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superior anterior and posterior medisatina Flashcards

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1
Q

What is mediastinum?

A

The mediastinum is the central compartment located in the thoracic cavity.

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2
Q

How many divisions and parts does the mediastinum have?

A

The mediastinum has two divisions but four parts: superior (anterior, middle, posterior) and inferior.

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3
Q

What is the boundary between the superior and inferior divisions of the mediastinum?

A

The boundary between the superior and inferior divisions of the mediastinum is the T4/5 transthoracic plane or sternal angle.

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4
Q

What are the superior and inferior boundaries of the mediastinum?

A

The superior boundary of the mediastinum is the superior thoracic aperture, while the inferior boundary is the diaphragm.

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5
Q

What are the lateral boundaries of the mediastinum?

A

The lateral boundaries of the mediastinum are the pulmonary cavities.

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6
Q

What are the boundaries of the middle mediastinum?

A

The middle mediastinum is located between the anterior and posterior mediastina, with the superior boundary being the superior mediastinum and the inferior boundary being the diaphragm (T8/9 supine or T9/10 standing).

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7
Q

What are the surface landmarks of the middle mediastinum?

A

The surface landmarks of the middle mediastinum include the left costal cartilage (CC) and the anterior rib ends III-V.

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8
Q

What structures are found in the middle mediastinum?

A

The middle mediastinum contains the pericardium, heart, and the origin/root of great vessels.

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9
Q

What is pericardium?

A

The pericardium is a fibroserous membrane surrounding the heart and is the root of great vessels.

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10
Q

What are the two layers of the pericardium?

A

The pericardium comprises a fibrous layer (external/tough layer) and a serous layer (internal/serous membrane).

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11
Q

What is the function of the fibrous pericardium?

A

The fibrous pericardium helps prevent overfilling of the heart.

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12
Q

What are the attachments of the fibrous pericardium?

A

The fibrous pericardium is superiorly continuous with the adventitia of the great vessels, inferiorly adhered to the central tendon of the diaphragm (pericardiophrenic ligament), anteriorly attached to the sternum (sternopericardial ligaments), and posteriorly loosely adhered to the posterior mediastinum content by loose connective tissue.

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13
Q

What is the serous pericardium?

A

The serous pericardium is the internal layer of the pericardium and consists of a parietal layer and a visceral layer (epicardium).

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14
Q

What is cardiac tamponade?

A

Cardiac tamponade occurs when excess fluid within the pericardial cavity prevents the heart’s filling.

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15
Q

What is the pericardial cavity?

A

The pericardial cavity is a potential space within the serous pericardium that contains fluid.

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16
Q

Where does the reflection of the parietal layer onto the visceral layer occur?

A

The reflections of the parietal layer onto the visceral layer occur at the origin of the great vessels. The aorta and pulmonary trunk (arterial) and the superior vena cava (SVC), inferior vena cava (IVC), and pulmonary veins (venous) are sites of reflection.

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17
Q

What are pericardial sinuses?

A

Pericardial sinuses are spaces formed by the reflections of the pericardium, particularly at the origin of the great vessels.

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18
Q

What are pericardial sinuses?

A

Pericardial sinuses are spaces formed by the parietal layer’s reflection onto the serous pericardium’s visceral layer.

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19
Q

What are the two types of pericardial sinuses?

A

The two types of pericardial sinuses are the transverse and oblique pericardial sinus.

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20
Q

Where is the transverse pericardial sinus located, and what does it separate?

A

The transverse pericardial sinus is located between the arterial and venous groups of great vessels. It separates these two groups.

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21
Q

What is the relevance of the transverse pericardial sinus?

A

The transverse pericardial sinus is important in cardiac surgeries, as the arterial group of great vessels can be cross-clamped during coronary bypass procedures.

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22
Q

Where is the oblique pericardial sinus located?

A

The oblique pericardial sinus reflects the pericardium around the venous group of great vessels.

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23
Q

What are the blood supply sources to the pericardium?

