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Anatomy Test Block III > Mediastinum and heart > Flashcards

Mediastinum and heart Flashcards

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1
Q

What divides the mediastinum into superier and inferior ?

A

sternal angle of louis

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2
Q

What is within the superior mediastinum?

A

great vessels, thymus, esophagus, trachea, phrenic n., recurrent laryngeal n. thyroid.

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3
Q

What is within the interior posterior mediastinum?

A

thoracic aorta, azygos, esophagus, thoracic splanchnic, thoracic duct

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4
Q

What is within the inferiro middle mediastinum?

A

heart, pericardium, great vessels, bronchi, azygos, phrenic

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5
Q

What join in the superior mediastinum to make the superior vena cava?

A

left and right brachicephalic (inominant) veins

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6
Q

What nerve is attached to the pericardial sac as it travels down to the diaphragm?

A

phrenic n

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7
Q

How does Vagus nerve travel in the superior mediastinum?

A

the left vagus goes over the arch of the aorta - right is harder to find

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8
Q

thymus gland

A

lymphoid structure that sits behind the manubrium in children - is replaced by fat w/ aging - would see a widened superior mediastinum on xray of child

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9
Q

Where does the right recurrent (of Vagus) occur?

A

under the r. subclavian artery

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10
Q

Where does the left recurrent of vagus recur?

A

under the arch of the aorta

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11
Q

Explain how the vagus nerve branches as it travels through the mediastinum

A

The vagus nerves form a plexus around the esophagus and then branch into anterior and posterior vagal trunks

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12
Q

The anterior vagal trunk is primary from what?

A

left vagus

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13
Q

The posterior vagal trunk is primary from what?

A

right vagus

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14
Q

Anterior vagal trunk supplies?

A

parasympathetics to the foregut (stomach/liver)

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15
Q

Posterior vagal trunk supplies ?

A

mid and hind gut

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16
Q

How many pulmonary veins are there?

A

4

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17
Q

What is the organism that causes syphilis?

A

treponema palladium

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18
Q

syphillis invasion of the aortic arch

A

would damage the left recurrent laryngeal n. causing horseness b/c 1 side of vocal cords have been paralyzed; no longer happens due to discovery of penicillin

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19
Q

ligamentum arteriorsum is a remnant of what?

A

ductus arteriosus (right to left shunt of blood)

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20
Q

Explain the embryological structure ductus arteriosus.

A

the lungs werent needed as an embryo so when the heart contracted, blood would go out the pulmonary trunk straight to the aorta through ductus arteriosus. Right heart shunting blood to left side.

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21
Q

What occurs if the ductus arteriosus does not form the ligamentum arteriosum?

A

PDA - patent ductus arteriosum

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22
Q

Where is the carina located?

A

at sternal angle; it bifurcates there

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23
Q

What veins does the azygos drain?

A

intercostal veins

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24
Q

the azygos vein drains into what?

