SM 106a - Heart and Mediastinum Anatomy (Incl. Lab Objectives) Flashcards
(219 cards)
1
Q
Which part of the heart is cut open in this picture?
How do you know?
A
Left ventricle and Left Atrium
Ventricle has thick muscular walls, no opening for coronary sinus to drain into
Left atrium sits on top of left ventricle
2
Q
What structure is labeled by #8?
A
Costal Pleura
3
Q
What structure is labeled by #1?
A
Ascending Aorta
4
Q
Which structure is labeled by #16
A
Right ventricle
5
Q
Which structure is labeled by #13?
A
Pectinate muscles (in the left auricle)
6
Q
Which structure is labeled by #10?
A
Left atrium
7
Q
Which structure is labeled by #7?
A
Opening of inferior vena cava and valve
8
Q
Which of the three major coronary arteries supplies blood to the left ventricle?
A
Front and bottom of LV: Anterior interventricular artery (aka Left anterior descending artery)
Back and side of LV: Circumflex artery
9
Q
Where is the Aortic Semi-Lunar Valve?
Where do you place your stethoscope to listen?
A
Valve: Between the left ventricle and the aorta
Stethoscope: In the second intercostal space to the right of the patient’s sternum
(Circled A)
10
Q
Which structure is labeled by #14?
A
Right coronary artery
11
Q
What is cardiac tamponade?
A
Cardiac tamponade = fluid in the pericardial cavity that compresses the heart
Parietal pericardium has low compliance; increased volume in the sac puts pressure on the heart, rather than expanding the pericardial sac.
12
Q
Describe the pathway of sympathetic innervation of the heart
A
- Presynaptic neuron
- Spinal cord
- Lower cervical or uppor thoracic sympathetic trunk
- Synapse in sympathetic trunk
- Cell body is here in the stellate ganglion
- Postsynaptic neuron
- Sympathetic trunk
- Cardiopulmonary splanchnic nerves
- Plexus at the bifurcation of the trachea
13
Q
What structure is labeled by #12?
A
Right Ventricle
14
Q
What structure is labeled by #9?
A
Left Internal Jugular Vein
15
Q
Which structure is lableled by #7?
A
Right coronary artery
16
Q
Which coronary artery suplies the left atrium?
A
Circumflex artery
17
Q
Why does angina sometimes radiate down a person’s arm?
A
The left ventricle is supplied by nerves from T1
Nerves from T1 also supply the brachial plexus
Therefore, anginal pain can be referred to nerves in the arm
18
Q
Which structure is labeled by #5?
A
Interventricular septum
19
Q
Which structure is labeled by #1?
A
Ligamentum Arteriosum
20
Q
What structure is labeled by #16?
A
Right Brachiocephalic Vein
21
Q
Which part of the lung does the heart interface on the…
Left side?
Right side?
A
Right side = middle lobe of the right lung
Left side = lingula of the upper lobe of the left lung
22
Q
What structure is labeled by G?
A
Left subclavian artery
23
Q
Which structure is labeled by #3?
A
Opening of the left coronary artery
24
Q
List the differences between the left and right ventricles
A
- Smooth top of chamber
- Left is called the aortic vestibule
- Right is called the conus arteriosus
- Left is round with thicker walls
- Right is bellow-shaped with thinner walls
25
Which structure is labeled by #7?
Cusp of bicuspid aka mitral aka left atrioventricular valve
26
Visceral sensory fibers from which spinal segment supply the ventricles?
T1
27
Which structure is labeled by #11?
Anterior cusp of the tricuspid valve (right atrioventricular valve)
28
Which structure is labeled by #9?
Apex of the heart
29
Which structure is labeled by #2?
Crista Terminalis
30
What structure is labeled by #5?
Cervical Pleura
31
What structure is labeled by #1?
Left Phrenic Nerve
32
Describe the general flow of blood into and out of the azygous vein
From left side
* Left posterior intercostal veins
* Hemiazygous vein
* **Azygous vein**
* Superior vena cava
* Must arch over root of the right lung to get here
From right side
* Intercostals drain directly into azygous vein
33
Which structure is labeled by #6?
Right cusp of the aortic semi-lunar valve
34
Which structure is labeled by #1?
Nodule of the posterior cusp of the aortic semi-lunar valve
35
What structure is labeled by #4?
Left Subclavian Artery
36
Which structure is labeled by #4?
