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Cardiovascular > Anatomy > Flashcards

Anatomy Flashcards

(69 cards)

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1
Q

Anterior mediastinum key points

A

Potential space

Only really contains thymus

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2
Q

Posterior mediastinum key points

A

Contains aorta and oesophagus

Everything behind pulmonary trunk

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3
Q

4 rough borders of the heart

A

Left: mid-clavicular line
Right: parasternal
Top: sternal angle
Bottom: normally no lower than 5th rib

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4
Q

The apex of the heart sits in the:

A

5th intercostal space

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5
Q

Fibrous pericardium key points

A

Blends with collagen of diaphragm
innervated by phrenic nerve
Referred pain to brachial plexus areas

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6
Q

Serous pericardium key points

A

Made of mesothelium
Consists of parietal and visceral pericardium with pericardial cavity between the two
Parietal pericardium innervated by phrenic nerve
Visceral pericardium innervated by sympathetic chain

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7
Q

The base of the heart is at the:

A

Top

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8
Q

The base of the pericardium is at the:

A

Bottom

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9
Q

Transverse pericardial sinus

A

Gap that separates arteries from veins

Useful for bypass surgery

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10
Q

Oblique pericardial sinus

A

Formed by reflection onto pulmonary veins due to cardiac looping
Underneath transverse pericardial sinus

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11
Q

Specific borders of the heart

A

Right: right atrium
Bottom: right ventricle
Left: left ventricle and auricle

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12
Q

The coronary sinus is also called:

A

The atrioventricular groove

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13
Q

Right coronary artery branches from top to bottom

A

Sinoatrial nodal branch
Marginal branch
Atrioventricular nodal branch
Posterior interventricular branch

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14
Q

Marginal branch supplies:

A

Right ventricle

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15
Q

Posterior interventricular branch supplies:

A

Posterior interventricular groove

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16
Q

Left coronary artery branches from top to bottom

A

Left circumflex branch

Anterior interventricular branch

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17
Q

Left circumflex branch supplies:

A

Left ventricle and interventricular groove

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18
Q

Venous drainage of heart

A

Coronary sinus
Posterior, anterior, great, small, middle cardiac veins
Also oblique vein of left atrium
CS pumps blood back into right atrium