A

Right side: superior vena cava

Left: accessory hemiazygos and hemiazygos

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25
Describe the splanchnic nerves in the inferior - posterior mediastinum
sympathetic preganglionics headed for the pre aortic ganglia in the gut
26
The thoracic duct is located where?
only on the LEFT
27
Thoracic duct
b/w descending aorta and azygos vein; starts in abdomen in cysterna chyli and is pushed into root of neck and empties into the junction of the internal jugular v and subclavian v on the LEFT
28
What all does the left thoracic duct drain?
all lymph drainage from lower extremeties, abdomen and pelvis (a small right duct drains the right side of head and upper extremity)
29
Greater splanchnic nerves
T5-T9
30
Lesser splanchnic nerves
T10 T11
31
Least splanchnic nerve
T12
32
From outside in, what are the layers of the heart?
fibrous pericardium, parietal layer of serous pericardium, paricardial cavity, visceral layer of serous pericardium
33
fibrous pericardium
dull in appearance, becomes continuous w/ the adventitia of the great vessels. has no stretch to it.
34
Serous pericardium
parietal layer attached to fibrous pericardium and visceral layer which is the outermost covering of the heart
35
Cardiac tamponade causes
blunt trauma to chest,malignancy, infection etc
36
Characteristics of cardiac tamponade
decreasing BP, faint heart sounds, low voltage EKG, PEA
37
What causes PEA in cardiac tamponade?
when fluid or blood builds up around in the pericardial cavity, the fibrous pericardium won't expand. Every time heart contracts, it lets more fluid in to the point it can no longer relax, causing normal cardiac activity but no cardiac output
38
From outside to in, what are the layers of the heart itself?
epicardium, myocardium (heart muscle itself), endocardium
39
the epicaridium aka outermost covering of the heart is also what?
visceral layer of serous pericardium
40
endocardium
inside lining of the heart, continuous w/ the endothelium of vessels
41
Base of heart
where the great vessels enter and leave
42
What forms the right border of the heart?
right atrium
43
what forms the left border of the heart?
left ventricle (most of it on posterior side)
44
What separates the 2 ventricles?
interventricular groove
45
What is the lateral border of the heart?
apex
46
What separates the ventricles from the atria?
coronary groove
47
valve from the RA to RV
tricuspid
48
valva from the LA to LV
mitral/bicuspid
49
What are the first 2 branches off the ascending aorta?
coronary arteries
50
Where is the left coronary a. found?
b/w the aorta and left auricle
51
L. coronary branches into?
circumflex and LAD (left anterior descending aka anterior interventricular)
52
LAD continues as?
posterior interventricular a
53
circumflex a. supplies?
wraps around in the coronary sulcus to supply the back side of the heart
54
How do you determine if you are right or left coronary dominant?
if the posterior interventricular branch is made up of mainly left coronary artery branches, you are left coronary artery dominany. (most are right)
55
What is the first branch of the right coronary a. ?
it comes off in front of aorta and branches into nodal branch which supplies the SA node
56
The right coronary a. continues in the coronary sinus to then give off what branch?
right marginal a. which supplies the inferior surface of the heart
57
What arteries anastomose at the back of the heart?
circumflex, LAD and right coronary
58
If there was an MI in the LAD what areas of the heart would be effected?
anterior, septal or lateral
59
If there was an MI in the right coronary a. , what would be effect?
inferior and posterior parts of heart; disturbance of rythm due to SA or AV node involvement
60
What vein drains the front of the heart?
great cardiac vein
61
What vein drains the back of the heart?
middle cardiac vein
62
What vein drains the inferior surface of the heart?
small cardiac vein
63
What are the small veins that drain the right atrium and base of the r. ventricle?
anterior cardiac veins
64
Where do the veins of the heart come together?
in the coronary sinus to drain into the right atrium
65
What major structures are located w/i the r. atrium?
SA node and AV node and fossa ovalis
66
fossa ovalis was what in embryological devpt?
foramen ovalis
67
foramen ovalis
didn't need blood going from r. atrium to l. ventricle so was shunted directly from r atrium to l atrium through foramen ovalis;
68
If foramen ovalis does not close when the cord is clamped, what can persist?
ASD - atrial septal defects; usually in fossa ovalis
69
Describe the anatomy within the right ventricle
cusps of the AV valces are attached to chordae tenineae which are connected to papillary muscles (ant. post. and septal). when atria contract the cusps openand when ventricles contract the papillary muscles contract to prevent regurg
70
rough walls in the ventricles
trabecula carnae
71
What is the muscular bridge w/i the ventricle?
septomarginal trabecula (moderator band)
72
fibrous skeleton
anchors and supports the valves; separates the atrium from ventricles; electrically isolates the atria from ventricles
73
What is the intrinsic automaticity of the heart ?
``` SA = 60 bpm AV = 40 bpm ```
74
What determines the HR?
influence of parasympathetics and sympathetics input into the SA / AV nodes
75
How is the electric impulse sent from the atria to ventricle?
when the impulse hits the AV node (atrial side), it is sent through the fibrous skeleton to the r. and l. bundle branches and release through the purkinje fibers. (want this to happen so the impulse is from the bottom up_
76
Where does the right bundle branch pass through?
the moderator band
77
What are the characteristics of RIGHT heart failure? keep in mind that right side is where venous return is
1. decrease in ability to pump blood through lungs 2. back up of venous return 3. increased jugular venous distension 4. increased dependent pedal edema
78
What are the characteristics of LEFT heart failure?
1. decrese in cardiac output to body 2. results in back up of blood in lungs 3. CHF
79
cor pulmonale
respiratory compromise as a result of cardiac failure
80
Location for auscultation of aortic valve?
right 2nd intercostal space by sternum
81
location for auscultation of pulmonic valve?
left 2nd intercostal space right by sternum
82
location for auscultation of mitral valve?
5th intercostal space
83
location of auscultation of tricuspid valve?
around the base of the sternum
84
sympathetics to heart
chronotropic (increase HR) and inotropic (increase force of contraction) - thus creating myocardial oxygen demand
85
parasympathetics to heart
slow heart rate
86
sympathomimetics
epinephrine, dopamine, meth, crack, energy drinks, adderal, psudophed
87
sympatholytics
proanolol (beta blocker) slows heart
88
parasympathomimetic
vagal stimulation - stimulating parasympathetics slows heart. Ex of vagal maneuvers: gag reflex, val salva, close eyes press on eye ball, mammalian diving reflex

Anatomy Test Block III (5 decks)

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