Anatomy

Question 1

What is the hilum of the lung?

Answer 1

The root of the lung.
The point where the bronchus, pulmonary arteries, pulmonary veins, lymphatic vessels (and bronchopulmonary lymph nodes) and nerves enter the lung.

Question 2

In relation to the pericardium, where is the phrenic nerve?

Answer 2

The phrenic nerve descends across the lateral border of the heart and into the diaphragm

Question 3

What is the epicardium?

Answer 3

the thin external layer formed by the visceral layer of serous pericardium

Question 4

What is meant by “haemopericardium”?

Answer 4

when the pericardial cavity if filled with blood following a penetrating injury or ruptures cardiac chamber following an MI

Question 5

What is a cardiac tamponade?

Answer 5

A condition where the pressure around the heart prevents cardiac contraction

Question 6

What is periocardiocentesis?

Answer 6

A procedure where the pressure of fluid within the pericardium is reduced
e..g. drainage of fluid from the pericardial cavity
must avoid parietal pleura so a needle is inserted via the infrasternal angle and directed superoposteriorly, aspirating continuously

Question 7

What is the transverse pericardial sinus?

Answer 7

A “space” within the pericardial cavity, posterosuperiorly
It lies posterior to the ascending aorta and pulmonary trunk
It lies anterior to the SVC

Question 8

What part of the heart forms the apex?

Answer 8

The inferolateral part of the left ventricle

Question 9

What part of the heart forms the base?

Answer 9

The base is the posterior aspect of the heart.

Formed mainly by the left atrium and part of the right atrium

Question 10

What part of the heart forms the anterior surface?

Answer 10

Mainly the right ventricle

Question 11

What part of the heart forms the diaphramatic (inferior) surface?

Answer 11

Mainly the left ventricle and part of the right ventricle

Question 12

What part of the heart forms the right border (right pulmonary surface?

Answer 12

Right atrium

Question 13

What part of the heart forms the left (lateral) border (left pulmonary surface)?

Answer 13

Left ventricle (and slightly by the left auricle)

Question 14

What are the three main branches off of the arch or the aorta?

Answer 14

brachiocephalic trunk
left common carotid
left subclavian artery

Question 15

What are the branches of the SVC? (2)

Answer 15

right and left brachiocephalic vein

Question 16

What do the brachiocephalic veins bifurcate to form?

Answer 16

subclavian vein and jugular vein

Question 17

What does the coronary groove indicate?

What runs within it?

Answer 17

the surface markings for the tricuspid valve

right coronary artery runs within it

Question 18

What does the anterior interventricular groove indicate?

Answer 18

the boundary between the two ventricles

left anterior descending (LAD) / anterior interventricular artery lies within it

Question 19

What is the coronary sinus?

Answer 19

A short venous channel which runs in the posterior atrioventricular groove.
It separated the base from the diaphragmatic surface.
It receives deoxygenated blood from the cardiac veins and drains into the right atrium (near IVC)

Question 20

What does the posterior interventricular groove indicate?

What runs within it?

Answer 20

It indicates the boundary between the 2 ventricles on the diaphragmatic surface of the heart.
Usually the posterior interventricular artery (branch of right coronary artery) along with the posterior interventricular vein

Question 21

What is hypoxaemia?

Answer 21

A reduction in the oxygen content of the systemic arterial blood.
A condition where arterial oxygen tension or partial pressure of oxygen (PaO2) is below normal.

Question 22

What is hypoxia?

Answer 22

The reduction of oxygen supply at the tissue level.

Question 23

What are the cusps on the tricuspid valve?

Answer 23

anterior, posterior and septal cusps

Question 24

What are the cusps on the mitral valve?

Answer 24

anterior and posterior cusps

Question 25

What are the cusps on the pulmonary valve?

Answer 25

anterior, left and right cusps

Question 26

What are the cusps on the aortic valve?

Answer 26

right, left and posterior cusps (and sinuses - coronary arteries arise from the right and left coronary sinuses)

Question 27

What was the oval fossa called before birth?

Answer 27

foramen ovale

Question 28

What is the function of the fibrous ring?

Answer 28

It is the fibrous part of the septum. | It acts as an electrical insulator.

Question 29

What is the septomarginal trabecula?

Answer 29

It is the moderator band. | It carries fibres of the right bundle branch to the papillary muscle of the anterior cusp of the tricuspid valve.

Question 30

Where do you auscultate the aortic valve?

Answer 30

2nd ICS, right sternal edge

Question 31

Where do you auscultate the pulmonary valve?