A

Several arteries, including the pericardiophrenic artery, musculophrenic artery, coronary arteries, and branches from the thoracic aorta, such as the bronchial artery, esophageal artery, and superior phrenic artery, provide the blood supply to the pericardium.

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24
Q

What are the venous drainage pathways from the pericardium?

A

The pericardiophrenic vein and tributaries of the azygos venous system drain the pericardium.

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25
What are the three layers of the heart?
The three layers of the heart are the endocardium (inner layer of endothelium and connective tissue), myocardium (middle layer of cardiac muscle cells), and epicardium (outer layer, also known as visceral serous pericardium).
26
What is the function of the endocardium?
The endocardium is responsible for lining the heart's inner surface and providing a smooth endothelial surface for blood flow.
27
What is the myocardium composed of?
The myocardium is composed of cardiac muscle cells (myocytes) and is responsible for heart contraction.
28
What is another name for the epicardium?
The epicardium is also known as the visceral serous pericardium, the heart's outer layer.
29
How many sides does the heart have, and what are they?
The heart has two sides: the right side and the left side.
30
How many chambers does the heart have, and what are they called?
The heart has four chambers: two atria (receiving chambers) and two ventricles (discharging chambers).
31
What are the four valves of the heart?
The heart has four valves: two atrioventricular (AV) valves, which are the tricuspid valve on the right side and the mitral (bicuspid) valve on the left side, and two semilunar valves, which are the pulmonary valve and the aortic valve.
32
What is the function of the right side of the heart?
The right side of the heart receives venous blood from the body and pumps it to the lungs for oxygenation.
33
What is the function of the left side of the heart?
The left side of the heart receives arterial blood from the lungs and pumps oxygenated blood to the rest of the body.
34
What happens during the first phase of the cardiac cycle?
Blood enters the atria.
35
How does blood enter the right atrium?
Blood enters the right atrium through the superior vena cava (SVC), inferior vena cava (IVC), and coronary sinus.
36
How does blood enter the left atrium?
Blood enters the left atrium through the four pulmonary veins (two superior and two inferior) that carry oxygenated blood from the lungs.
37
What happens during the second phase of the cardiac cycle?
Blood flows through the atrioventricular valves into the ventricles during diastole (relaxation phase).
38
What are the atrioventricular valves and where are they located?
The atrioventricular valves include the tricuspid valve on the right side and the mitral (bicuspid) valve on the left side. They are located between the atria and the ventricles.
39
What happens during the third phase of the cardiac cycle?
The atria contract.
40
What happens during the fourth phase of the cardiac cycle?
The atrioventricular valves close, producing the first heart sound.
41
What happens during the fifth phase of the cardiac cycle?
The ventricles contract (systole), and blood is pumped out through the semilunar valves.
42
Where does blood flow on the right side of the heart during ventricular contraction?
Blood flows through the pulmonary valve into the pulmonary trunk, which leads to the pulmonary arteries carrying blood to the lungs.
43
Where does blood flow on the left side of the heart during ventricular contraction?
Blood flows through the aortic valve into the ascending aorta, which distributes oxygenated blood to the rest of the body.
44
What happens during the sixth phase of the cardiac cycle?
The semilunar valves close, producing the second heart sound.
45
How is the orientation of the heart described?
The orientation of the heart is trapezoid-shaped when viewed from the anterior and posterior perspectives.
46
Where is the apex of the heart located?
The apex of the heart is located at the 5th intercostal space (ICS) at the midclavicular line (MCL) and is formed by the inferolateral part of the left ventricle (LV).
47
Where is the base of the heart located?
The base of the heart is located approximately at the level of the T6-T9 vertebrae. It is primarily formed by the left atrium (LA) with a minor contribution from the right atrium (RA).
48
What are the four surfaces of the heart?
The four surfaces of the heart are the anterior surface (sternocostal) primarily formed by the right ventricle (RV), the inferior surface (diaphragmatic) formed by the LV and a portion of the RV, the right pulmonary surface formed by the RA; and the left pulmonary surface formed by the LV.
