CARDIOLOGY - Anatomy, Surgery and Trauma

Question 1

What is the pericardium

Answer 1

Double-walled fibrous membrane enclosing heart and roots of great vessels

Question 2

What is the function of the fibrous pericardium

Answer 2

Protects heart against sudden overfilling

Question 3

What is the pericardial cavity?

Answer 3

Potential space between visceral and parietal layers of pericardium

Question 4

Through which sinus do the aorta and pulmonary trunk leave the pericardium?

Answer 4

Transverse pericardial sinus

Question 5

Through what sinus do the SVC,IVC and pulmonary vv enter the heart?

Answer 5

Oblique pericardial sinus

Question 6

Aa supply to the pericardium

Answer 6

Pericardiophrenic aa

Question 7

Vv drainage of pericardium

Answer 7

Pericardiophenic vv

Question 8

Nn supply to pericardium

Answer 8

phrenic nn C3-5
CNX
Sympathetic trunk

Question 9

Where is the apex of the heart

Answer 9

Anterior to the left

Post to L ICS 5

Question 10

Where is the base of the heart

Answer 10

Posterior
LA with bit of RA
Ant to T6-9

Question 11

What are the 4 surfaces of the heart?

Answer 11

Anterior (Sternocostal) - RV
Diaphragmatic (inf) - LV + RV
Left pulmonary - LV
R pulmonary - RA

Question 12

What are the 4 borders of the heart

Answer 12

R - RA
Inf - RV
L - LV
Sup - RA/LA + great vessels

Question 13

Which heart chamber forms most of the base of the heart

Answer 13

LA

Question 14

Which heart chamber forms the R border of heart

Answer 14

RA

Question 15

Where does the con sinus receive blood from

Answer 15

Cardiac vv

Question 16

What does the con sinus become

Answer 16

Sinus venarum

Question 17

What part of the heart does the LV form

Answer 17

Apex and L surface

Question 18

What level is the mitral valve at

Answer 18

4th CC

Question 19

What level is the aortic valve at

Answer 19

3rd ICS

Question 20

Where do you auscultate for: aortic valve:

Answer 20

2nd ICS, R sternal edge

Question 21

Where do you auscultate for: pulmonary valve

Answer 21

2nd ICS - L sternal edge

Question 22

Where do auscultate for: Tricuspid valve

Answer 22

5th ICS L sternal edge

Question 23

Where do you auscultate for: Mitral valve

Answer 23

5th ICS MCL

Question 24

Where does the R coronary aa arise from?

Answer 24

Coronary sulcus

Question 25

Where does the L coronary aa arise from?

Answer 25

Aortic sinus of ascending aorta

Question 26

Where do the great, middle and small cardiac vv empty?

Answer 26

Coronary sinus

Question 27

Where does the anterior cardiac vv empty?

Answer 27

RA

Question 28

Sympathetic innervation of heart

Answer 28

Accelerator nn

Question 29

Parasympathetic innervation of heart

Answer 29

CNX

Question 30

What is the 'lub' sound

Answer 30

Blood being transferred from atrai to ventricles

Question 31

What is the 'dub' sound

Answer 31

Ventricles contract and expel blood from heart

Question 32

When is a median sternotomy incision used for?

Answer 32

Ops on heart and aortic arch

Question 33

When is a anterolateral thoractomy incision used?

Answer 33

Access to RHS heart

Question 34

When is a posterior throacotomy incision used?

Answer 34

For access to distal aortic arch and descending thoracic aorta

Question 35

When is a bilateral transverse throacotomy used?

Answer 35

for H-L transplant

Question 36

What is the main complications of Cardiopulmonary bypass

Answer 36

Clotting within machine

Question 37

Which artery is most commonly used as a conduit in CABG

Answer 37

L internal mammary aa

Question 38

Complications CABG (7)

Answer 38

``` MI Bleeding Arrhythmias Stroke Tamponade Aortic dissection Resp/systemic complications ```

Question 39

Example of man made heart valve names

Answer 39

Ball-in-cage | Bileaflet

Question 40

What must be coprescribed with man-made valves?

Answer 40

Warfarin

Question 41

How to tell if a patient has a manmade heart valve

Answer 41

Can hear clicking from bedside

Question 42

Which type of prosthetic valve is more prone to degenerative failure?

Answer 42

Tissue valve

Question 43

What Ix must all patients with blunt chest trauma have

Answer 43

CHX (supine)

Question 44

Sign of cardiac tamponade CXR

Answer 44

Rounded heart border

Question 45

What is a myxoma

Answer 45

Common myocardial tumour

Question 46

What conditions does myxoma mimic?

Answer 46

Infective endocarditis | Mitral stenosis

Question 47

Ix myxoma

Answer 47

Echo

Question 48

mx myxoma

Answer 48

Excise

Question 49

What is constrictive pericarditis due to?

Answer 49

Pericardial inflammation (e.g. due to RA/trauma/radiotherapy)

Question 50

Signs constrictive pericarditis

Answer 50

Pulmonary/systemic congestion

Question 51

Mx constrictive pericarditis

Answer 51

excise whole pericardium

Question 52

`Why are ball in cage valves not really used anymore

Answer 52

Due to high risks of clot --> stroke

Question 53

Click replacing 1st heart sound =

Answer 53

Mitral valve replacement

Question 54

Click replacing 2nd heart sound =

Answer 54

Aortic valve replacement

Question 55

What is TAVI and when is it used

Answer 55

Transcatheter aortic valve replacement Through femorals up to aorta Balloon opened + valve implanted For high risk patients with aortic stenosis

Question 56

Prognosis TAVI

Answer 56

Unsure as new but lower rate of infective endocarditis and clots

Question 57

What % of prosthetic valves --> infective endocarditis

Answer 57

2.5%