The Heart Flashcards
State the external features of the heart
- Apex- lies in the 5th intercostal space medial To interclavicular line
- Valves- behind left border of the sternum except tricuspid valve which is behind the center (PAMT-3344)
• Pulmonary - 3rd sternocostal junction
• Aortic- 3rd intercostal space • Mitral- 4th intercostal junction
• Tricuspid- 4th intercostal space
List the sites it auscultation of the valves.
PAMT-2255
- Pulmonary- medial end of left 2nd intercostal space
- Aortic- medial end of right of 2nd intercostal space
- Mitral- apex of heart at left 5th intercostal space
- Tricuspid- left of lower part of sternum at medial end of 5th intercostal space
Outline the divisions of the mediastinum
- Superior mediastinum
- Inferior mediastanum
- anterior mediastinum
- middle mediastinum
- posterior mediastinum
List the boundaries and contents of the superior mediastinum
Boundaries:
Anterior- manubrium sterni
Posterior- bodies of upper 4 thoracic vertebra
Superior- plane of superior thoracic aperture
Inferior- imaginary plane passing through the sternal angle and lower border of T4.
Sides- mediastinal pleura
Contents:
A. Arteries
1. Arch of aorta
2. Brachiocephalic artery
3. Left common carotid artery
4. Left subclavian artery
B. Veins
1. Right and left brachiocephalic veins
2. Upper half of superior Vena cava
3. Left superior intercostal vein
C. Nerves:
1. Phrenic nerves (right and left)
2. Vagus nerves (right and left)
3. Sympathetic trunks and cardiac nerves (R+L)
4. Left recurrent laryngeal Nerves
D. Lymphoid organs & lymphatics
1. Lymph nodes
2. Thoracic duct
3. Thymus
E. Tubes:
1. Trachea
2. Esophagus
F. Muscles:
1. Sternohyoid
2. Sternothyroid
3. Longus colli
List the boundaries and contents of the anterior mediastinum
Boundaries:
Anterior- body of sternum
Posterior- pericardium enclosing heart
Superior- transverse thoracic plane
Inferior- diaphragm
Sides- mediastinal pleura
Contents:
1. Loose areolar tissue
2. Superior and inferior sternopericardial ligaments stretching between sternum and pericardium.
3. Lymph nodes
4. Mediastinal branches of internal thoracic (mammary) arteries.
5. Lower portion of thymus ( children)
Name the boundaries and contents of the middle mediastinum
** Boundaries:**
Anterior- anterior mediastinum
Posterior- posterior mediastinum
Superior- superior mediastinum
Inferior- diaphragm
Contents:
1. Heart
2. * Pericardium*
3. * Arteries:*
- ascending aorta
- pulmonary trunk
- pericardiophrenic arteries
4. Veins:
- superior Vena cava (lower 1/2)
- azygos vein ( terminal part)
- pulmonary veins ( R+L)
5. Nerves:
- phrenic nerves
- deep cardiac plexus
6. * Lymph nodes:*
- tracheobronchial lymph nodes
7. Tubes:
- bifurcation of trachea
- R+L principal bronchi
• the main contents are pericardium and its contents; heart and roots of great vessels.
• pulmonary trunk divides into pulmonary arteries
Name the boundaries and contents of the posterior mediastinum
Boundaries:
Anterior
-pericardium and its contents
- bifurcation of trachea
- pulmonary vessels
Posterior - bodies of lower 8 thoracic vertebra and IVD
Superior- transverse thoracic plane separating superior and inferior mediastinum
Inferior- diaphragm
Sides- mediastinal pleura
Contents:
1. Esophagus
2. Thoracic duct
3. Descending thoracic aorta and its branches
4. Azygos, hemiazygos and accessory hemiazygos veins.
5. Vagus nerves
6. Sympathetic trunks and splanchnic nerves.
7. Posterior mediastinal lymph nodes.
Name the contents of the thoracic inlet (superior thoracic aperture)
•Muscles:
1. Sternohyoid
2. Sternothyroid
3. Longus colli
•Arteries:
1. R+L internal thoracic arteries
2. Brachiocephalic trunk/artery
3. Left CCA
4. Left subclavian artery
5. R+L superior intercostal arteries
•Nerves:
1. R+L vagus nerves
2. Left recurrent laryngeal
3. R+L phrenic nerves
4. R+L first thoracic nerves
5. R+L sympathetic chains
•Veins:
1.R+L brachiocephalic veins
2. R+L 1st posterior intercostal veins
3. Inferior thyroid veins
