Anatomy Flashcards

(77 cards)

1
Q

what is haemopericardium?

A

if the pericardial cavity fills with blood

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2
Q

what is cardiac tamponade?

A

when haemopericardium occurs and the pressure around the heart prevents cardiac contraction

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3
Q

what is a pericardiocentesis?

A

drainage of fluid from the pericardial cavity

needle is inserted via the infrasternal angle and directed superoposteriorly, aspirating continuously

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4
Q

what is the transverse pericardial sinus?

A

a space within the pericardial cavity, posteorsuperiorly

surgeons use it to isolate and identify the great vessels for open heart surgery

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5
Q

where is the transverse pericardial sinus?

A

it lies posterior to the ascending aorta and pulmonary trunk

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6
Q

what are the surfaces of the heart?

A

anterior (sternocoatsal) surface
base (posterior) surface
inferior (diaphragmatic) surface

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7
Q

what are the borders of the heart?

A

right (lateral) border
left (lateral) border
inferior border
superior border

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8
Q

where can the apex beat be palpated?

A

5th left intercostal space in the midclavicular line

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9
Q

when would the apex beat be shifted?

A

cardiomegaly often shifts it to the left

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10
Q

what does the coronary groove indicate?

A

the surface marking for the tricuspid valve

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11
Q

what does the anterior interventricular groove indicate?

A

the boundary between the two ventricles

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12
Q

where are the nerves of the heart?

A

the vagus nerves are closer the the heart and the phrenic nerves are further away

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13
Q

what does the right common carotid artery and the right subclavian artery come together to form?

A

the brachiocephalic trunk

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14
Q

what does the interatrial groove indicate?

A

the boundary between the 2 atria

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15
Q

what are the coronary arteries and their branches?

A

the arterial blood supply to the epicardium and myocardium

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16
Q

where can the coronary arteries be found?

A

they course just deep to the epicardium, usually embedded in adipose tissue and arise from the ascending aorta

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17
Q

describe the right coronary artery

A

in the coronary (right atrioventricular) groove

forms the right marginal artery and the posterior interventricular artery

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18
Q

describe the left (main stem) coronary artery

A

in the left atrioventricular groove between the pulmonary trunk and the left auricle

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19
Q

name the branches of the left coronary artery

A

circumflex artery
left marginal artery
lateral (diagonal) branches
posterior interventricular artery

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20
Q

what is the coronary sinus?

A

a short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

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21
Q

what divides the heart into a right and left side

A

a septum

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22
Q

what is the part of the septum between the 2 atria?

A

interatrial septum

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23
Q

what is the part of the septum between the 2 ventricles?

A

interventricular septum

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24
Q

describe a septal defect

A

it can allow the mixing of arterial and venous blood in the heart
can be life threatening because it reduces the oxygen content of systemic arterial blood in the aorta causing hypoxaemia