Left ventricle
37
Which structure is labeled by #14?
Conus arteriosus
38
Which structure is labeled by #12?
Right atrium
39
Which structure is labeled by #3?
Remnants of foramen ovale
40
Which structure is labeled by #3?
Marginal branch of the right coronary artery
41
What structure is labeled by #15?
Right Vagus Nerve
42
Which structure is labeled by #10?
Chordae tendineae
43
What is the function of the papillary muscles?
Located in the ventricles
Stabilize the AV (tricuspid and bicuspid) valves via chordae tendineae to prevent flaps from swinging into the atrium when the ventricle contracts
44
Which structure is labeled by #13
Right pulmonary veins
45
What is the name of the valve shown in this picture?
What is the name of this valve on the other side of the heart?
Shown (left side): Bicuspid aka Mitral aka Left Atrioventricular Valve
Other (right) side: Tricuspid aka Right Atrioventricular valve
46
Which structure is labeled by #8?
Remnants of the fossa ovalis
47
Describe the structure and function of the atrioventricular valves
* **Structure:**
* Flat cusps that are stabilized by papillary muscles and chordae tendineae
* Right: Tricuspid = 3 flaps
* Left: Bicuspid (mitral) = 2 flaps
* **Function:**
* Prevent backflow into the atrium during ventricular contraction
48
Which blood vessel is cut open in this picture?
How do you know?
The aorta
The pulmonary trunk woudl look similar, but the aorta has openings for the left and right coronary arteries
49
Describe the pathway of visceral sensory innervation of the heart
* Heart
* Cardiopulmonary splanchnic nerves
* Sympathetic trunk
* Joins spinal nerve
* Enters spinal curve via dorsal root
* Cell body is in the dorsal root ganglion
50
What structure is labeled by #10?
Esophagus
51
What structure is labeled by #13?
Right Phrenic Nerve
52
List the differences between the right and left atria
* Right has the crista terminalis
* Contains pace maker tissue
* Right recieves blood from systemic circulation (vena cavae)
* Left receives blood from the pulmonary circulation
53
Which structure is labeled by #5?
Anterior papillary muscle
54
What structure is labeled by B?
Thymus
55
Which structure is labeled by #1?
Right atrial "nodal" branch of the right coronary artery
56
What structure is labeled by #11?
Left Ventricle
57
What structure is labeled by #3?
Right Phrenic Nerve
58
Which structure is labeled by #9?
Left ventricle
59
Which structure is labeled by #11?
Trabeculae carneae
60
What structure is labeled by #3?
Diaphragm
61
What structure is labeled by #7?
Left Subclavian vein
62
Which section of the mediastinum contians the heart?
Middle mediastinum
63
Which structure is labeled by #5
Left atirum
64
What is the coronary sinus?
An endothelial-lined venous channel imbedded in the cardiac muscle in the posterior AV groove
(Not a vein)
65
What structure is labeled by D?
Trachea
66
What is epicardium?
Viscerial pericardium
67
Which structure is lableled by #4?
Great cardiac vein
68
Which structure is labeled by #2?
Pulmonary semi-lunar valve
69
Which structure is labeled by #4
Pulmonary arteries
70
What structure is labeled by C?
Superior vena cava
71
Which structure is labeled by #3?
Aortic arch
72
Which structure is labeled by #6?
Opening of coronary sinus and valve
73
What structure is labeled by #13?
Right Atrium
74
Trace the flow of blood through the heart
1. Enters via superior and inferior vena cavae
2. Right atrium
3. Through tricuspid valve
4. Right ventricle
5. Through pulmonary semi-lunar valve
6. Pulmonary trunk
7. Pulmonary arteries
8. Lungs (Lobes -\> Bronchopulmonary segments)
9. Pulmonary veins
10. Left atrium
11. Bicuspid (mitral) valve
12. Left ventricle
13. Aortic semi-lunar valve
14. Aorta
15. Systemic circulation
75
What is the effect of sympathetic innervation on the hearth/
Increase heart rate by stimulating the SA node
Act on myocardial cells to increase force of contraction
* Increase myocyte metabolism
* Dilate coronary arteries
* Increase blood flow to muscles
*Sympathetic innervation = helps us run away from scary things*
76
What is the effect of parasympathetic innervation on the heart?
