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pt momints ver 2.0 > Org Ana: Mediastinum and Heart > Flashcards

Org Ana: Mediastinum and Heart Flashcards

1
Q

what is the mediastinum

A

tough and thick movable partition betw sternum and pleural cavities and the vertebrae

divides into superior and inferior through the plane passing sternal angle anteriorly and lower border of T4 body

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2
Q

what are the boundaries of the mediastinum

A

sup - thoracic outlet and root of neck
inf - diaphragm
ant - sternum
post - thoracic vertebrae
lat - pleura

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3
Q

describe the superior mediastinum

A

above the sternal angle

boundaries:
ant - manubrium
post - T1-T4

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4
Q

what are the contents of superior mediastinum

A

thymus gland
large veins
large arteries
trachea
esophagus and thoracic duct

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5
Q

describe the inferior mediastinum

A

below the sternal angle and divides into anterior, middle and posterior

boundary:
ant - body of sternum
post - T5-T12

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6
Q

what are the contents of inferior mediastinum

A

ant: thymus

middle: heart with pericardium and phrenic nerve on sides

post: esophagus and thoracic duct, descending aorta and sympathetic trunks

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7
Q

what is the pericardium

A

fibroserous sac enclosing heart and roots of great vessels

lubricated container and prevent excessive movement

boundaries:
ant - body of sternum
lat - 2nd to 6th CC
post - T5-T8

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8
Q

describe serous pericardium

A

lines fibrous pericardium and coats heart

parietal - inner of fibrous pericardium and reflex around roots of great vessels

visceral - applied to epicardium

parietal continues to become visceral

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9
Q

what is the pericardial cavity

A

space between parietal and visceral that contains 50 ml of pericardial fluid

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10
Q

describe fibrous epicardium

A

strong fibrous outer layer attached to central tendon

fuses w outer coats of great vessels

attaches to sternum via sternopericardial ligament

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11
Q

what is pericarditis

A

inflammation of pericardium bc of excessive fluid that causes compression of the atrium interfering with filling during diastole

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12
Q

what is cardiac tamponade

A

can occur secondary to stab or gsw when chambers are penetrated

compression of heart

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13
Q

describe the heart

A

muscular organ

pyramidal

found in mediastinum

connected at the base to great vessels

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14
Q

describe the orientation of the heart

A

oblique w apex pointing down, forward and left

2/3 midline on left side

LV from apex at 5th ICS 3.5 in away from midline

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15
Q

what is the sternocostal surface of the heart

A

anterior surface formed by RA and RV separated by AV groove or coronary sulcus

anterior interventricular groove separates RV and LV

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16
Q

what is the diaphragmatic surface of the heart

A

inferior surface formed by RV and LV separated by posterior interventricular groove

inferior surface of atrium where IVC opens forms part of this

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17
Q

what is the base surface of the heart

A

posterior surface formed by LA where 4 pulmonary veins open

opposite apex

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18
Q

what are the borders of the heart

A

right - RA
left - left auricle and LV
inferior - RV and portion of RA
apex - LV

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19
Q

discuss the layers of the heart from superficial to deep

A

epicardium - visceral pleura

myocardium - cardiac muscle; contracts

endocardium - endothelium on CT; lines heart and creates valves

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20
Q

explain the fibrous cardiac skeleton

A

made of four interconnected fibrous rings that surround AV, pulmonary and aortic valve orifices

continous w lower part of atrial septum and upper part of ventricular septum

attachment for muscle fibers and support the bases of valve cusps keeping valves patent

electrical insulation betw atria and ventricles

21
Q

compare atria and ventricles

A

atria wall is thin divided by interatrial septum

ventricles have thick walls divided by interventricular septum

22
Q

describe the right atrium

A

primary pump

has main cavity and auricle

recieves O2 poor blood

ventral wall made of rough pectinate muscle

has fossa ovalis on interatrial septum

23
Q

what is sulcus terminalis and crista terminalis

A

sulcus: vertical groove on outside surface at the junction betw RA and auricle

crista: same but on inside surface

24
Q

what are the openings of the RA

A

SVC and IVC
coronary sinus
RV orifice - tricuspid valve

25
Q

describe the RV

A

communicates with RA; recieves O2 poor blood through tricuspid valve and pumps to the pulmonary vein through pulmonary valve