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25
describe the interior of the right atrium
``` opening of the superior vena cava location of the SA node crista terminalis oval fossa opening of the coronary sinus opening go the inferior vena cava ```
26
how does the heart ensure unidirectional flow?
the 4 cardiac valves | one valve at the exit from each cardiac chamber
27
describe the tricuspid valve
between the right atrium and the right ventricle | has anterior, posterior and septal cusps
28
describe the mitral valve
between the left atrium and left ventricle | has anterior and posterior cusps
29
describe the pulmonary valve
between the right ventricle and the pulmonary trunk | has anterior right and left cusps
30
describe the aortic valve
between the left ventricle and the aorta | has right, left and posterior cusps and sinuses
31
describe the interior of the left atrium
the left auricle bilateral openings of superior and inferior pulmonary veins remains of the valve of foramen ovale may be visible cusps of mitral valve
32
what is the 1st heart sound?
the closure of the tricuspid and mitral valves
33
what is the 2nd heart sound?
closure of pulmonary and aortic valves
34
how do sympathetic nerve fibres get from the CNS to the organs?
a presynaptic fibre connects between CNS and ganglion the ganglion is aceytlcholine (neurotransmitter) the post synaptic fibre is noradrenaline
35
describe the route of presynaptic fibres from the brain
they travel inferiorly within spinal cord tracts and then exit the spinal cord in one of the T1-L2/3 spinal nerves
36
describe the T1-T5 ganglia and cervical ganglia
cardiopulmonary splanchnic nerves which are the sympathetic nerves to the heart and lungs
37
how do postsynaptic sympathetic fibres reach the heart?
there is bilateral sympathetic innervation (preodminalty left sided)
38
how do parasympathetic signals from the CNS reach the organs?
a presynaptic fibre connects between CNS and ganglion the ganglion is acetylcholine the postsynaptic fibre is acetyl choline
39
what is a ganglion?
a synapse between the axon of the presynaptic neurone and the cell body of the postsynaptic neurone
40
what is a postsynaptic fibre?
connects between the ganglion and the organ
41
how do parasympathetic signals reach the organs?
through the cranial nerves III, VII, IX + X
42
how do parasympathetic signals reach the heart?
``` CN X (the vagus nerve) presynaptic parasympathetic fibres in vagus nerve then synapse onto postsynaptic neurones ```
43
describe the nature of somatic pain
sharp stabbing well localised
44
sources of somatic pain
``` muscular joint bony intervertebral disc fibrous pericardial nerve ```
45
nature of visceral pain
dull aching nauseating poorly localised
46
sources of visceral pain
heart and great vessels trachea oesophagus abdominal viscerae
47
nature of radiating pain
felt in centre of chest and felt spreading from there
48
sources of radiating pain
upper limbs back neck
49
nature of referred pain
only felt at site remote from area of tissue damage in the chest
50
sources of referred pain
upper limbs back neck
51
describe acute or chronic pain
repeated acute episodes vs chronic pain
52
where in the brain does the sensation of pain reach consciousness?
the cerebral cortex
53
where do APs arrive to bring body wall sensations into consciousness?
postcentral gyrus of the parietal lobe | somatosensory
54
where do APs originate to bring about contractions of skeletal muscle?
precentral gyrus of the frontal lobe | somatomotor
55
what are somatic central chest pain sources?
``` herpes zoster (shingles) muscle, joint and bone parietal pleura and fibrous pericardium ```
56
what is herpes zoster (shingles)?
reactivation of dormant virus in posterior root ganglion pain can be felt anywhere in that dermatome pain precedes shingles patient with it developing in T4/T5 dermatome may present with central chest pain
57
what are muscle, joint and bone causes of chest pain?
pectorals major or intercostal muscle strain dislocated costochondral joint costovertebral joint inflammation 'slipped' thoracic intervertebral disc
58
what can cause chest pain associated with the parietal pleura and the fibrous pericardium?
pleurisy | pericarditis
59
what are visceral central chest pain sources?
``` oesophagus heart abdominal visceral aorta trachea ```
60
what causes chest pain from the oesophagus?
oesophagitis
61
what causes chest pain from the heart?
angina | MI
62
what causes chest pain from the abdominal viscerae?
gastritis cholecystitis pancreatitis hepatitis
63
what causes chest pain from the aorta?
ruptured aneurysm of aortic arch
64
what causes chest pain from the trachea?
tracheitis
65
what are the sub divisions of the mediastinum?
superior inferior anterior middle (heart location) posterior
66
how do pain signals from the organs reach the brain?
cardiopulmonary splanchnic nerves plus pain afferents from chest organs visceral afferent action potentials pass bilaterally to thalamus and hypothalamus then diffuse areas of the cortex
67
where is radiating pain originating from a somatic structure?
along the affected dermatome(s)
68
where is radiating pain from the heart?
to the dermatomes supplied by the spinal cord levels at which the cardiac visceral afferents enter the spinal cord ie bilaterally to cervical and upper thoracic dermatomes
69
what is visceral radiating pain?
although it is felt in a dermatomal pattern, it is still dull, aching nd poorly localised in nature
70
what causes referred pain?
due to afferent fibres from soma and afferent fibres from viscera entering the spinal cord at the same levels the brain chooses to believe that the pain signals coming from the organ are actually coming from the soma
71
what is cardiac referred pain?
the brain chooses to believe the pain signals are coming from the upper limbs (especially left side) or from the back, neck or jaw
72
where is the most common site of coronary atherosclerosis?
anterior interventricular branch of LCA
73
where is the second most common site of coronary atherosclerosis?
RCA
74
where is the third most common site of coronary atherosclerosis?
circumflex branch of LCA
75
where is the least common site of coronary atherscelrosis?
LCA
76
where are commonly used grafts for coronary arteries?
radial artery/ internal thoracic artery | great saphenous vein
77
what is the arterial blood supply of the interventricular septum?
left anterior descending or anterior interventricular artery left and right bundle branches posterior interventircular artery