Quiz 3- Autonomic nervous system, Mediastinum, Heart, Cardiac Embryology Flashcards
(117 cards)
1
Q
how would you classify all neurons within the ANS? (afferent/efferent/visceral/somatic
A
all visceral efferent
2
Q
describe the make up of a nerve
A
epineurium- surrounds the outside of the nerve. fasicles- a bundle of axons bound together by perineurium within a nerve. endoneurium is found between individual neurons within the nerve
3
Q
where are the cell bodies of the somatic afferent nerves?
A
PNS- pseudounipolar
4
Q
where are the cell bodies of the visceral afferent nerves?
A
PNS- pseudounipolar
5
Q
where are the cell bodies of the somatic efferent nerves
A
CNS- multipolar
6
Q
where are the cell bodies of the visceral efferent nerves?
A
CNS and PNS. it is a two neuron chain. multipolar
7
Q
where are the cell bodies of sympathetic nerves located?
A
T1-L2/3
8
Q
where are cell bodies of the parasympathetic nerves?
A
brainstem and s2-s4
9
Q
compare the post ganglionic fibers of sympathetic and parasympathetic nerves
A
parasympathetic nerves synapse much closer to the target organ and thus have much smaller sympathetic neurons
10
Q
what structures does the visceral efferent system innervate?
A
smooth muscles of organs, smooth muscle of blood vessels, cardiac muscles, glands, arrector pili muscles
11
Q
list effects of the sympathetic nervous system
A
increase heart rate, dilated pupils, increased sweating, dilating bronchial tree, diverting blood to skeletal muscles
12
Q
what is the thorcolumbar division
A
another name for the sympathetic nervous system d/t the fact that it starts from t1-l2/3
13
Q
what 2 places do you find post ganglionic cell bodies of sympathetic nerves
A
sympathetic chain ganglia and prevertebral ganglia (associated with plexuses in the abdomen and pelvis
14
Q
how far does the sympathetic chain extend?
A
base of the brain to the coccyx
15
Q
what is the name of the structures that connects the sympathetic chain to the spinal nerves?
A
rami communicantes
16
Q
difference between white and gray rami communicantes
A
white- neurons entering the sympathetic chain/ grey- neurons exiting the sympathetic chain
17
Q
how often are ganglia found in the sympathetic chain? what are the exceptions?
A
one associated with each vertebrae. the exception is in the cervical vertebrae. these have merged to form the superior, middle and inferior cervical ganglia.
18
Q
which is closer to the spinal cord: the white or gray communicantes?
A
gray
19
Q
describe how sympathetic nerves enter the head
A
travel up to the superior sympathetic ganglia, synapse, leave on the internal and external carotid nerves running alongside major vessels
20
Q
where do the sympathetic nerves that innervate the heart originate? where do they leave the sympathetic chain?
A
they originate in the t1-t4, and while some leave from the t1-t4 cardiac nerves, some also travel up to cervical vertebrae and leave from there.
21
Q
describe the splanchnic nerves
A
they collectively innervate the abdominopelvic cavity. they arise from anywhere from t5-L2 and do not synapse in the sympathetic chain but rather in the prevertebral ganglia
22
Q
describe parasympathetic effects on the body
A
decreasing the heart rate, constricting the pupils, constricting the bronchial tree, increasing peristalsis, increasing secretion of digestion enzymes
23
Q
what is the craniosacral division?
A
parasympathetic nervous system
24
Q
where are the preganglionic cell bodies found in the parasympathetic nervous system?
A
brainstem and sarcral spinal cord
25
are cranial/pelvic splanchnic pre or post ganglionic?
pre
26
which cranial nerves are parasympathetic?
