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ANATOMY > CVS > Flashcards

CVS Flashcards

1
Q

What is the mediastinum?

A

central compartment of thoracic cavities
located between 2 pleural sacs
contains most of thoracic organs

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2
Q

superior mediastinum

A

extends upwards, ending at the superior thoracic aperture

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3
Q

inferior mediastinum

A

extends downwards, ending at the diaphragm

further subdivided into anterior, middle and posterior

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4
Q

anterior mediastinum

A

smallest subdivision of the mediastinum, lies between body of sternum, and the transverse thoracis muscles anteriorly and the pericardium posteriorly

continuous with superior mediastinum at the sternal angle and is limited inferiorly by the diaphragm

consists of sternopericardial ligaments - fibrous bands that pass from pericardium to sternum , fat, lymphatic vessels, lymph nodes and branches of internal thoracic vessels

in infants, contains inferior part of thymus

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5
Q

middle mediastinum

A

coincides with the pericardium, containing the heart, ascending aorta, pulmonary trunk, SVC, arch of azygos vein, and main bronchi

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6
Q

pericardium

A

double-walled fibroserous membrane that encloses the heart and the roots of the great vessels, much like the pleura encloses the lungs

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7
Q

pericardial sac

A

lies posterior to body of sternum and the 2nd-6th costal cartilages at the level of T5-T8 vetrbrae

its tough external fibrous layer - fibrous pericardium - continues with the central tendon of the diaphragm

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8
Q

serous membrane of pericardium

A

parietal layer of serous pericardium -

visceral layer of serous pericardium

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9
Q

fibrous pericardium

A

fused with tunica adventitia of the great vessels entering and leaving the heart
attached to the posterior surface of the sternum by sternopericardial ligaments
fused with the central tendon of the diaphragm

protects heart from a sudden overfilling because it’s unyielding and closely related to the great vessels that pierce it superiorly and posteriorly

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10
Q

pericardial cavity

A

potential space between the opposing layers of the parietal and visceral layers of serous pericardium

normally contains thin film of serous fluid that enables the heart to move and beat in a frictionless environment

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11
Q

epicardium

A

comprised of visceral layer of serous pericardium
thin external layer of heart wall (mesothelium)

reflects from heart and great vessels to become continuous with the parietal layer of serous pericardium

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12
Q

anterior supply of the pericardium

A

mainly from pericardiacophrenic artery - branch of internal thoracic artery , which may accompany or parallel the phrenic nerve to the diaphragm

smaller contributions come from musculophrenic artery , terminal branch of internal thoracic artery

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13
Q

venous drainage of the pericardium

A

pericardiacophrenic veins , tributaries of the brachiocephalic veins (internal thoracic)
variable tributaries of the azygos venous system

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14
Q

nerve supply of pericardium

A 
phrenic nerves (C3-C5) a primary source of sensory fibres ; pain sensations conveyed by these nerves are commonly referred to the skin (C3-C5 dermatomes)of ipsilateral shoulder region
vagus nerves (CN X) - function uncertain
sympathetic trunks - vasomotor
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15
Q

myocardium

A

thick middle layer composed of cardiac smooth muscle

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16
Q

endocardium

A

thin internal layer (endothelium and subendothelial connective tissue) or lining membrane of the heart that also covers its valves

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17
Q

apex of heart

A

directed anteriorly and to the left and is formed by the inferolateral part of the left ventricle
located posterior to the left 5th intercostal space in adults , usually 9cm from median plane
where sounds of the mitral valve closure are maximal (apex beat) the apex underlies the site where the heartbeat may be auscultated on the thoracic wall

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18
Q

base of the heart

A

heart’s posterior aspect
formed mainly by the LA, with a lesser contribution by the RA
faces posteriorly toward the bodies of the vertebrae T6-T9 and is seperated from them by the pericardium, oblique pericardial sinus, oesophagus and aorta
extends superiorly to bifurcation of pulmonary trunk and inferiorly to coronary sulcus (groove)
receives pulmonary veins on R and L sides of LA and the SVC and IVC at the superior and inferior ends of the RA

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19
Q

what are the 2 divided parts of the mediastinum

A

superior and inferior

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20
Q

explain how the superior mediastinum is bordered

A 
superior - thoracic inlet
inferior - continuous with inferior mediastinum at level of sternal angle
anterior - manubrium of sternum
posterior - vertebral bodies of T1-T4
lateral - pleurae of lungs
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21
Q

contents of superior mediastinum

A

neural, vascular and respiratory structures passing from the adjacent regions of neck and abdomen

