Mediastinum Heart & lungs Flashcards
(61 cards)
1
Q
The descending (thoracic) aorta passes ____ to the left main bronchus.
A
posterior
2
Q
The descending (thoracic) aorta is positioned _____ to the pericardial sac.
A
posterior
3
Q
The descending (thoracic) aorta is positioned to the ____ of the vertebral bodies
A
left(lateral)
4
Q
The superior vena cava is positioned ____ to the ascending aorta
A
lateral (right)
5
Q
- The inferior vena cava is positioned _____ the descending aorta
A
to the right of
6
Q
- The arch of the aorta passes _____ to the pulmonary trunk
A
superior
7
Q
- The left vagus nerve passes directly ____ to the arch of the aorta
A
lateral
8
Q
- The left recurrent laryngeal nerve passes _____ to the ligamentum arteriosum
A
posterior
9
Q
- The left recurrent laryngeal nerve passes directly ______ to the arch of the aorta.
A
inferior
10
Q
- The azygos vein (arch) passes _____ to the right main bronchus
A
superior
11
Q
- The left vagus nerve passes _____ to the left main bronchus
A
posterior
12
Q
- The right vagus nerve is positioned _____ to the trachea.
A
lateral
13
Q
- The right vagus nerve passes _____ to the arch of the azygos vein and posterior to the right main bronchus.
A
medial
14
Q
- At the hilum of the left lung, the pulmonary artery is positioned _____ to the main bronchus.
A
superior
15
Q
- At the hilum of the left lung, the pulmonary veins are positioned _____ and _____ to the main bronchus.
A
anterior, inferior
16
Q
- At the hilum of the right lung, the pulmonary artery is positioned ____ to the main bronchus.
A
anterior
17
Q
- At the hilum of the right lung, the pulmonary veins are positioned ____ to the main bronchus.
A
anterior
18
Q
- At the hilum of the right lung, the pulmonary veins are positioned ___ and _____ to the pulmonary arteries.
A
anterior, inferior
19
Q
- The descending (thoracic) aorta passes ___ to the left main bronchus
A
posterior
20
Q
- The descending (thoracic) aorta is positioned ______ to the pericardial sac.
A
posterior
21
Q
- The descending (thoracic) aorta is positioned to the _____of the vertebral bodies
A
left (lateral)
22
Q
- The esophagus is positioned ______ to the trachea.
A
posterior
23
Q
- The esophagus passes ______ to the left main bronchus
A
posterior
24
Q
- The esophagus is positioned ______ to the pericardial sac
A
posterior
25
4. The right vagus nerve is positioned ____ to the trachea.
lateral
26
5. The right vagus nerve passes ____ to the azygos vein and ____ to the right main bronchus.
medial, posterior
27
6. The left vagus nerve passes directly _____ to the arch of the aorta.
lateral
28
7. The left vagus nerve passes _____ to the left main bronchus
posterior
29
8. The azygos vein passes _____ to the right main bronchus.
superior
30
9. The thoracic duct is positioned directly _____ to the thoracic vertebral bodies.
anterior
31
10. The right posterior intercostal arteries pass _____ to the vertebral bodies.
anterior
32
11. The sympathetic chain is positioned _____ to the thoracic vertebral bodies
lateral
33
12. The greater splanchnic nerve is positioned ____ to the sympathetic chain.
anterior-medial
34
L Lung features
lingula
superior + inferior lobes
apex
oblique fissure
35
R lung features
superior + inferior + middle lobe
apex
oblique fissure
horizontal fissure
36
What is included in the R lung medial surface?
Super vena cava
Espohagous
azygous vein
heart
37
What is included in the L lung medial surface?
```
aortic arch
thoracic aorta
esophagus
heart
lingula
```
38
Describe the L lung root
includes: pulmonary arteries, pulmonary veins, bronchi
The pulmonary artery is superior to the primary bronchus
39
Describe the R lung root
The pulmonary artery is anterior to the primary bronchus
40
What are the layers of pericardium? From superficial to deep
```
superficial: fibrous pericardium
parietal pericardium
visceral pericardium
myocardium
deep: endocardium
```
41
What are the surface features of the heart?
```
Ascending aorta
ligamentum arteriosum
pulmonary trunk
left auricle
pericardium
anterior interventricular sulcus
cardiac apex
inferior vena cava
right ventricle
coronary sulcus
right atrium
right auricle
superior vena cava
pulmonary veins
coronary sinus
left atrium, ventricle, auricle
arch of aorta
```
42
What are the internal features of the heart? Right ventricle
```
valve of pulmonary trunk
septal papillary muscle
anterior papillary muscle
posterior papillary muscle
septomarginal trabecula
interventricular septum
trabeculae carneae
right AV valve(tricuspid vale)
supraventricular crest
conus arteriosus
```
43
What are the internal features of the heart? left atrium and ventricle
```
pecintate muscles
anterior papillary muscle
posterior papillary muscle
trabeculae carneare
chordae tendinae
left AV valve (bicuspid)
left auricle
left superior pulmonary v
valve of forman ovale
interatrial septum
```
44
What are the cardiac auscultation sites?