3 7 9 10
27
what are the borders of the mediastinum?
superior thoracic aperture; sternum, diaphragm, thoracic vertebrae, lungs
28
describe how the pericardium is used to segment the mediastinum
the top of the pericardium divides the mediastinum into superior and inferior sections along the transverse thoracic plane. posterior to the pericardium is the posterior mediastinum, inside the pericardium is the middle mediastinum, and anterior to the pericardium is the anterior mediastinum
29
where is the thymus? what does it do?
anterior to the pericardium. it is especially active during childhood developing the immune system (t-cells) and is replaced by fat in adults
30
describe the pericardium
the fibrous pericardium surrounds the outside of the parietal pericardium. it is rigid and continuous with the tunica adventitia of the great vessels. the parietal and visceral serous membranes create a potential space called the pericardial cavity
31
describe the 3 layers of the heart
epicardium- visceral membrane; myocardium- heart muscle; endocardium- internal lining of the heart
32
what are the great vessels?
IVC, SVC, aorta (ascending and descending), pulmonary trunk
33
describe the vasculature converging on the SVC starting with the subclavian vein
the left and right subclavian veins merge with the internal jugular veins to form the brachiocephalic veins. The brachiocephalic veins merge to form the SVC
34
where does the IVC enter the diaphragm?
t8
35
what defines the ascending aorta, descending aorta, and aortic arch?
transverse thoracic plane (top of the pericardium)
36
describe the vasculature that extends off the aortic arch
the first branch is the brachiocephalic trunk, which then splits to the left (subclavian artery) and right (right common carotid). the next branch from the aorta is the left common carotid, followed by the left subclavian artery
37
what branches off the descending aorta?
bronchial arteries, esophogeal arteries, and posterior intercostal arteries
38
at what level does the aorta pass through the diaphragm?
t12
39
distinguish between the ligamentum arteriosum and the ductus arteriosus
ductus arterious is a shunt in the developing heart that moves blood from pulmonary trunk to the descending aorta
40
at what level does the trachea bifurcate?
t4/t5
41
where are the tracheobronchial and paratracheal nodes?
tracheobroncial- at bifurcation. paratracheal- along the lateral aspect of the trachea
42
where is the esophagus located and where does it exit the diaphragm?
posterior to trachea and t10
43
describe the azygous venous system
receives drainage from the thoracic wall and from viscera. travels along the right anterolateral surface of the vertebral column. hemizygous and accessory hemizygous run parallel on the left anterolateral surface. can form an anastomosis w/ superior vena cava
44
cisterna chyli
a dilatoin in the upper abdomen that becomes the thoracic duct
45
thoracic duct
travels left of the azygous and right of the thoracic aorta through the thorax and merges with the venous system at the junction between the left internal jugular and left subclavian vein
46
what do cardiac nerves innervate?
the heart AND the thorax (post ganglionic)
47
where do visceral nerves go in the mediastinum?
the cardiac, pulmonary, and esophageal plexii
48
describe the thoracic splanchnic nerves
greater t5-9, lesser t10-11, and lease splanchnic nerves t12
49
what is the origin of the phrenic nerves and what do they innvervate
c3-c5. travel anterior to pericardium. the are somatic efferent nerves on the diaphragm, and somatic afferent for central diaphragm, fibrous and parietal pericardium, mediastinal and diaphragmatic pleura
50
what are the preicardiacophrenic vessels?
travel with the phrenic nerve and provide blood to ther pericadium and diaphragm
51
describe the path of the vagus nerve
left- travels down along the aorta and posterior to the root of the lung. right- down side of trachea (still posterior to lung). left vagus enters esophogeal plexus anteriorly, right enters posteriorly
52
what are the efferent effects of the vagus nerve?
decrease heart rate, constrict bronchial tree, stimulate GI
53
what are the afferent effects of the vagus nerves?
