Anatomy

Question 1

The phrenic nerve runs (anterior/posterior) to the root of the lung?

Answer 1

Anterior

Question 2

The vagus nerve runs (anterior/posterior) to the root of the lung?

Answer 2

Posterior

Question 3

Name the pericardial layers, starting from the outside

Answer 3

• Fibrous pericardium
• Parietal serous pericardium
• Pericardial cavity
• Visceral serous pericardium (epicardium)
• The heart

Question 4

What is the name for blood collection in the pericardial cavity?

Answer 4

Haemopericardium

Question 5

Where is the needle inserted for pericardiocentesis? (drainage of fluid from the pericardial cavity)

Answer 5

• Via the infrasternal angle

- The needle is directed superoposteriorly while aspirating continuously

Question 6

Name the space found behind the ascending aorta and pulmonary trunk

Answer 6

The transverse pericardial sinus

Question 7

What is the first branch of the aorta?

Answer 7

The coronary arteries

Question 8

Name 2 branches of the right coronary artery

Answer 8

• Right marginal artery

- Posterior interventricular artery

Question 9

Name 4 branches of the left coronary artery

Answer 9

• Left anterior descending (LAD)
• Circumflex artery
• Left marginal artery
• Lateral (diagonal) branch

Question 10

Which coronary arteries supply the following surfaces of the heart…

• Anterior
• Anterolateral
• Lateral
• Posterior

Answer 10

• Anterior: LAD
• Anterolateral: LAD
• Lateral: Left circumflex
• Posterior: Right coronary artery

Question 11

Where is the coronary sinus found?

Answer 11

In the posterior atrioventricular groove of the heart

Question 12

What are the 3 openings in the right atrium?

Answer 12

• SVC
• IVC
• Coronary sinus

Question 13

The fossa ovalus is an embryological remnant of…

Answer 13

The foramen ovale

Question 14

What is the crista terminalis?

Answer 14

The thick, smooth part of the right atrium that usually forms a crescent moon shape

Question 15

Which of the 4 heart valves are leaflet valves and which are semilunar valves?

Answer 15

Leaflet valves: Tricuspid and mitral

Semilunar: Aortic and pulmonary

Question 16

What is the function of the chordae tendinae?

Answer 16

They attach the heart valves to papillary muscles in the cardiac chamber walls to prevent prolapse of the valves into the atria during contraction

Question 17

Which valves have chordae tendinae?

Answer 17

The leaflet valves - mitral and tricuspid

Question 18

Describe the structure of the semilunar valves

Answer 18

They consist of 3 cusps and sinuses (spaces within the cusps)

Question 19

What can be seen just above the right and left aortic sinuses?

Answer 19

The coronary arteries arise there

Question 20

Name the 3 cusps in the aortic and pulmonary valves

Answer 20

Aortic - right, left and posterior cusps

Pulmonary - right, left and anterior cusps

Question 21

What is the moderator band?

Answer 21

A thick band of muscle at the base of the right ventricle that carries fibres of the right bundle branch to papillary muscles

Question 22

What are the right and left auricles?

Answer 22

Extensions of the atria that give the atria a little more capacity to fill with blood if required

Question 23

What is the transverse thoracic plane?

Answer 23

An invisible line that separates the superior and inferior mediastinum

Question 24

What level is the transverse thoracic plane found?

Answer 24

T4/T5

also the level of the sternal angle and the carina

Question 25

What is found in the anterior mediastinum?

Answer 25

- The thymus in children | - Mainly adipose tissue in adults

Question 26

What is found in the middle mediastinum?

Answer 26

- The heart | - The parts of the great vessels that connect with the heart

Question 27

What is found in the posterior mediastinum?

Answer 27

- Descending (thoracic) aorta - 2 main bronchi - Oesophagus - Sympathetic chains/trunks - Azygous vein - Thoracic duct

Question 28

What is the function of the azygous vein?

Answer 28

Drains blood from the intercostal veins to the SVC

Question 29

When does the descending/thoracic aorta become the abdominal aorta?

Answer 29

Once it passes through the diaphragm

Question 30

The thoracic duct drains lymph into the...

Answer 30

Left venous angle

Question 31

The left venous angle is made up of the angle between...

Answer 31

The left internal jugular vein and the left subclavian vein

Question 32

Describe the route of lymph draining from the lungs to the venous angles

Answer 32

Pulmonary tissue -> bronchopulmonary lymph nodes (hila) -> tracheobronchial lymph nodes (carina) -> thoracic duct/right lymphatic duct -> left/right venous angle

Question 33

What is the cisterna chyli?

Answer 33

The start of the thoracic duct in the abdomen

Question 34

What structures are found in the superior mediastinum?

Answer 34

- SVC - Arch of aorta and its branches - Trachea - Oesophagus - Thoracic duct - Phrenic, vagus and recurrent laryngeal nerves

Question 35

Order the nerves in the superior mediastinum from most lateral to most medial: - Recurrent laryngeal - Phrenic - Vagus

Answer 35

- Phrenic - Vagus - Recurrent laryngeal

Question 36

The phrenic nerve (C3,4,5) supplies somatic motor to...?

Answer 36

The diaphragm

Question 37

The phrenic nerve (C3,4,5) supplies somatic sensory to...?

Answer 37

- The mediastinal parietal pleura - Fibrous pericardium - Diaphragm

Question 38

Why can pain from gallbladder inflammation be referred to the shoulder?

Answer 38

- The inflamed gallbladder can irritate the diaphragm | - The phrenic nerve senses this, but C3 and 4 also supply the shoulder so pain from the diaphragm may be referred there

Question 39

What type of nerves does the vagus nerve contain?

Answer 39

- Somatic sensory - Somatic motor - Parasympathetic

Question 40

When does the vagus nerve only contain parasympathetic fibres?

Answer 40

Once it has given off its recurrent laryngeal branch (which contains the somatic sensory and motor nerves)

Question 41

How can a cancerous tumour in the left upper lobe cause difficulty swallowing?

Answer 41

The cancer can metastasise through the lymph nodes and form a mass in them This may push against the oesophagus and cause difficulty swallowing

Question 42

How can a cancerous tumour in the left upper lobe cause a hoarse voice?

Answer 42

The cancer can metastasise through the lymph nodes and form a mass in them This may push against the recurrent laryngeal nerve, which supplies the voice box