49
What are the four borders of the heart?
The four borders of the heart are the right border between the superior vena cava (SVC) and the inferior vena cava (IVC) formed by the RA, the inferior border formed by the RV and a portion of the LV, the left border formed by the LV and the left auricle, and the superior border formed by the RA, LA, right auricle, left auricle, ascending aorta, pulmonary trunk, and SVC.
50
What are the main components of the right atrium?
The right atrium consists of the right auricle, the smooth-walled sinus venarum, pectinate muscles, the crista terminalis (internal ridge), the sulcus terminalis (external groove), and openings for the superior vena cava (SVC), inferior vena cava (IVC), and coronary sinus.
51
What is the remnant of the foramen ovale in the right atrium?
The remnant of the foramen ovale is known as the fossa ovalis.
52
What are the main components of the right ventricle?
The right ventricle consists of the conus arteriosus (infundibulum), trabeculae carneae, supraventricular ridge, tricuspid valve (with cusps and orifice), chordae tendineae, papillary muscles (anterior, septal, and posterior), moderator band (septomarginal trabecula), and the pulmonary valve (with semilunar cusps and sinuses).
53
What are the main components of the left atrium?
The left atrium consists of the left auricle, pectinate muscles, and the fossa ovalis (remnant of the foramen ovale).
54
What are the main components of the left ventricle?
The left ventricle consists of trabeculae carneae, papillary muscles (anterior and posterior), the mitral valve (with cusps and orifice), chordae tendineae, the aortic vestibule, the aortic valve (with semilunar cusps and sinuses), and the orifices for the right and left coronary arteries.
55
What are the two main coronary arteries?
The two main coronary arteries are the right coronary artery (RCA) and the left coronary artery (LCA).
56
Where do the right and left coronary arteries arise from?
The right and left coronary arteries arise from the aortic sinuses through the coronary orifices.
57
What is the pathway of the right coronary artery (RCA)?
The right coronary artery follows a pathway in the coronary sulcus (also known as the atrioventricular sulcus or groove).
58
What is the location of the left coronary artery (LCA)?
The left coronary artery is located between the pulmonary trunk and the left auricle in the coronary sulcus.
59
What are the main branches of the right coronary artery?
The main branches of the right coronary artery include the sinoatrial (SA) node branch (supplying the SA node), the right marginal branch (supplying the right ventricle), the atrioventricular (AV) node branch (supplying the AV node), and the posterior interventricular branch (supplying the posterior part of the interventricular septum). Note: Cardiac dominance refers to which artery supplies the posterior interventricular branch and can vary between individuals.
60
What structures are supplied by the right coronary artery?
The right coronary artery supplies the right atrium (RA), right ventricle (RV), and a portion of the left ventricle (LV) known as the diaphragmatic surface.
61
What is the location of the left coronary arteries?
The left coronary arteries arise from the left aortic sinus through the coronary orifice.
62
What are the main branches of the left coronary arteries?
The main branches of the left coronary arteries include the anterior interventricular branch (also known as the left anterior descending artery or LAD), the diagonal branches (from the anterior interventricular branch), the circumflex branch, and the left marginal branch (from the circumflex branch).
63
What structures are supplied by the left coronary arteries?
The left coronary arteries supply the left atrium (LA), left ventricle (LV), and a portion of the right ventricle (RV).
64
How do the cardiac veins drain?
The cardiac veins drain into the coronary sinus.
65
Where is the coronary sinus located?
The coronary sinus lies in the posterior coronary sulcus.
66
What are the tributaries of the coronary sinus?
The tributaries of the coronary sinus include the great cardiac vein (from the anterior interventricular branch), the small cardiac vein (from the right marginal branch), the middle cardiac vein (from the posterior interventricular branch), and the left posterior ventricular/cardiac vein.
67
When does the development of the heart tube begin?
The development of the heart tube begins on day 18 of embryonic development.
68
What are the origins of the heart tube?
The heart tube arises from cardiac progenitor cells.
69
When do the paired heart tubes fuse in the midline, and when does the heart start to beat?