Decrease heart rate by inhibiting the SA node
## Footnote
*Parasympathetic = rest and digest*
77
Trace the pathway of the conductive system that regualtes the heart beat
1. SA node = pacemaker
2. Three nodal pathways
3. AV node = backup pacemaker
4. AV bundle (bundle of hiss)
5. Right and left branch bundle (septal branch)
6. Right and left purkinje fibers
7. Right and left ventricular muscle
78
What structure is labeled by #11?
Trachea
79
Where does blood from the coronary sinus drain into?
Right atrium
80
Which structure is labeled by #2
Left inferior pulmonary vein
81
What structure is labeled by #12?
Right Internal Jugular Vein
82
What structure is labeled by #7?
Aortic Arch
83
What structure is labeled by #4?
Serous Visceral Pericardium (Epicardium)
84
What structure is labeled by #7?
Descending Aorta
85
Which structure is labeled by #7 (the space)?
Aortic sinus (there are 3 sinuses shown in this picture)
86
What structure is labeled by #17?
Superior Vena Cava
87
What structure is labeled by B?
Manubrium of the sternum
88
Which structure is lableled by #6?
Right marginal artery and vein
89
Where is the Tricuspid valve?
Where do you place your stethoscope to listen?
Valve: Between the right atrium and the right ventricle
Stethoscope: Left 5th intercostal space
(Circled T)
90
What are the arrows pointing to?
Right (lower arrow) and left (upper arrow) **phrenic nerves**
91
What structure is labeled by I?
Esophagus
92
Which structure is labeled by #10?
Brachocephalic trunk
93
Which structure is labeled by #5?
Circumflex branch of the left coronary artery
94
What is the name of the colored structure as a whole?
Pericardial Sac
95
Which structure is labeled by #9?
Anterior papillary muscle
96
Which ventricle is the right?
Which is the left?
How do you know?
A = Left; thicker walls, round
B = Right; thinner walls, crescent shaped
97
Which structure is the red arrow pointing to?
Pulmonary Trunk
98
What structure is labeled by #8?
Left Phrenic Nerve
99
What structure is labeled by E?
Esophagus
100
Which structure is labeled by #1?
Left superior pulmonary vein
101
List the structures of the heart supplied by the right coronary artery
Posterior of the heart
* Right atrium and ventricle
* Posterior part of the left ventricle (adj. to IV septum)
* Posterior 1/3 of IV septum
* SA and AV nodes (usually)
102
Which structure is labeled by #7?
Membranous interventricular septum
103
Which structure is lableled by #2?
Left coronary artery
104
Which side of the heart is shown in this picture?
How do you know?
Left
The ventricle has a thick muscle layer
105
Which structure is labeled by #13?
Supraventricular crest
106
Which structure is labeled by #8?
Posterior papillary muscles
107
Which coronary artery typically supplies the SA and AV nodes?
Right coronary artery
108
What structure is labeled by D?
Left brachiocephalic vein
109
Which structure is labeled by #6?
Anterior interventricular branch of the left coronary artery
110
Which structure is labeled by #8?
Posterior papillary muscle
111
Which structure is labeled by #4?
Posterior papillary muscle
112
Which structure is labeled by #7?
Circumflex artery
113
What does the left coronary artery divide into?
Circumflex artery & Left anterior descending artery
114
Which structure is labeled by #11
Superior vena cava
115
Which structure is labeled by #2?
Posterior cusp of the mitral valve
116
Which structure is labeled by #7?
Septomarginal trabecula (aka moderator band)
117
Which structure is labeled by #3
Coronary sinus
118
What structure is labeled by A?
Body of the sternum
119
Which structure is lableled by #5?
Anterior interventricular artery
| (Left anterior descending artery)
120
Which chamber is labeled by #1?
Left atrium
121
What structure is labeled by #3?
Left Recurrent Laryngeal Nerve
122
What structure is labeled by #5?
Diaphragm
123
What structure is labeled by #6?
Intercostal Muscles
124
What structure is labeled by #2?
Superior Vena Cava
125
Which structure is lableled by #1?
Left auricle
126
What structure is labeled by #9?
Greater Splanchnic Nerve
127
What structure is labeled by #1?
Serous Parietal Pericardium
128
What structure is labeled by #13?
Right Vagus Nerve
129
Which structure is labeled by #6?
Muscular interventricular septum
130
Wich structure is supplied by #8?
Sinoatrial node
131
Which structure is labeled by #1?