sense stretch in lungs, pain from heart, and participate in visceral reflexes
54
anterior and posterior vagal trunks
after traveling through the esophogeal plexus, the nerves reassemble and travel with the esophogus
55
left recurrent laryngeal nerve
branches off vagal nerve around aortic arch and ascends back through aortopulmonary window posterior to ligamentum arteriosus to innvervate larynx muscles
56
list the openings to the right atrium
IVC, SVC, coronary sinus, tricuspid valve
57
list the features inside the right atrium
pectinate muscles- along the anterior wall; crista terminalis- separation between smooth wall and pectinate muscles; fossa ovalis- remnant of foramen ovalis in fetal heart
58
what valve separates the RA and RV
tricuspid
59
list the features of the right ventricle
trabecular carnae- "web" along the wall; papillary muscles- hold the valve; chordae tendineae- connect papillary muscle to valve; conus arteriosus- smooth wall leading to pulmonary valve; moderator (septomarginal trabecula)- band w/ purkinje fibers attaching ventricular septum to ventricular wall
60
which valves are semilunar?/
pulmonary and aortic
61
list the features of the left atrium
pectinate muscles- only found in the left auricle; valve of the foramen ovale- indentation on atrial septum remnant of foramen ovale in fetus
62
which valve separates the left atrium and left ventricle
mitral (bicuspid)
63
list features of the left ventricle
trabeculae carneae- "web" along walls; papillary muscles- holds the valves; chordae tendineae- tendons attaching papillary muscles to valves
64
where are the base and apex of the heart?
apex- anteroinferior point of LV. base- superior posterior of atria
65
where is the apex located relative to the ribs?
5th intercostal space
66
what makes up the anterior surface of the heart and what is it adjacent to?
right ventricle. sternum and costal cartilage
67
what makes up the posterior surface of the heart and what is it adjacent to?
left atrium (and part of the right atrium)
68
what makes up the right lateral surface of the heart
right atrium. adjacent to right lung
69
what makes up the left lateral surface of the heart
left ventricle and left auricle adjacent to left lung
70
what makes up inferior surface of the heart
adjacent to diaphragm, left and right ventricles
71
what are the two main branches of the coronary arterial circulation?
left and right coronary arteries
72
what are the major branches of the right coronary artery?
sinoatrial branch (SA node). marginal artery (runs down right border). posterior interventricular artery (runs down interventricular groove of the back of the heart)
73
what are the major branches of the left coronary artery
circumflex (loops around posteriorly); left anterior descending (down interventricular groove)
74
what is the coronary sinus?
where almost all coronary blood drains to. found in the posterior heart and drains into right atrium.
75
great cardiac vein
originate near apex and runs up anterior interventricular sulcus, posteriorly through the coronary sulcus and into the coronary sinus
76
middle cardiac vein
runs up w/ posterior interventricular artery in posterior interventricular sulcus
77
small cardiac vein
travels with the marginal artery
78
what is different about small anterior cardiac veins?
the drain directly into the atrium w/o going through the coronary sinus
79
what is the point of maximum impulse
point on the chest wall closest to the heart during systole. usually apex and found at 5th intercostal at midclavicular line
80
describe cardiac conduction
SA node- atrial myocardium- AV node- AV bundle of his (thru membranous interventricular septum)- atrioventricular branch bundles- purkinje fibres
81
what can happen if coronary conduction is impeded
desynchronization of atrial and ventricular contraciton
82
cardiac plexus
found on the aortic arch and anterior tracheal bifrication recieves afferent signals from heart and sends efferent signals
83
cardiac nerves
sympathetic innervation of heart. originates from t1-5. some travel up to cervical level in sympathetic chain. ally synapse in ganglia and leave directly (not via GRC).
84
what do cardiac nerves do on the heart
increase heart rate and contractility
85
describe visceral afferent cardiac signals and how they travel
pain travel afferently along with cardiac nerves. usually d/t ischemia. reflexes also travel afferently from heart w/ information changing blood pressure. these travel via vagus
86
describe referred pain
pain from visceral heart mixes with afferent fibers from t1-4 dermatomes and gets misinterpreted as pain in arm/chest
87
what germ layer does the heart form from?
lateral plate mesoderm
88
what are the first cells that differentiate into precursor heart cells called? what do they separate to form?
angiogenic clusters form two tubes- endocardial tubes and dorsal aortae
89
where are the endocardial tubes relative to the dorsal aortae
endocardial are lateral. dorsal aortae are medial
90
how does lateral folding affect the developing heart?
it folds the endocardial tubes together so they fuse into one
91
do the endocardial tubes fuse completely?
no- remain separate at the caudal end (primitive sinus venosus)
92
at what day do the endocardial tubes fuse?