- valves can be assesed by taking advantage of the fact that blood carries sound in the direction of flow
- sites are located superficial to the vector blood follows as it passes through each chamber/vessel
- intercostal spaces
- 2nd intercostal for semilunar
- 5th intercostal space for AV valves
45
Explain blood flow through the heart
1. SVC and IVC > R atrium
2. through tricuspid valve > R ventricle
3. through pulmonary valve >pulmonary trunk
4. then, > pulmonary arteries > lung
5. oxynegated in the lungs
6. pulmonary veins > L atrium
7. through the mitral valve, > L ventricle
8. through the aortic valve, > ascending aorta, > arch of aorta, > throacic aorta
46
Explain the conduction system of the heart
- the heart has specifically developed cells that have lost their contractile proteins, but effective in transmitting electrical signals
- they are interconnected cardiac cells
47
Explain cardiac referred pain
-someone having a heart attack- they are having cardiac/myocardium stimulus but they are telling you that they have pain in their skin
- pain also comes from viscera
- pain receptors in myocardium, visceral afferent axons, cell bodies in DRG, shared with general somatic axons, brain interprets pain from skin
-usually in L pec, shoulder, medial UE
48
Describe fetal circulation
- lungs are not fully developed, no respiration is happening
- pulmonary circulation can be bypassed to a large extent
- Ductus arteriosus>ligamentum arteriosum (pulmonary trunk to arch of aorta)
- Foramen Ovale> fossa ovalis (Right to left atrium)
- post birth, you will have closure of these structures that were formally patent
49
Explain the arrangement between chordae tendineae and the valves of the heart
the atrioventricular valves (aka tricuspid and bicuspid) are the valves that go from the atria to the ventricles. The cordinae tendineae attach from the flaps of the valves and anchor to the papillary muscles in the ventricles. When blood flows through the valves, the pressure causes the flaps to shut and the cordinae tendinae/papillary muscles seal the valves shut by not allowing the flaps to reverse back into the atria
50
What are the internal features of the R atrium?
```
SVC
interatrial septum
fossa ovalis
pectinate muscles
crista terminalis
right auricle
```
51
what are the internal features of the R ventricle?
```
conus arteriosus
supraventricular crest
tricuspid valve
chordae tendinae
anterior, posterior, septal papillary muscles
interventricular septum
trabeculae carneae
valve of pulmonary trunk
pectinate
```
52
What are the left atrium internal features?
left auricle
left superior pulmonary v
valve of foramen ovale
interatrial septum
53
what are the internal features of the L ventricle?
```
pecintate muscles
anterior and posterior papillary muscles
Bicuspid valve
trabeculae carneae
chordae tendineae
```
54
What structures are found in the superior mediastinum?
organs: thymus, trachea, esophagus
Arteries: aortic arch, brachiocephalic trunk, left common carotid artery, left subclavian artery
Veins and lymphatics: superior vena cava, brachiocephalic veins, the arch of the azygos, thoracic duct
Nerves: left and right vagus, recurrent laryngeal, cardiac, left and right phrenic nerves
55
What structures are found in the anterior mediastinum?
Organs: thymus
Arteries: internal thoracic branches
Veins and lymphatics: internal thoracic branches, parasternal lymph nodes
Nerves: none
56
What structures are found in the middle mediastinum?
Organs: the heart and its great vessel roots, trachea and main bronchi
Arteries: ascending aorta, pulmonary trunk, pericardiacophrenic arteries
Veins and lymphatics: superior vena cava, pulmonary veins, pericardiacophrenic veins
Nerves: phrenic, vagus, sympathetics
57
What structures are found in the posterior mediastinum?
Organs: esophagus
Arteries: descending thoracic aorta
Veins and lymphatics: azygos hemiazygos veins, thoracic duct
Nerves: vagus, splanchnic, sympathetic chain
58
Why is the anterior interventricular (LAD) so important?
it is the largest artery of the heart
- serves largest amount of cardiac tissue
- w/blockage= loss of cardiac tissue
59
Describe the pleural coverings of the lungs
parietal=outer
visceral=inner
the pleural coverings are a serrous membrane
60
Describe the regions of the pleural coverings
superior aspect= cervical
most extensive portion= costal part that wraps from posterior to lateral+anterior
diaphragmatic= overlying diaphragm
most medially= mediastinal part
61
Describe the parietal pleura recesses
recesses are the site of fluid accumulation, maybe seen from infection. they are where parts of the parietal pleura take a change in direction
- Costomediastinal= costal pleura transitioning into mediastinal
- costodiaphragmatic= costal pleura transitioning into diaphragmatic