Right auricle
132
What structure is labeled by #14?
Right Subclavian Vein
133
What structure is labeled by #3?
Left Common Carotid Artery
134
List the layers of the pericardium from outermost to innermost
From outermost to innermost:
1. Fibrous parietal pericardium
2. Serous parietal pericardium
3. Visceral pericardium (aka epicardium)
135
Which structure is labeled by #4?
Right ventricle
136
What is the function of the coronary sinus?
Drains blood from most of the heart to the right atrium
137
What structure is labeled by #6?
Superior Vena Cava
138
What structure is labeled by #11?
Splanchnic Nerves
139
Which structure is labeled by #10?
Chordae tendineae
140
Which structure is labeled by #4
Left pulmonary artery
141
Which structure is labeled by #3?
Pectinate muscles
142
What structure is labeled by #4?
Pericardial Sac
143
What structure is labeled by #6?
Ligamentum Arteriosum
144
In a posterior-anterior x-ray, pneumonia in which lung lobe would obscure the right margin of the heart?
Which structure of the heart would be ill-defined?
Middle right lobe
This would make it difficult to define the right atrium
145
Which structure is labeled by #6?
Trabeculae carneae
| (muscle columns)
146
Which structure is labeled by #8?
Interatrial septum
147
Which structure is labeled by #6
Left pumonary veins
148
Where is the Bicuspid Valve??
Where do you place your stethoscope to listen?
Valve: Between the left atrium and the left ventricle
Stethoscope: Left 5th intercostal space near the mid clavicular line
(Circled M)
149
What structure is labeled by #4?
Left Vagus Nerve
150
Which structure is labeled by #1?
Right pulmonary artery
151
Which structure is labeled by #4?
Left cusp of the aortic semi-lunar valve
152
Which structure is lableled by #3?
Circumflex artery
153
Which structure is labeled by #3?
Chordae tendineae
154
What structure is labeled by #2?
Ligamentum Arteriosum
155
List the structures of the heart supplied by the left coronary artery
Anterior of the heart
* Left atrium and ventricle
* Anterior part of the right ventricle (adj. to IV septum)
* AV bundle branches in the IV septum
156
What structure is labeled by #10?
Left Atrium
157
What structure is labeled by #9?
Pulmonary Trunk
158
Which structure is labeled by #15?
Left pulmonary artery
159
What structure is labeled by #14?
Superior Vena Cava
160
What structure is labeled by A?
Thymus
161
Describe the composition of each layer of pericaridum
Parietal pericardium
* Fibrous parietal pericardium = outermost layer
* Dense connective tissue
* Protects the serous parietal pericardium
* Serous parietal pericardium
* Fused to the fibrous parietal pericardium
* Interfaces with the visceral pericardium
* Simple cuboidal epithelium
Visceral pericardium aka epicardium
* Attached to the heart
* Simple cuboidal epithelium
162
What structure is labeled by C?
Right brachiocephalic vein
163
Which structure is labeled by #5
Inferior vena cava
164
Which structure is labeled by #2?
Left auricle
165
Which structure is labeled by #7?
Posterior interventricular branch of the right\* coronary artery
**\***Usually the right coronary artery suppolies the posterior interventricular artery = **right dominance**
If the left coronary artery supplies, it is called **left dominance**
166
What structure is labeled by #6?
Left Brachiocephalic Vein
167
Which part of the heart is cut open in this image?
Right ventricle
168
Describe the pathway of parasympathetic innervation to the heart
* Pre synaptic neuron
* Vagus nerve
* Synapse
* Plexus on the bifurcation of the trachea
* Post synaptic neuron
* Begins after synapse (very short neuron)
169
An atherosclerotic occlusion in which artery will affect the function of the AV bundle branches?
The anterior interventricular branch of the left coronary artery
170
What structure is labeled by #12?
Sympathetic Trunk aka Sympathetic Chain
| (specifically a ganglion)
171
Which structure is labeled by #2?
Left subclavian artery
172
Which cardiac chamber has the greatest muscle mass?
Left ventricle
173
Which structure is labeled by #3?
Sepatal papillary muscle
174
What structure is labeled by #5?
Fibrous Pericardium
175
What structure is labeled by #10?
Esophagus
176
What is the AV node?
What does it do?