Answer 31

2nd ICS, left sternal edge

Question 32

Where do you auscultate for the tricuspid valve?

Answer 32

4th ICS, left sternal edge

Question 33

Where do you auscultate for the mitral valve?

Answer 33

5th ICS, midclavicular line

Question 34

What is the course of the phrenic nerve(s)?

Answer 34

Passes through neck on the anterior surface to the scalenus anterior Passes through the chest to the diaphragm, between the mediastinal parietal pleura and the fibrous pericardium

Question 35

What is the somatic sensory function of the phrenic nerves?

Answer 35

To innervate: - the mediastinal parietal pleura - the fibrous pericardium - the diaphragmatic parietal pleura - the diaphragm (muscle and central tendon) - the diaphragm parietal peritoneum

Question 36

What is the somatic motor function of the phrenic nerves?

Answer 36

To innervate the skeletal muscle of the diaphragm

Question 37

What is the sympathetic function of the phrenic nerves?

Answer 37

To innervate arterioles

Question 38

What sympathetic nerve passes straight to the organ it supplies without synapsing?

Answer 38

one of the abdominopelvic splanchnic nerve passes straight to the adrenal medulla without synapsing

Question 39

What level of the spinal cord do sympathetic fibres leave?

Answer 39

T1-L2/3

Question 40

What is the name of the nerves supplying sympathetic innervation to the heart and lung? At what level do these nerve leave the spinal cord?

Answer 40

Cardiopulmonary splanchnic nerves. | Formed from T1-T5 ganglia and cervical ganglia (superior, middle and inferior).

Question 41

What does the cardiac plexus consist of? | Whereis the cardiac plexus found?

Answer 41

sympathetic fibres, parasympathetic fibres and visceral afferent fibres. Stuck posteriorly on heart, between the heart and the trachea

Question 42

In the parasympathetic nervous system where are the ganglia found (i.e. location of synapsing)?

Answer 42

There are 4 main ganglia in the head and neck. | The rest are in the walls of the organs (vagus and pelvic splanchnic nerves - post-synaptic fibres are very short)

Question 43

What are the parasympathetic cranial nerves?

Answer 43

``` CN III (oculomotor) CN VII (facial) CN IX (glossopharyngeal) CN X (vagus) ```

Question 44

Is the pelvic splanchnic nerve part of the sympathetic or parasympathetic system?

Answer 44

parasympathetic

Question 45

What level of the spinal cord to parasympathetic nerves leave?

Answer 45

cranial sacral outflow | cranial nerve 3, 7, 9, 10

Question 46

What nerves travel in the cardiopulmonary splanchnic nerves?

Answer 46

the postsynaptic sympathetic efferents and the cardiac visceral afferents

Question 47

Where are the chemoreceptor nerve endings found?

Answer 47

in the root of the aorta and in the inter ventricular septum

Question 48

Where are the visceral afferent nerve endings (for stretch any chemicals found?

Answer 48

``` inner aortic arch pulmonary trunk around the SA node outflow tracts from both ventricles papillary muscles vena cava ```

Question 49

Where are the baroreceptors found?

Answer 49

Aortic arch | Carotid sinus

Question 50

What part of the brain do somatic sensory action potentials arrive?

Answer 50

the post-central gyrus of the parietal lobe

Question 51

What part of the brain of somatomotor action potentials originate from ?

Answer 51

the pre-central gyrus of the frontal lobe

Question 52

Give some sources of somatic (sharp) central chest pain

Answer 52

Herpes zoster (shingles) developing in the T4/T5 dermatome Pectorals major of intercostal muscle strain dislocated costochondral joint Costovertebral joint inflammation Slipped thoracic intervertebral disc Pleurisy Pericarditis - pain can be felt anywhere along the one dermatome

Question 53

Give some sources of visceral (dull) chest pain

Answer 53

angina MI tracheitis oesophagitis

Question 54

What is found in the anterior mediastinum?

Answer 54

Mainly fatty tissue in adults. | The thymus gland in children.

Question 55

How does the right vagus nerve pass through the thorax?

Answer 55

On the trachea then the oeophagus

Question 56

What is the ligament arteriosum?

Answer 56

the remnant of the ductus arteriosus, connecting the pulmonary trunk to the arch of the aorta

Question 57

How does the left vagus nerve pass through the thorax?

Answer 57

It crossed the left side of the aortic arch heading posterior to the lung hilum towards the oesophagus

Question 58

Does the phrenic nerve pass anterior or posterior to the hilum of the lung?

Answer 58

anterior