20
93
how does longitudinal folding affect developing heart?
forces the endocardial tubes into the thoracic region. move the heart so that it is cranial to the septum transversum
94
where is the pericardial cavity relative to the developing heart?
ventral
95
describe the heart tube at approximately 20 days of development from caudal to cranial
sinus venosus (left and right)- primaitive atrium- atrialventricular sulcus- primitive ventricle- interventricular sulcus- bulbus cordis- outflow through dorsal aortae
96
transverse pericardial sinus
passage between inflow and outflow of heart
97
describe the anatomy of the heart by day 25
growth, combined with the rigid cranial and caudal ends, has folded the heart so that the sinus venosus is on the right side, along with the prima\itive atrium and ventricle. the bulbus cordis is now anterior and right. new structures have developed cranial to the bulbus cordis- the conus cordis and truncus arteriosus
98
what 4 things must happen for the separation of the heart into right and left tracts
1.. shifting of the AV valve 2. partitioning of atrium 3. partitioning of ventricle and bulbis cordis 4. division of the outflow tracts
99
describe the shifting of the AV valve
there is a valve between the primitive atrium and primitive ventricle. it needs to shift right, so that is half in the primitive ventricle and half in the bulbus cordis. when the endocardial cushions form the interventricular septum, the AV valve will split into the primitive tricuspid and mitral valves
100
describe the partitioning of the atria
septum primum (more left) grows down to meet endocardial cushions from ventricles. it does not close entirely at first and this is the ostium primum. As the ostium primum is closing, the septum secundum forms and grows inferiorly. it naturally leaves a hole called the foramen ovalis. the ostium secundum forms via cell death in the septum primum.
101
describe the partitioning of the ventricle
the muscular portion is made of muscular tissue from the wall growing superiorly to the endcardial cushions. the membranous part of the septum is formed via the downgrowth of the endocardial cushions and aorticopulmonary septum.
102
describe the division of the outflow tracts
the left and right trunconal ridges grow from the conus cordis and the truncus arteriosus to fuse with the endcoardial cushions and muscular interventricular septum. develops in a twist
103
the pulmonary trunk is what and what of the aorta?
right and anterior
104
is the ascending aorta in front of or behind the right pulmonary artery? what about the descending aorta and the left pulmonary artery?
posterior; anterior
105
what is the difference between the cardinal, vitelline, and umbilical veins?
cardinal- drain blood from body; vitelline- drains yolk sac and gut tube; umbilical- oxygenated blood from mom
106
what forms the SVC and IVC
right sinus venosus
107
what are the 3 shunts in the fetus?
ductus arteriosus- pulmonary trunk to descending aorta; ductus venosus- umbilical vein to IVC, bypassing liver; foramen ovale- right atrium to left atrium
108
2 big changes to the pressure and circulation after birth
left side becomes high pressure and pulmonary and systemic circulation are separated
109
what happens to the 3 fetal shunts after birth?
foramen ovale is closed by the high pressure left heart, followed by fusion of the tissue to form the fossa ovalis. the ductus arteriosus closes to form the ligamentum arteriosum. the ductus venosus closes to form the ligamentum venosum
110
what happens to the umbilical vessels?
form the medial umbilical ligaments (arteries) and ligamentum teres hepatis (umbilical veins)
111
dextrocardia
the heart folds to the right instead, causing organs to develop on the opposite side of normal
112
atrial septal defect
abnormality of septum between l and r atria - patent foramen ovale
113
vententricular septal defect
most common in the membranous portion of the septum
114
transposition of great vessels
aorta rises from right ventricle and pulmonary trunk from left ventricle
115
patent ductus arteriosus
ligamentum arteriosum does not form
116
coartation of the aorta
severe constriction of the aorta near ductus arteriosus- usually post ductus arteriosus
117
tetralogy of fallot
1. VSD 2. pulmonic stenosis 3. over-riding aorta- aortic valve is not restricted by left ventricle 4. right ventricle hypertrophy