A secondary conduction site for electrical signals through the heart
Normally, signal goes from SA node -\> AV node -\> rest of heat
If the SA node isn't working, the AV node and purkinje fibers together can generate a beat, but it is slower.
177
Which structure is labeled by #2?
Lunule of the posterior cusp of the aortic semi-lunar valve
178
Which structure is labeled by #5?
Right atrioventricular valve + orifice
179
What is the azygous vein?
Where is it located?
A vein located on the right side of the body that delivers blood to the superior vena cava
180
Where in the body is the crista terminalis found?
Right atrium of the heart
181
What is the SA node?
The pacemaker that initiates heartbeat **without** any other stimulation
(Sympathetic and parasympathetic influence can **alter** the heart beat)
182
What is #14 called in the left ventricle?
The aortic vestibule
183
What structure is labeled by H?
Trachea
184
A tumor near the root of the left lung would compress which major vessel in the mediastinum?
The arch of the aorta
185
Describe the structure and function of the semi-lunar valves
* **Structure**
* Each valve has 3 half-moon shaped cusps
* Blood-filled sinuses between the valve cusps and arterial walls prevent sticking
* Aortic semi-lunar valve
* Cusps: Left, Right, Posterior (non-coronary)
* Left and Right = origins of left and right coronary arteries respectively
* Pulmonary semi-lunar valve
* Cusps: Left, Right, Anterior
* **Function**
* Prevent backflow from artery to ventricle after systole
186
What does the septomarginal trabecula (moderator band) do?
Carries part of the right bundle branch to the anterior papillary muscles. This is important for electrical conduction throught the heart
187
What structure is labeled by J?
Thoracic Duct
188
What structure is labeled by F?
Left common carotic artery
189
Which structure is labeled by #9?
Anterior cusp of the mitral valve
190
What structure is labeled by #1?
Trachea
191
Which structure is labeled by #6?
Inferior vena cava
192
Which structure is labeled by #4?
Left atrium
(Interarterial septum separates left and right atrium)
193
Heart muscle ischemia near which structure will impair the initiation of a normal heartbeat?
Superior vena cava
194
Which structure is labeled by #4?
Left coronary artery
195
What structure is labeled by #5?
Aortic Arch
196
What is the stellate ganglion?
Where is it?
Sympathetic trunk
A large, star-shaped ganglion that supplies the heart and lungs
197
Which organs do not have anastomosis?
Why is this significant?
End organs have no anastomosis
Ex: Renal arteries, central artery to retina of the eye
If the arteries reaching these organs are occluded, blood flow will stop; there is no backup
198
Which structure is labeled by #9?
Interatrial septum
199
What structures are supplied by the right coronary artery?
Right atrium
Right ventricle
Bottom portion of the left ventricle (near the apex)
Back of the Interventricular septum
200
Which structure is the green arrow pointing to?
Superior Vena Cava
201
What structure is labeled by #2?
Mediastinal Pleura
202
Which structure is labeled by #12?
Anterior papillary muscles
203
What structure is labeled by F?
Arch of the Aorta
204
What structure is labeled by #7?
Neurovascular Bundle
| (contains intercostal vein, intercostal artery, intercostal nerve)
205
Which structure is labeled by #12?
Right atrium
206
Which structure is labeled by #14?
Pulmonary trunk
207
Which structure is the blue arrow pointing to?
Aorta
208
What structure is labeled by E?
Brachiocephalic trunk
209
Which structure is labeled by #8
Coronary sinus
210
Failure of which valve will cause pooling in the left atrium?
The bicuspid (mitral) valve
211
What physiological feature provides collateral circulation if one artery is occluded?
Anastomosis
212
Which structure is labeled by #5?
Posterior cusp of the aortic semi-lunar valve
213
Where is the Pulmonary Semi-Lunar Valve?
Where do you place your stethoscope to listen?
Valve: Between the right ventricle and the pulmonary trunk
Stethoscope: In the second intercostal space to the left of the patient's sternum
(Circled P)
214
What structure is labeled by #2?
Brachiocephalic Trunk
215
What is anastamosis?
What is its significance?
End to end joining of the branches of 2 distinct vessels
It allows blood to reach an area even if one of the vessels is occluded
216
Which structure is labeled by #1
Left common carotid artery
217
Which structure is labeled by #2?
Right coronary artery
218
What structure is labeled by #8?
Left Pulmonary Artery
219
Which structure is labeled by #15?
Right posterior interventricular artery
