Anatomy

Question 1

What travels through the hilum of the lungs?

Answer 1

Pulmonary arteries, 
Pulmonary veins, 
Main bronchus,
Pulmonary lymphatic vessels,
Bronchopulmonary lymph nodes,
Pulmonary visceral afferents,
Autonomic motor nerves

Question 2

Which part of the thorax is the heart and pericardium in?

Answer 2

Middle mediastinum

Question 3

Is the phrenic nerve a unilateral or bilateral structure?

Answer 3

Bilateral

Question 4

Which is anterior to the hilum, the phrenic or vagus nerves?

Answer 4

Anterior = phrenic 
(posterior = vagus)

Question 5

What are the layers of the pericardium?

Answer 5

Outer layer = fibrous pericardium

Inner = serious (split into visceral and parietal)

Question 6

What occurs if the pericardial cavity fills with abnormal quantities of fluid?

Answer 6

Cardiac tamponade
(if blood = haemopericardium)

Question 7

How is fluid in the pericardium released?

Answer 7

Pericardiocentesis:

aspiration superoposteriorly under xyphoid process

Question 8

What is the transverse pericardial sinus?

Answer 8

A space posterior to the ascending aorta and pulmonary trunk - finishes anteriorly to SVC

Question 9

What are the 3 surfaces of the heart?

Answer 9

Anterior,
Base (the most posterior surface),
Inferior

Question 10

Where is the apex normally and what can it indicate if it has shifted?

Answer 10

5th intercostal space, left mid-clavicular line

If shifted to left = cardiomegaly

Question 11

Which is more lateral, the phrenic or vagus nerves?

Answer 11

Lateral = phrenic
Medial = vagus

Question 12

Which vein drains the head and neck?

Answer 12

Left and right internal jugular veins

Question 13

Which vein drains the upper limbs?

Answer 13

Left and right subclavian veins

Question 14

Describe the venous drainage into the SVC

Answer 14

Left internal jugular + subclavian 
==>
Left brachiocephalic,
Left + right brachiocephalic 
==>
SVC
Azygous vein also drains into the SVC just above the right atrium

Question 15

What structure of the surface of the atria allow them to fill with more blood?

Answer 15

Auricles

Question 16

What is the order or branches on the arch of the aorta?

Answer 16

Brachiocephalic trunk, left common carotid, left subclavian

Question 17

Which veins drain into the right atrium?

Answer 17

SVC, IVC, coronary sinus

Question 18

Which artery supplies the head and neck?

Answer 18

Common carotid arteries

Question 19

What are the important borders of the heart?

Answer 19

Right and left lateral borders
Inferior border
Superior border

Question 20

Which chambers make up the base, apex, anterior and inferior surfaces?

Answer 20

Base: left atrium
Inferior: right and left ventricles
Anterior: right ventricle
Apex: left ventricle

Question 21

What are the first branches of the ascending aorta?

Answer 21

The right and left coronary arteries

Question 22

Describe the right coronary artery and its branches

Answer 22

Right coronary artery (in coronary groove),

Has a right marginal branch

Question 23

Describe the left coronary artery and its branches

Answer 23

Left main stem, left anterior descending (LAD), diagonal, left marginal and circumflex

Question 24

Where does all the venous drainage from the heart drain into?

Answer 24

The coronary sinus (in the atrioventricular groove)

Question 25

What divides the heart into a left and right side?

Answer 25

Septum: | interatrial septum + interventricular septum

Question 26

What is an atrial or ventricular septal defect?

Answer 26

A hole in the interatrial or interventricular septum that allows mixing of the blood - can be life threatening

Question 27

How many cusps does each valve have:

Answer 27

Tricuspid: 3 Pulmonary: 3 Bicuspid/mitral: 2 Aortic: 3

Question 28

What kind of valves are the aortic/pulmonary or the tricuspid/mitral?

Answer 28

Aortic/pulomary: semi-lunar | Tricuspid/mitral: leaflet

Question 29

What prevents reflux of the tricuspid/mitral valves during ventricular contraction?

Answer 29

Leaflets connected to papillary muscles via tendinous cords

Question 30

What gives the heart valves structural integrity?

Answer 30

Fibrous skeleton (made of connective tissue)

Question 31

Where dot he right common carotid and the right subclavian arise from?

