Chapter 2: Thorax (continued 3)

Question 1

What are the 3 layers of the pericardium?

Answer 1

• the outer fibrous layer
• a double layered parietal and visceral serous layer

Question 2

What is the transverse pericardial sinus?

Answer 2

a space posterior to the ascending aorta and pulmonary trunk and anterior to the superior vena cava and pulmonary veins

separates the great arteries from the great veins

Question 3

What is the oblique pericardial sinus?

Answer 3

is the blind, inverted, U-shaped space posterior to the heart and bounded by reflection of serous pericardium around the 4 pulmonary veins and inferior vena cava as they enter the heart?

Question 4

What is cardiac tamponade?

Answer 4

the pathological accumulation of fluids serous or blood within the pericardial cavity.

Question 5

How is pericardiocentesis performed?

Answer 5

with a needle at the left infrasternal angle through the cardiac notch of the left lung

Question 6

The right border of the heart mainly is formed by which part of the heart?

Answer 6

right atrium

Question 7

The left border of the heart is mainly formed by which part of the heart?

Answer 7

The left ventricle

Question 8

The apex of the heart is mainly formed by which heart structure?

Answer 8

the left ventricle

Question 9

The anterior (sternocostal) surface of the heart is mostly formed by which structure?

Answer 9

the right ventricle

Question 10

The posterior surface of the heart is mostly formed by which structure?

Answer 10

left ventricle

Question 11

What are the 3 main sulci of the heart?

Answer 11

coronary
anterior interventricular
posterior interventricular

Question 12

The upper right aspect of the heart is deep to which costal cartilage?

Answer 12

3rd right costal cartilage

Question 13

The lower right aspect of the heart is deep to which costal cartilage?

Answer 13

6th right costal cartilage

Question 14

The upper left aspect of the heart is deep to which costal cartilage?

Answer 14

the left second costal cartilage

Question 15

The apex of the heart is in which intercostal space?

Answer 15

left fifth intercostal space at the midclavicular line

Question 16

The right border of the heart lies between which structures of the rib cage?

Answer 16

the third right costal cartilage to the sixth right costal cartilage just to the right of the sternum

Question 17

The left border of the heart extends between which parts of the rib cage?

Answer 17

between the fifth left intercostal space to the second left costal cartilage

Question 18

The inferior border of the heart extends between what structures of the rib cage?

Answer 18

between the sixth right costal cartilage to the fifth left intercostal space at the midclavicular line

Question 19

The superior border of the heart extends to between which structures of the rib cage?

Answer 19

the inferior margin of the second left costal cartilage to the superior margin of the third right costal cartilage

Question 20

Describe the auricle of the heart ?

Answer 20

part of the right atrium that includes rough myocardium known as pectinate muscles

Question 21

Describe the sinus venarum.

Answer 21

the smooth-walled portion of the atrium which receives blood from the superior and inferior venae cavae. Derived from sinus venosus

Question 22

What is the crista terminalis?

Answer 22

the vertical ridge that separates the smooth from the rough portion (pectinate muscles) of the right atrium

Question 23

Which valve is on the left side of the heart separating the atria from the ventricles?

Answer 23

the mitral or bicuspid valve

Question 24

What are the ridges of myocardium in the ventricular wall?

Answer 24

trabeculae carneae

Question 25

This structure projects into the cavity of the ventricle and attaches cusps of the AV valve by the strands of the chordae tendineae?

Answer 25

papillary muscle

Question 26

What is the function of the chordae tendineae?

Answer 26

fibrous cords between the papillary muscles and the valve leaflets that control closure of the valve during contraction of the ventricle

Question 27

What is infundibulum?

Answer 27

the smooth area of the right ventricle leading to the pulmonary valve

Question 28

What is another name for septomarginal trabecula?

Answer 28

moderator band

Question 29

What is the septomarginal trabeculae?

Answer 29

band of cardiac muscle between interventricular septum and anterior papillary muscle

Question 30

The first heart sound occurs at the closure of which valves?

Answer 30

at the closure of the atrioventricular valves at the beginning of systole

Question 31

The second heart sound occurs at the closure of what occurrence of the heart?

