, Can do CPR
Dis:
risk of puncture sub clavian artery, pneumothorax, Brachial plexus risk, Difficult to apply pressure to stop bleeding
What is the advantage and disadvantage of lines in the femoral vein
Ad: Fast, easy to access. No interference with CPR, no pneumothorax
Dis:
Increased risk of infection, embolism, difficult to mobilise patient
What are the peripheral lines and the central lines
Peripheral : femoral and external jugular
Central: internal jugular, subclavian
What are the inside features of the right atrium vs left atrium
Both auricles are derived from primitive atrium and are contractile. They also have musculi pectinati.
RA - has musculi pectinati on the anterior wall. Posterior wall is sinus venosum (smooth). Between the two regions is the crista terminalis.
The Fossa ovalis is on the wall between atria
Valve of the coronary sinus is down near the IVC.
-LA is smooth walled.
Compare the structures in the Left and right ventricle
Both walls have trabeculae carnae: contractile cardiac muscle.
-RV has septomarginal trabeculae: moderator band which goes from the interventricular septum to anterior group of papillary muscles with electrical purpose. . It also has Conus arteriosus: collecting blood just under the pulmonary trunk.
- LV: more smooth walled for less turbulence
Compare atrioventricular valves
Both prevent backflow into atrium. Chordae tendinae connect to papillary muscles. Valves tethered to fibrous skeleton for strength and electrical insulation. Valves ballooning into the atrium = venous pressure spike.
R: tricuspid
L: Mitral (bicuspid): bigger papilla
Which nerves supply the cardiac plexuses + oesophageal plexus for symp and parasymp innervation
Sup cardiac plexus: beneath the aortic arch mostly the left vagus nerve + cervical branch of sympathetic trunk
Deep plexus : infront of bifurcation of trachea: Both vagal cardiac branches and cardiac nerves from sympathetic trunk T1-4/5 and recurrent laryngeal nerves