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19
Q

Sinus venarum

A

Smooth muscle wall space of right atrium that veins drain into

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20
Q

Musculi pectinati

A

Bundles of cardiac muscle arranged in parallel fashion

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21
Q

Valve of inferior vena cava

A

Channels blood from placenta through foramen ovale before birth

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22
Q

Fossa ovalis

A

Closed over hole, remnant of foramen ovale

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23
Q

Foramen ovale

A

Hole between right atrium and left atrium before birth

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24
Q

Tricuspid valve

A

Atrioventricular

Between right atrium and right ventricle

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25
Right auricle origin
Muscular piece of atrium from primitive atrium
26
Chordae tendineae
Tethered, but only to inlet valves | With papillary muscles, responsible for pushing AV valve up to close it
27
Pulmonary valve
Semilunar 3 cusps Between right ventricle and pulmonary trunk
28
Moderator band
Also called septomarginal trabecula Runs from septum, which is the wall between two ventricles, to margin Only in right ventricle Allows papillary muscles to contract just before ventricles fully activate
29
Mitral valve
Bicuspid Atrioventricular Between left atrium and left ventricle
30
Coronary ostia
2 holes right by the cusps of the aortic valve which ascend into left and right coronary arteries
31
Stenosis
Narrowing of blood vessels Generates turbulence downstream Causes noise and potentially regurgitation
32
1st heart sound
Lub | Generated by inlet valves closing
33
2nd heart sound
Dub | Generated by outlet valves closing
34
Best place to hear the mitral valve sound
5th intercostal space medial | Away from bones and other turbulence
35
Best place to hear the tricuspid valve sound
5th intercostal space | Left edge of sternum
36
Best place to hear the aortic valve sound
2nd intercostal space, just below sternal angle | Right edge of sternum
37
Best palce to hear pulmonary valve sound
2nd intercostal space, just below sternal angle | Left edge of sternum
38
Laminar flow
Normal blood flow Silent Velocity occurs in layers, with fastest blood flow in the middle of the vessel
39
Interventricular septum function
Stiffens before left ventricle contracts to protect right ventricle from the power of the left ventricle
40
3 nervous supplies of the heart
Somatic SNS PSNS
41
Somatic nervous supply
Phrenic nerve supplies outer pericardium | Pain refers to C3, 4 and 5 which can be felt in the upper shoulder and upper neck
42
SNS nervous supply
Sympathetic chain Heart by T1 - T4 Angina felt in the chest, nipple line and running down arms Functions to increase heart rate, contraction of heart, systemic blood pressure and coronary artery vasodilation
43
PSNS nervous supply
Vagus nerve General referred pain, nausea and malaise Decreases heart rate and systemic blood pressure Increases coronary artery vasoconstriction
44
7 structures in the transthoracic plane
``` Carina Arch of aorta Arch of azygous vein Thoracic duct Cardiac plexus Ligamentum arteriosum Pulmonary trunk bifurcation ```
45
Great veins of the thorax
Superior vena cava Branches into left and right brachiocephalic veins Each branches off internal and external jugular veins Both continue as right and left subclavian veins
46
Branches of the aorta
``` To the right: Brachiocephalic trunk Branches into right common carotid Continues as right subclavian Branches into right internal thoracic with small anterior intercostal branches To the left: Branches into left common carotid Branches into left subclavian which branches into left internal thoracic with small posterior intercostal branches ```
47
Phrenic nerve position
C3 and 4 from cervical plexus C5 from brachial plexus Both come through ribcage Right phrenic nerve around the side of right atrium Left phrenic nerve around the side of left ventricle Both give off pericardial branches
48
Vagus nerve position
Right vagus comes down over right subclavian artery Branches off into right recurrent laryngeal nerve which loops around right subclavian artery Left vagus comes down to the left of aorta Branches off into left recurrent laryngeal nerve which comes around aorta then back up towards neck Vagus nerves link back into plexus at lower oesophagus which goes on to supply abdominal viscera
49
Muscle between subclavian artery and subclavian vein
Anterior scalene muscle
50
Things to consider when inserting a central line
``` Access Risk of puncture Lungs Risk of bleeding Risk of infection Short or long term placement ```
51
4 places you could put a central line
External jugular vein Internal jugluar vein Femoral vein Subclavian vein
52
Central line in external jugular vein +ves and -ves
``` +ve: Easy access Low risk of pneumothorax -ve: Small vessel Uncomfortable for patient ```
53
Central line in internal jugular vein +ves and -ves
``` +ve: Won't get in the way Easy to find and thread -ve: High risk of carotid artery puncture High risk of pneumothorax ```
54
Central line in femoral vein +ves and -ves
``` +ve: Fast, easy access No risk of pneumothorax -ve: High risk of infection High risk of embolism ```
55
Central line in subclavian vein +ves and -ves
``` +ve: Comfortable for patient Good for long term -ve: High risk of subclavian artery puncture High risk of damage to brachial plexus ```
56
Azygous vein
When the right superior intercostal vein moves from the superior mediastinum into the thorax it becomes the azygous vein Past the thorax it is known as the right ascending lumbar vein
57
Hemiazygous vein
Branches from the azygous around the T8/9 vertebral level and crosses vertebral column to left hand side Descends down and leaves thorax, becoming ascending lumbar vein
58
Accessory hemiazygous vein
Branches from the azygous around the T8/9 vertebral level and crosses vertebral column to left hand side Ascends up, ends around the T4 level
59
Thoracic duct
Between azygous and hemiazygous veins, exits between left internal jugular vein and left subclavian vein Valves prevent venous backflow Gets extra fluid back into blood system Main lymphatic drainage
60
Cisterna chylii
Goes over azygous/hemiazygous connections | 'Water reservoir' of thoracic duct
61
4 major constrictions of oesophagus
1) junction of oesophagus with pharynx 2) where oesophagus is crossed by arch of aorta 3) where oesophagus is compressed by left main bronchus 4) at the oesophageal hiatus
62
Aortic coarctation
Diagnosed on a 6 week baby check Take radial and femoral pulse - should be in sync and same strength If below left subclavian artery branch it can be fixed by anastamosing posterior and anterior intercostal arteries to resupply legs
63
Coarctation after branching of left subclavian artery
Radial pulses will be in sync but femoral pulse will be out of sync and weaker
64
Coarctation before branching of left subclavian artery (after branching of left common carotid)
Left radial pulse will be weaker and out of sync with the right radial pulse
65
Two anastamoses to alleviate aortic coarctation
Between posterior and anterior intercostal arteries | Between superior and inferior epigastric arteries
66
Oesophageal arterial supply
Superior: inferior thyroid artery Middle: branches of the aorta Inferior: left gastric aftery
67
Venous drainage of oesophagus
Superior: brachiocephalic trunk Middle: azygous system Inferior: left gastric vein
68
3 areas for portosystemic shunts
Oesophageal varices Anorectal varices Caput medusae
69
Portal hypertension
Cirrhotic liver causes blockages and blood flows back through the portal and gastric veins, joining back up with inferior mesenteric vein and azygous vein Vessels too small to handle large backflow so they become distended and can rupture

Cardiovascular (6 decks)

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