Answer 31

at the closure of aortic and pulmonary semilunar valves

Question 32

Which valves are more commonly involved in valvular disease?

Answer 32

aortic and mitral

Question 33

T/F. A heart murmur is heard downstream from the valve. Thus stenosis is retrograde and insufficiency is orthograde.

Answer 33

false; stenosis is orthograde and insufficiency is retrograde

Question 34

What type of valvular dysfunction is heard in the right upper sternum?

Answer 34

systolic: aortic stenosis

Question 35

What types of valvular dysfunction is heard in the right lower sternum?

Answer 35

systolic: tricuspid insufficiency

Question 36

What type of murmur is heard in the upper left lateral chest wall?

Answer 36

systolic: mitral insufficiency

Question 36

What type of murmur is heard at the apex of the heart?

Answer 36

diastolic: mitral stenosis aortic insufficiency

Question 37

In MI which artery is obstructed in 50% of cases?

Answer 37

anterior descending artery

Question 38

In MI which artery is obstructed 30% of the time?

Answer 38

the right coronary

Question 39

Which artery is obstructed in 20% of cases of MI?

Answer 39

circumflex artery

Question 40

What are the main branches of the right coronary artery?

Answer 40

SA nodal artery AV nodal artery posterior interventricular artery

Question 41

What is the 1st branch of the right coronary artery?

Answer 41

SA nodal artery

Question 42

Which part of the right coronary artery would the AV nodal artery be found?

Answer 42

arises from the distal end of the right coronary artery as it forms the posterior interventricular artery

Question 43

Which sulcus does the posterior interventricular artery lie??

Answer 43

lies in the posterior interventricular sulcus

Question 44

What are the 2 branches of the left coronary artery?

Answer 44

anterior interventricular or left anterior descending artery and circumflex artery

Question 45

What is the most common site of coronary occlusion?

Answer 45

LAD

Question 46

Which sulcus does the coronary sinus lie?

Answer 46

posterior coronary sulcus

Question 47

Where does the coronary sinus drain?

Answer 47

to an opening in the right atrium

Question 48

What is the main tributary of the coronary sinus?

Answer 48

the great cardiac vein

Question 49

Which artery supplies the SA node?

Answer 49

right coronary artery

Question 50

Which artery supplies the AV node?

Answer 50

right coronary artery

Question 51

The bundle of His is supplied by what artery?

Answer 51

the LAD

Question 52

Nerves that sense pain associated with coronary artery ischemia (angina) follow the sympathetic pathways back into which spinal cord segments?

Answer 52

T1-T5

Question 53

What is the cause of herniation of abdominal contents into the pleural cavity in congenital diaphragmatic hernia?

Answer 53

failure of the pleuroperitoneal membranes to develop properly

Question 54

What is an esophageal hiatal hernia?

Answer 54

a herniation of the stomach into the pleural cavity due to an abnormally large esophageal hiatus to the diaphragm

Question 55

What phase of the heart cycle would you hear A-V valve insufficiency?

Answer 55

systolic murmur

Question 55

What phase of the heart cycle would you hear A-V valve stenosis

Answer 55

diastole

Question 56

What phase of the heart cycle would you hear pulmonic and aortic valve stenosis?

Answer 56

systolic murmur

Question 57

What phase of the heart cycle would you hear pulmonic and aortic valve regurgitation?

Answer 57

diastolic murmur

Question 58

What part of the heart does the right marginal artery supply?

Answer 58

supplies right ventricle

Question 59

Which parts of the heart does the posterior descending artery PDA aka posterior interventricular artery supply?

Answer 59

* AV node * posterior 1/3 of interventricular septum * posterior 2/3 of walls of ventricles * posteriomedial papillary muscle

Question 60

Which parts of the heart does the LAD supply?

Answer 60

* anterior 2/3 of interventricular septum * anterolateral papillary muscle * anterior surface of left ventricle

Question 61

What area of the heart does the left circumflex artery supply?

Answer 61

* supplies lateral and posterior walls of the left ventricle * anterolateral papillary muscle