CVS

Question 1

1. Where does the left coronary artery arise from? What are its two main branches?

Answer 1

Ascending aorta, left aortic sinus. Anterior interventricular (left anterior descending)

Question 2

1. At what vertebral level do the aorta and IVC pass through the diaphragm?

Answer 2

T12; T8

Question 3

1. What does the azygos vein drain?

Answer 3

Posterior intercostal veins right side and hemeiazygos and accessory hemiazygos vv from the left side

Question 4

1. Name 3 structures in the posterior mediastinum

Answer 4

Oesophagus, Descending aorta, Vagus n.

Question 5

1. What is the function of the coronary sinus?

Answer 5

Drains the cardiac veins of the heart wall to the right atrium

Question 6

1. Name the valve which lies between the left atrium and ventricle? How many cusps does it have?

Answer 6

Bicuspid (Mitral); 2

Question 7

1. Name the layers of pericardium?

Answer 7

Visceral, Parietal, Fibrous

Question 8

1. Where can the trabeculae carneae be found?

Answer 8

R+L Ventricles

Question 9

1. Where does the sinuatrial node lie? What is its function?

Answer 9

Where SVC enters right atrium. Cardiac pacemaker.

Question 10

1. At which vertebral level does the arch of the aorta begin and end?

Answer 10

T4

Question 11

The anterior interventricular artery is sometimes described as being an “end artery”. What is an end artery?

Answer 11

An end artery is one which is the only supply to a particular area of the body

Question 12

Describe the effect of reduced blood flow through an end artery (coronary artery).

Answer 12

A reduced blood flow will result in a lack of oxygen to the area of the heart supplied by this vessel. Due to the high oxygen demand of the cardiac muscle cells a reduction in arterial blood flow will result in inadequate energy metabolism and give pain.

Question 13

5. A 67 years old woman was seen by a physician and said to have a mediastinal tumour.

Define the term mediastinum.

Answer 13

The space between the two lungs (interpleural space) is called the mediastinum.

Question 14

5. A 67 years old woman was seen by a physician and said to have a mediastinal tumour.

List the structures in the mediastinum which could have been affected in her condition.

Answer 14

Heart, pericardium, thymus, trachea, oesophagus, vagus nerve, phrenic nerve, arch of aorta & its branches are some of the important structure present in the mediastinum.

Question 15

3. An elderly man was brought to the hospital with a history of severe chest pain. The physician wants to examine his chest to rule out any heart problem. From your anatomy knowledge answer the following questions.

Where would the physician normally attempt to listen to the apex beat of the heart?

Answer 15

The physician would normally attempt to listen to the heat beat with a stethescope in the 5th left intercostal place, in the midclavicular line.

Question 16

Which blood vessels perfuse the heart?

Answer 16

Right and left coronary arteries bring oxygenated blood to the wall of the heart. The coronary sinus takes away the (majority of) deoxygenated blood back to the venous chamber (right atrium) of the heart.

Question 17

Which intercostal space is ideal to listen to pulmonary heart sound?

Answer 17

The left 2nd intercostal space close to the sternal margin is used to hear the pulmonary heart sound.

Question 18

What is the common reason for a shift in the apex beat?

Answer 18

A shift in the apex beat is a good indicator of cardiac (heart) enlargement.

Question 19

4. A 65 years old patient has seen by a physician with difficulty in breathing. During his examination, he palpated the man’s trachea in the jugular notch and felt the trachea has moved to one side abnormally. Radiographic studies revealed an aneurysm of the arch of aorta.

What is an aneurysm of the arch of aorta?

Answer 19

An aneurysm is the abnormal dilatation of the wall of a blood vessel (in this case the aorta).

Question 20

What structure may be compressed by the aneurysm?

Answer 20

The arch of aorta lies behind the manubrium of the sternum and runs anterior to the trachea. Pressure may be exerted on the trachea and oesophagus, causing difficulty in breathing and swallowing.

Question 21

Radiographic studies revealed an aneurysm of the arch of aorta.

Why is this abnormality common in older people?

Answer 21

It is common in old people due to arterial disease and certain congenital disorders.

Question 22

b) Make a list of important structures close to the right subclavian vein and superior vena cava.

What might happen if the needle in the catheter were, inadvertently, to damage these structures?

Answer 22

b) Subclavian vein – pleura, apex of right lung, subclavian artery, brachial plexus, first rib
Superior vena cava – arch of aorta, upper lobe right lung, superior mediastinum, phrenic nerve, vagus nerve, right main bronchus

c) Pneumothorax, haemorrhage, loss of nerve function, pain. The first two might go on to produce shock via hypoxia and hypovolaemia and then death