Answer 31

The brachiocephalic trunk

Question 32

How does sympathetic/parasympathetic stimulation affect the heart?

Answer 32

Symp: Increases heart rate and force Parasympathetic: decreased heart rate

Question 33

Is there a cardiac plexus?

Answer 33

Yes, behind the heart by the bifurcation of the trachea

Question 34

What is a ganglia?

Answer 34

A collection of nerve cell bodies outside of the CNS

Question 35

Describe the course and neurotransmitters of sympathetic fibres

Answer 35

Pre-synaptic fibre (from CNS to ganglion in sympathetic chain) Acetyl choline neurotransmitter Post-synaptic fibre (from ganglion to organ) Noradrenaline neurotransmitter

Question 36

Which spinal cords is the sympathetic outflow from?

Answer 36

T1-L2 (thoracolumbar)

Question 37

What sympathetic nerves supply the heart and lungs?

Answer 37

Cardiopulmonary splanchnic nerves

Question 38

Describe the course and neurotransmitters of parasympathetic fibres

Answer 38

Pre-synaptic fibre (from CNS to ganglion on structure) Acetyl choline neurotransmitter Post-synaptic fibre (from ganglion to organ) Acetyl choline neurotransmitter

Question 39

Where is parasympathetic outflow from?

Answer 39

CN III, VII, IX, X (3,7,9,10) (3,7,9 remain within the head and neck, 10 = vagus travels down to supply most of the upper body) Sacrum (craniosacral outflow)

Question 40

Which nerve do the baroreceptor signals (afferents) act upon?

Answer 40

Parasympathetic = vagus nerve

Question 41

What divides the brain the parietal and frontal lobe and what type of sensation is on either side?

Answer 41

Central sulcus Parietal: somatosensory Frontal: somatomotor

Question 42

Which side is the azygous vein on?

Answer 42

right

Question 43

What is the route of the right and left vagus nerves?

Answer 43

Right: surface of the trachea and then follows the oesophagus Left: Follows the aorta and directly touches the hilum

Question 44

What is the difference between radiating and referred pain?

Answer 44

Radiating: pain felt at site of injury + at site elsewhere Referred: pain only felt at site remote from the injury

Question 45

Which arteries supply the anterior, inferior or inferiolateral surfaces of the heart (are blocked in an MI in these areas)

Answer 45

Anterior: LAD Inferior: Right Lateral: Left

Question 46

Which coronary artery is more often dominant?

Answer 46

Right

Question 47

Which coronary artery supplies the SA and AV nodes?

Answer 47

Right

Question 48

What is CABG and what vessels are more commonly used?

Answer 48

Coronary artery bypass grafting (if atheroma etc) | Radial or internal thoracic

Question 49

What are the divisions of the mediastinum?

Answer 49

Superior and inferior | Inferior = anterior, middle, posterior

Question 50

What is in the anterior mediastinum?

Answer 50

In children, thymus gland | In adults, adipose tissue

Question 51

What is in the middle mediastinum?

Answer 51

Heart and the start of the great vessels

Question 52

Where does the azygous vein drain into the SVC?

Answer 52

Superiorly to the hilum

Question 53

What is the main lymphatic drainage of the body, where does it drain and what does it drain into?

Answer 53

Thoracic duct, drains all but the upper right quadrant of the body Into the left venous angle (where internal jugular vein meets the subclavian to from brachiocephalic)

Question 54

What is the lymphatic drainage of the last quarter of the body?

Answer 54

Right lymphatic duct, drains upper right quadrant Drains into the right venous angle (where the internal jugular vein meets the subclavian to form he brachiocephalic vein)

Question 55

Where is the thoracic duct in the mediastinum?

Answer 55

Between the azygous vein and the oesophagus (only structure there)

Question 56

Where is pain from the diaphragm referred to?

Answer 56

Right shoulder

Question 57

Where does the phrenic nerve provide sensory supply to?

Answer 57

Parietal pleura, Fibrous pericardium Diaphragmatic parietal peritoneum

Question 58

What are the named arteries down the arm?

Answer 58

Brachial artery | Radial artery

Question 59

What are the named arteries down the leg?

Answer 59

Femoral artery, Popliteal artery, Posterior tibial, Dorsalis pedis

Question 60

What drains the anterior and posterior intercostal spaces?

Answer 60

Anterior: Internal thoracic vein Posterior: Azygous vein