Anatomy

Question 1

Vessels in superior mediastinum

Answer 1

Deep to manubrium
Contains superior vena cava and aorta
oesophagus
phrenic nerves (left and right) and vagus nerves (left and right)
thoracic duct
thymus gland

Question 2

Contents of anterior inferior mediastinum

Answer 2

Fat and connective tissue

Question 3

Contents of inferior middle mediastinum

Answer 3

Deep to anterior mediastinum and contains heart in pericardial sac

Question 4

Contents of inferior posterior mediastinum

Answer 4

Deep to heart and contains descending thoracic aorta, thoracic lymphatic duct and oesophagus

Question 5

Layer of the pericardium

Answer 5

Fibrous - Tough outer layer
Serous - Lines the fibrous pericardium (parietal layer) and also the the heart as epicardium (visceral layer).

Question 6

What is the transverse sinus

Answer 6

Space posterior to the aorta and pulmonary trunk - can clamp the vessels with your fingers

Question 7

What is the oblique sinus

Answer 7

Pericardial space posterior to the heart.

Question 8

Innervation of the pericardium

Answer 8

C3-C5 Phrenic nerve. Pain, vasomotor innervation via sympathetic nerves.

Question 9

Contents of the RA

Answer 9

Superior Vena Cava
Inferior Vena Cava
Coronary sinus
Fossa Ovale
Tricuspid Valve

Question 10

Contents of the LA

Answer 10

4 Pulmonary Arteries - 2 x right and 2 x left
Foramen Ovale
Mitral Valve

Question 11

Role of the right and left atrial appendage

Answer 11

Outpouching forwards
It helps regulate blood volume by releasing natriuretic peptides (proteins) when blood volume is high, causing the LAA walls to stretch.

The LAA acts as a decompression chamber during periods of high atrial pressure, particularly during left ventricular systole.

Question 12

Contents of the R Ventricle

Answer 12

Infundibulum and conus leading to the Pulmonary valve
Tricuspid Valve
Trabeculae
Chordae Tendinae and papillary muscles
Tribeculae Carnae - criss cross wall pattern especially up to apex.

Question 13

Function of chordae Tendinae and papillary muscles

Answer 13

Prevent valve leaflets prolapsing back into atrium during systole

Question 14

Contents of L ventricle

Answer 14

Mitral Valve
Aortic Valve
2 sets of chordae tendinae on the posterolateral wall and anteromedial wall

Question 15

Differences between R and L ventricle

Answer 15

R ventricle - Thinner wall with C shape

L Ventricle - Thick wall and Circle shaped

Question 16

Leaflets on tricuspid and mitral valve

Answer 16

Tricuspid - 3 - Anterior, posterior and inferior

Mitral - Anterior and posterior

Question 17

Branches of the pulmonary trunk

Answer 17

Right Pulmonary artery - Superior to LA and posterior to Superior Vena Cava
Left Pulmonary Artery
+ Ligamentum Anteriosum

Question 18

Importance of ligaments Anteriosum

Answer 18

Remenant of the ductus arteriosus that connected pulmonary trunk to the aorta, so blood could bypass the lungs

Question 19

Right Coronary Supply

Answer 19

Right aortic sinus –> right coronary artery -> Right atrioventricular groove to the right interventricular artery.

Question 20

Left Coronary Supply

Answer 20

Left aortic sinus –> Left inter ventricular artery (LAD) + Left circumflex (underside in L atrioventricular groove)

Question 21

Coronary veins

Answer 21

Leads back to the underside of the RA just below and anterior to the inferior vena cava

Question 22

Attachments of the pericardium

Answer 22

Posterior of the sternum and superior aspect of the diaphragm.
Medially to the parietal pleura.

Question 23

Supply of the LAD

Answer 23

Anterior and anterolateral walls of the left ventricle
Anterior septum

Question 24

Supply of the LCx

Answer 24

Left Atrium
Posterior Left Ventricle

Question 25

Supply of the RCA

Answer 25

Right Atrium Right Ventricle Inferior aspect of the LV Posterior Septal Area

Question 26

Branches of the ascending aorta

Answer 26

1. Brachiocephalic. -> Right subclavian and right common carotid. 2. Left Common Carotid 3. Left Subclavian After branches it leads to the descending aorta.

Question 27

Veins from the SVC

Answer 27

SVC <-- L+R Brachiocephalic Veins <-- Internal jugular and subclavian vein anastomosed from the right side together and the left side together.

Question 28

What is the pericardial cavity and its function.

Answer 28

Pericardial fluid filled space that lubricates the membranes allowing them to slide over each other to prevent friction upon heart beating.

Question 29

Apex of the heart

Answer 29

The apex is formed by the left ventricle. It is located at the left 5th intercostal space in the midclavicular line and the apex beat is palpable here.

Question 30

Borders of the heart

Answer 30

Right border = right atrium * Left border = left ventricle * Inferior border = right ventricle and part of the left ventricle.

Question 31

Right border of the heart

Answer 31

lateral to the right sternal edge, from the right 3rd costal cartilage to the right 6th costal cartilage.

Question 32

Left border of the heart

Answer 32

extends from the left 2nd intercostal space to the left 5th intercostal space in the midclavicular line (i.e. the apex).

Question 33

Superior border of the heart

Answer 33

along the line connecting the superior extents of the right and left borders (i.e. from the right 3rd costal cartilage to the left 2nd intercostal space).

Question 34

Inferior border of the heart

Answer 34

along the line connecting the inferior end of the right border with the apex (mostly formed by the right ventricle).