funnel shaped towards pulmonary orifice - infundibulum

26
Q

what are the 3 types of trabeculae carnae of the RV

A

papillary muscle
moderator band
prominent ridges

muscular bundles that form bridges

27
Q

describe the papillary muscles

A

cone shaped muscles where chordae tendinae are attached to connecting to the cusp of tricuspid valve

ant - largest and most constant
post - 1-3 structures from ventricular wall
septal - inconsistent; from septal wall

28
Q

what is the moderator band

A

muscular band forming a bridge connecting ant papillary to interventricular septum

attaches at end of ventricular wall and free in middle

resists over distention of AV wall

also carries part of cardiac conduction system - R AV bundle branch

29
Q

what are the valves found in the right side of the heart

A

R AV valve - betw R atrium and R ventricle

pulmonary valve - betw R ventricle and pulmonary vein
- closed during diastole or ventricular filling

30
Q

describe the LA

A

consists of main cavity and auricle

upper wall - smooth
lower wall - pectinate

recieves O2 rich blood from pulmonary veins

31
Q

describe the LV

A

has the thickest wall and no moderator bands

L AV valve - bicuspid
aortic valve - contains aortic sinus

32
Q

what is the aortic sinus

A

ant aortic sinus - right coronary a.

left posterior sinus - left coronary a.

33
Q

what is the extrinsic nerve supply of the heart

A

sympathetic - upper thoracic spinal segments
- cardiac acceleration and inc force of contraction
- dilation of coronary arteries

parasympathetic - vagus nerve
- reduction in rate and force of contraction
- constriciton of the coronary arteries

34
Q

what is the intrinsic nerve supply of the heart

A

via conducting system of heart

35
Q

where is the SA node located

A

wall of RA betw crista terminalis and SVC

36
Q

where is the AV node located

A

right lower atrial septum

37
Q

where is the AV bundle of his located

A

at the ventricular septum

38
Q

discuss the conducting system sequence

A

SA node - AV node - AV bundle of his - R and bundle branches

R bundle branch - moderator band - purkinje fibers

L bundle branch - ant and post - purkinje plexus

39
Q

what has the highest conduction velocity

A

subendocardial branches or pukinje fibers

4-5 m/s

40
Q

what does the right coronary artery supply to

A

aortic sinus
betw pulmonary trunk and R auricle
RA and most of RV
LV - diaphragmatic surface
posterior third of ventricular septum
SA node - 60%
AV node - 80%

41
Q

describe the right coronary artery

A

descend vertically from ant aortic sinus

42
Q

what are the branches of the right coronary artery

A

right conus - RV

ant ventricular branches - ant RV and apex and costal surface; largest

post ventricular branches - RV and AV node

post interventricular - RV and LV, AV node

atrial - RA and SA node

43
Q

describe the left coronary artery

A

larger; supplies LA, LV and ventricular septum

from left aortic sinus

44
Q

what does the left coronary artery supply

A

LA

LV

RV

ventricular septum - 2/3

SA node - 40%

AV and bundle branches

45
Q

what are the branches of the left coronary artery

A

ant ventricular - RV and LV
- left diagonal
- left conus

circumflex - from ant ventricular
- left marginal - LV to apex
- ant and post ventricular - LV
- atrial - LA

46
Q

explain the venous drainage of the heart

A

most blood drains to RA via coronary sinus

great cardiac vein - left coronary

middle and small cardiac vein - right coronary artery

47
Q

what is myocardial infarction

A

when coronary flow is reduced or stopped = cardiac tissue undergoes necrosis

48
Q

what is angina pectoris

A

cardiac pain on exertion and relieved by rest or nitroglycerin (vasodilates)

pt momints ver 2.0 (14 decks)

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