Heart + Mediastinum

Question 1

What are the superior and inferior boarders of the mediastinum?

Answer 1

● Superior: thoracic inlet
● Inferior: diaphragm

Question 2

What are the anterior, posterior and lateral boarders of the mediastinum?

Answer 2

● Anterior: sternum
● Posterior: bodies of thoracic vertebrae
● Lateral: mediastinal parietal pleura

Question 3

The mediastinum can be divided into :

Answer 3

superior and inferior mediastinum

Question 4

the inferior mediastinum can be divided into:

Answer 4

anterior, middle and posterior

Question 5

What is in the superior mediastinum?

Answer 5

thymus,
V: SVC, brachiocephalic vein
A: ABCS
trachea
esophagus
lymphatics
nerves: phrenic, vagus

Question 6

What is in anterior mediastinum?

Answer 6

thumus, lymph nodes, fat

Question 7

what is in the middle mediastinum?

Answer 7

heart, phrenic nerve

Question 8

What is in the posterior mediastinum?

Answer 8

● Descending (Thoracic) aorta
● Azygos system of veins
● Thoracic duct
● Esophagus
● Sympathetic (parasympathetic) nerves

Question 9

What is the role of the thymus?

Answer 9

growth through childhood, then site for T lymphocyte development (tumor on it could effect facial and eye muscles)

Question 10

what are the great vessels of the superior mediasteinum?

Answer 10

-R/L brachiocephalic vein
-Aortic arch and branches
–Brachiocephalic artery
–Left common carotid artery
–Left subclavian artery

Question 11

The trachea ends at the level of
the_________ by dividing into
the right and left main bronchi

Answer 11

sternal angle

Question 12

the majority of the heart is on which side of the body?

Answer 12

left

Question 13

the anterior surface of the heart is made up mostly of

Answer 13

right ventricle

Question 14

the visceral pericardium is the same as the ____

Answer 14

epicardium

Question 15

what is the layers of the pericardium?

Answer 15

● Fibrous pericardium
● Serous pericardium
-Parietal layer
-Visceral layer (deepest)

Question 16

pulmonary veins carry what where?

Answer 16

oxygenated blood to the left atrium

Question 17

where does the apex of the heart lie?

Answer 17

Lies posterior to the left 5th
intercostal space,
approximately 9 cm from the
median plane

Question 18

where can you best hear the sound of the mitral value closing?

Answer 18

closest to the apex

Question 19

How can you tell if someone has an enlarged heart?

Answer 19

you wont hear mitral valve in correct spot

Question 20

where is the base of the heart and what forms it?

Answer 20

posterior aspect
Formed mainly by the left atrium, with lesser contributions by the right atrium

Question 21

what great veins are found on the base of the heart?

Answer 21

 Pulmonary veins (PV)
 Superior vena cava (SVC)
 Inferior vena cava (IVC)

Question 22

the right atrium receives blood from?

Answer 22

SVC, IVC, and coronary sinus

Question 23

right atrium Has a ________ which allows the discharge of blood into the right ventricle

Answer 23

right AV orifice (mitral valvue)

Question 24

What muscles are in the right ventricle?

Answer 24

–trabeculae carneae (muscular elevations)
–Papillary muscles (prevent tricuspid valve from prolapsing)

Question 25

what is the difference between the posterior and anterior walls of the right atrium?

Answer 25

● Posterior wall is smooth and contains openings for blood return ● Anterior wall is rough and composed of pectinate mm

Question 26

what do the chordae tendineae do?

Answer 26

arise from papillary muscles and attach to the free edges of the cusps

Question 27

what valve connects the right atrium and ventricle, what valve connects the right ventricle and pulmonary trunk?

Answer 27

tricuspid pulmonary SEMILUNAR valve

Question 28

where is pectinate mm found?

Answer 28

both atria

Question 28

what drains into the left atria?

Answer 28

four pulmonary veins

Question 28

what is unique about the left ventricle and why does it have this feature?

Answer 28

2-3x thicker, covered with trabeculae carneae, papillary mm are larger to pump blood to the rest of the body

Question 29

what connects the left atrium to left ventricle and what connects the left ventricle to the aorta?

Answer 29

left AV orifice (or mitral or bicuspid valve) aortic semilunar valve

Question 30

where the pulmonary semilunar valve audible?

Answer 30

2nd left intercostal space

Question 31

where the aortic semilunar valve audible?

Answer 31

2nd right intercostal space

Question 31

where the tricuspid valve audible?

Answer 31

4th/5th left intercostal space

Question 31

where the mitral valve audible?

Answer 31

5th left intercostal space

Question 32

what is infective endocarditis?

Answer 32

● Microbial invasion of heart valves or endocardium with destruction of cardiac tissue. ● Bacteria associated with infective endocarditis originate from the oral cavity in 26–45% of cases

Question 33

What supplies the heart itself with blood and where do they come from?

Answer 33

coronary arteries first branches off the aorta

Question 34

what is a myocardial infarction?

Answer 34

clot or clog in coronary arteries causes decrease in blood flow to heart and necrosis of heart tissue (since heart tissue does not regenerate)

Question 35

what is the path of the conducting system of the heart?

Answer 35

SA node → AV node → AV bundle → Right & Left bundle branches →Purkinje fibers

Question 36

The heart is supplied by autonomic nerve fibers from the _______

Answer 36

cardiac plexus

Question 37

The cardiac plexus has which fibers?

Answer 37

sympathetic, parasympathetic, visceral afferent

Question 38

What are some examples of cardiac referred pain?

Answer 38

● Visceral organs are insensitive to incisions, temperature, and touch ● They are sensitive to distension and ischemia ● Visceral sensory nerves travel through the sympathetic chain and enter the spinal cord at T1-4

Question 39

Where does the descending aorta begin?

Answer 39

left side of T4 vertebra, descends on the left sides of the T5– T12 vertebrae ● Enters the abdomen through the aortic hiatus

Question 40

what do the azygos and hemiazygos veins drain?

Answer 40

● Azygos: drains intercostal spaces on the right side ● Hemiazygos: drains intercostal spaces on left side --BOTH Empties into SVC

Question 41

what does the thoracic duct do?

Answer 41

Conveys most lymph of the body to the venous system, except that from the right superior quadrant.

Question 41

Where does the thoracic duct drain?

Answer 41

Empties into the venous system near the union of the left internal jugular and subclavian veins

Question 42

where does the thoracic duct originate?

Answer 42

cisterna chyli

Question 43

what are the three parts of the aorta?

Answer 43

cervical thoracic abdominal

Question 44

the vagus nerve gives what type of innervation for the organs?

Answer 44

parasympathetic

Question 45

The right recurrent laryngeal nerve loops under the ___ ____ ______, while the left RLN loops under the ___________

Answer 45

right subclavian artery aortic arch

Question 46

What controls the heart rate?

Answer 46

ANS

Question 47

Thoracic splanchnic nerves ● ________ sympathetic fibers ● Pass through the diaphragm to synapse in _______ in the abdomen

Answer 47

Preganglionic collateral ganglia