The paired heart tubes fuse in the midline on day 21 or 22, and the heart starts to beat around day 22 to 23.
70
What are the initial components of the developing heart?
The initial components of the developing heart include the bulbus cordis, truncus arteriosus, ventricle, primordial atrium, and sinus venosus.
71
What is the process of heart tube folding called, and when does it occur?
Heart tube folding is known as dextral looping and occurs between day 22 and 28 of embryonic development. It results in the formation of the "bulboventricular loop."
72
How to do the atria and sinus venosus position relative to the truncus arteriosus, bulbus cordis, and ventricle during heart tube folding?
During heart tube folding, the atria and sinus venosus lie dorsally to the truncus arteriosus, bulbus cordis, and ventricle.
73
When do the endocardial cushions form, and what is their role?
The endocardial cushions form during the end of week 4 of embryonic development. They play a crucial role in dividing the atrioventricular (AV) canal, primordial atrium, and ventricle.
74
When do the partitioning of the truncus arteriosus and the spiraling of the heart occur?
The partitioning of the truncus arteriosus and the 180° spiraling of the heart occur by the end of week 5 of embryonic development.
75
What happens to the bulbus cordis during development?
The bulbus cordis is incorporated into the walls of the ventricles.
76
When does the interventricular (IV) septum close?
The IV septum closes by the end of week 7 of embryonic development.
77
What are the components of the prenatal circulation?
The components of the prenatal circulation include the ductus venosus, ductus arteriosus, foramen ovale, umbilical vein (left), and umbilical arteries.
78
What are the remnants of the prenatal circulation structures after birth?
After birth, the remnants of the prenatal circulation structures include the fossa ovalis (from the foramen ovale), ligamentum arteriosum (from the ductus arteriosus), ligamentum venosum (from the ductus venosus), ligamentum teres hepatis (from the left umbilical vein), and the median umbilical ligament (from the umbilical arteries).
79
What is the function of the conducting system in the heart?
The conducting system generates and transmits electrical impulses across cardiac myocytes, contributing to the myogenic conduction of the heart.
80
What is the location and function of the sinoatrial (SA) node?
The SA node, located at the superior end of the sulcus terminalis, functions as the cardiac pacemaker, initiating electrical impulses at a rate of approximately 70 beats per minute.
81
What is the location of the atrioventricular (AV) node?
The AV node is located near the opening of the coronary sulcus.
82
What are the components of the AV bundle (bundle of His)?
The AV bundle consists of the right and left bundles.
83
What are the subendocardial branches responsible for transmitting electrical impulses?
The subendocardial branches, also known as Purkinje fibers, are responsible for transmitting electrical impulses throughout the ventricular myocardium.
84
What are the sensory innervation and autonomic innervation of the pericardium?
The sensory innervation of the pericardium is provided by the phrenic nerve (C3-5), while the autonomic sympathetic innervation comes from the sympathetic trunk.
85
What are the sensory innervation and autonomic innervation of the heart?
The sensory innervation of the heart follows the same pathways as the sympathetic innervation (T1-5/6). The autonomic innervation includes both sympathetic innervation from the sympathetic trunk (T1-5/6) and parasympathetic innervation from the vagus nerve (CN X).
86
What is referred pain?
Referred pain refers to pain felt in a location distant from the actual source of the pain. It occurs when visceral structures, such as organs and vessels, share common neural pathways with somatic structures.
87
What are the characteristics of somatic pain?
Somatic pain is sharp and localized, originating from structures such as skeletal muscles, bones, and connective tissues. It follows the dermatome or cutaneous mapping of the affected area.
88
What are the characteristics of visceral pain?
Visceral pain is dull and poorly localized, originating from the viscera of body cavities and vessels. It is often referred to a dermatome, meaning the pain is felt in a different area than the source. Visceral pain is typically caused by factors such as stretch, ischemia, or chemical irritation.
89
Where is cardiac referred pain typically felt?
Cardiac-referred pain is commonly felt in the dermatomes corresponding to the spinal levels T1-5/6.

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