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22
Q

what are the 3 main branches of the aortic arch

A

brachiocephalic artery
left common carotid artery
left subclavian artery

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23
Q

what does the brachiocephalic artery supply

A

right side of head and neck and the right upper limb

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24
Q

what does LCC supply

A

left side of head and neck

25
Q

what does left subclavian artery supply

A

left upper limb

26
Q

which tributaries of SVC are located in superior mediastinum

A

brachiocephalic veins
left superior intercostal vein
supreme intercostal vein
azygos vein

27
Q

what do brachiocephalic veins do

A

drain blood from upper body

28
Q

what does left superior intercostal vein do

A

collects blood from left 2nd and 3rd intercostal vein - drains it into left brachiocephalic vein

29
Q

what does supreme intercostal vein do

A

drains vein from first intercostal space directly into the brachiocephalic veins

30
Q

what does azygos vein do

A

receives blood from right posterior intercostal veins

left intercostal veins drain first into hemiazygos and accessory hemiazygos veins

31
Q

what 2 paths does vagus nerve take in superior mediastinum

A

right vagus nerve

left vagus nerve

32
Q

what does right vagus nerve do

A

runs parallel to trachea and passes posteriorly to the SVC and right primary bronchus

33
Q

what does left vagus nerve do

A

enters between LCC and Lsubclavian arteries

descends anteriorly to the aortic arch, before travelling posterior to the left bronchus

34
Q

what are the roots of the phrenic nerve

A

C3-C5

35
Q

at what vertebral level is mediastinum divided into superior and inferior

A

T4

36
Q

what forms the posterior border of the superior mediastinum

A

vertebral bodies T1-T4

37
Q

what is the largest artery in the body

A

aorta

38
Q

what does aorta carry

A

oxygenated blood (pumped by LHS of heart) to the rest of the body

39
Q

what branches from ascending aorta and where does the ascending aorta lie

A

lies within the pericardium

coronary arteries branch from it

40
Q

what do pulmonary arteries carry

A

deoxygenated blood from RV and deliver to the lungs for gas exchange to take place

41
Q

what do the arteries begin as and how is it separated from RV

A

pulmonary trunk

separated by pulmonary valve

42
Q

at what vertebral level does the pulmonary trunk split into R & L

A

T5-T6

43
Q

how many branches do the R & L pulmonary arteries divide into and what do they supply?

A

divide/bifurcate into 2

supply each lobe of the lung

44
Q

what do the pulmonary veins carry

A

receive oxygenated blood from the lungs, delivering it to LHS side of heart to be pumped back around the body

45
Q

how many pulmonary veins are there?

A

4 - one superior and inferior for each lung

46
Q

where can the oblique pericardial sinus be found

A

within the pericardium, between right and left veins

47
Q

where is the inferior left pulmonary vein

A

hilum of lung

48
Q

where is right inferior pulmonary vein founf

A

runs posteriorly to the SVC and the RA

49
Q

what does the SVC carry

A

receives deoxygenated blood from the upper body (superior to diaphragm, excluding lungs and heart), delivering it to the RA

50
Q

how is SVC formed?

A

merging of brachiocephalic veins, which travel inferiorly through thoracic region until they drain into the superior portion of the RA at rib3

51
Q

what does IVC carry

A

receives deoxygenated blood from the lower body (all structures inferior to the diaphragm), delivering it back to the heart

52
Q

how is IVC formed

A

in the pelvis by the common iliac veins joining together
passes through diaphragm, entering pericardium at the level of T8
drains into inferior portion of RA

53
Q

what are the 5 surfaces of the heart

A 
anterior (sternocostal) - RV
posterior (base) - LA
inferior (diaphragmatic) - L&RVs
right pulmonary - RV
left pulmonary - LV
54
Q

what are the 4 borders of the heart

A

right border - RA
inferior border - LV and RV
left border - LV and some LA
superior border - R&LA and great vessels

55
Q

what are sulci

A

grooves on the surface of heart

56
Q

what is the coronary sulcus (atrioventricular)

A

runs transversely around the heart - represents the wall dividing the atria from the ventricles
contains important vasculatures such as RCoronaryA

57
Q

what is anterior and posterior interventricular sulci

A

running vertically on their respective sides of the heart

represent the wall separating the ventricles

58
Q

what are the pericardial sinuses

A

oblique pericardial sinus - posterior surface of heart

transverse pericardial sinus - superiorly on heart, can be used in coronary artery bypass grafting

59
Q

summary of sequence of events during one full contraction of the heart muscle

A

an excitation signal is created by the sinoatrial node
wave of excitation spreads across atria, causing them to contract
upon reaching the AV node, signal is delayed
then conducted into the bundle of His, down interventricular septum
bundle of His and the Purkinje fibres spread the wave impulses along the ventricles, causing them to contract

ANATOMY (13 decks)

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