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Block 2 Anatomy > The heart and mediastinum > Flashcards

The heart and mediastinum Flashcards

(60 cards)

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1
Q

Which 2 veins join to form the brachiocephalic veins?

A

Internal jugular veins and subclavian veins

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2
Q

The brachiocephalic veins are formed behind what?

A

Sternoclavicular joints

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3
Q

The brachiocephalic veins join to form what?

A

Superior vena cava

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4
Q

Where is the SVC formed?

A

2nd right costal cartilage

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5
Q

Which procedure involves both the venous system and liver biopsy?

A

Transjugular liver biopsy

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6
Q

What are the 3 main arteries that branch off the aortic arch in the superior mediastinum?

A

Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

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7
Q

The ligamentum arteriosum is a remnant of what?

A

Ductus arteriosus

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8
Q

Which 2 structures did the ductus arteriosus join together?

A

Pulmonary trunk + aortic arch

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9
Q

What was the function of the ductus arteriosus?

A

Allowed blood to bypass the lungs during embryological development

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10
Q

What can happen if the ductus arteriosus fails to close after birth?

A

It results in a patent ductus arteriosus, which allows for mixing of low oxygenated blood from the pulmonary trunk with high oxygenated blood in the aorta, therefore decreasing the oxygen content of the blood heading towards systemic circulation

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11
Q

The internal thoracic arteries branch off from which arteries?

A

Subclavian arteries

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12
Q

The internal thoracic arteries can be grafted for use in which procedure?

Why are these arteries particularly beneficial for this procedure?

A

CABG – coronary artery bypass graft

They resist atherosclerotic plaque build up

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13
Q

What happens to the thymus gland after childhood?

A

Atrophies

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14
Q

What surrounds the heart?

A

Pericardial sac

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15
Q

The fibrous pericardium is attached to what inferiorly?

A

Central diaphragmatic tendon

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16
Q

What are 2 things that are most likely to cause a blockage of the SVC?

A

Extrinsic compression by a tumour

Metastasis to mediastinal lymph nodes

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17
Q

Which levels of the sympathetic chain carry fibres to the heart?

A

T1 – T4

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18
Q

Why does cardiac pain occur in the T1 – T4 dermatomes, mainly on the left?

A

Cardiac visceral sensory fibres travel back to the CNS with the sympathetic nerves T1 – T4

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19
Q

What 2 layers is the pericardium composed of?

A

Fibrous pericardium
Serous pericardium

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20
Q

The parietal layer of the serous pericardium lines what?

A

The inside of the fibrous pericardium

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21
Q

The visceral layer of the serous pericardium lines and forms what?

A

The heart and forms the epicardium

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22
Q

What innervates the fibrous pericardium?

A

Phrenic nerve

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23
Q

Describe how a haemopericardium can lead to cardiac tamponade?

A

In a haemopericardium, blood accumulates in the pericardial sac. The fibrous pericardium is relatively inelastic, so blood in the sac can compress the heart and prevent it from being able to fill properly during diastole due to external compression – this is cardiac tamponade

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24
Q

What are the 2 sinuses of the heart?

A

Transverse pericardial sinus
Oblique pericardial sinus

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25
What clinical manoeuvre can the transverse pericardial sinus be used for?
Can be used during cardiac surgery (e.g. coronary artery bypass graft) to pass a surgical clamp around the aorta and pulmonary trunk to control blood flow while on a heart-lung machine
26
Which 3 vessels deliver blood to the right atrium of the heart?
Superior vena cava Inferior vena cava Coronary sinus
27
Which valve does blood pass through as it passes from the right atrium to the right ventricle?
Tricuspid valve
28
At which point of the cardiac cycle is the tricuspid valve closed?
During ventricular contraction / systole
29
What does the crista terminalis mark the boundary between?
The smooth and rough wall of the right atrium
30
Atrial fibrillation can cause blood clots to form in which area of the atrium?
Atrial appendage / auricle
31
Which structure can be found on the interatrial septum of the right atrium? What is it a remnant of and what was its function?
Fossa Ovalis – a remnant of the foramen ovale, which allowed oxygenated blood to bypass the lungs and travel directly from the right atrium to the left atrium in foetal circulation
32
What is the smooth-walled region of the right ventricle which leads to the pulmonary valve and trunk?
Conus arteriosus / infundibulum
33
What are the prominent muscular ridges on the inner wall of the right ventricle called?
Trabeculae carnae
34
Which fibrous cords connect the valve leaflets to the papillary muscles in the right ventricle?
Chordae tendinae
35
In the right ventricle, what are the papillary muscles and what is their function?
Muscle projections that anchor the chordae tendinae and prevent valve prolapse during ventricular contraction
36
Which trabeculae carnae is essential for the rapid conduction of electrical impulses, where does it extend to and from, and what does it carry?
Moderator band – runs from the interventricular septum to the base of the anterior papillary muscle, and carries the right bundle of the atrioventricular bundle
37
The left atrium receives oxygenated blood from how many pulmonary veins?
4
38
Which valve does blood pass through as it passes from the left atrium to the left ventricle?
Mitral valve
39
At what stage of the cardiac cycle do the papillary muscles contract?
Systole
40
Describe the composition of the cardiac skeleton.
Dense collagen fibres that form a rigid, non-conductive framework
41
List the 3 functions of the cardiac skeleton.
Mechanical stability Attachment point for cardiac muscle and valve cusps Electrical insulation
42
How many cusps do the aortic and pulmonary semi-lunar valves each have?
3
43
Name the 3 leaflets of the aortic valve.
Right coronary leaflet Left coronary leaflet Non-adjacent leaflet
44
Name the 3 leaflets of the pulmonary valve.
Right-adjacent leaflet Left-adjacent leaflet Non-adjacent leaflet
45
Which 2 heart valves are most commonly affected by valvular heart diseases?
Mitral Aortic
46
What is the most common type of congenital heart disease in adults?
Mitral valve prolapse – one or both leaflets are enlarged, redundant, or floppy
47
What is the most frequent heart valve abnormality, what is it often caused by, and what does it result in?
Aortic stenosis – often the result of degenerative calcification, and results in left ventricular hypertrophy
48
In which circumstances might the tricuspid and pulmonary valves be affected by disease?
As the result of an infection – rheumatic fever or infective endocarditis
49
What sign could be seen on the nails of someone with right-sided valve disease?
Splinter haemorrhages
50
Where do the coronary arteries arise from?
Coronary sinuses
51
The main inflow of the coronary arteries is during which stage of contraction?
Diastole
52
List the 4 main branches of the right coronary artery.
Sinoatrial nodal artery Anterior ventricular arteries Right marginal artery Inferior interventricular artery (arises from RCA in 60% of people)
53
List the 4 areas the right coronary artery supplies.
Right atrium + right ventricle SA node + AV node Conduction system up to AV bundles Posterior 1/3rd of IV septum
54
List the 5 main branches of the left coronary artery.
Sinoatrial nodal artery (in some people) Circumflex artery Anterior interventricular artery (left anterior descending (LAD) artery) Marginal artery Inferior interventricular artery (arises from LCA in 40% of people)
55
List the 4 areas the left coronary artery supplies.
Left atrium + ventricle AV bundle Right + left bundle branches Anterior 2/3rd of IV septum
56
What are the 3 main veins which drain the heart? What do they drain into?
Great, middle and small cardiac veins Drain into the right atrium via the coronary sinus
57
The base of the heart is primarily made up of which chamber?
Left atrium
58
The smooth wall of the right atrium is derived from what?
Sinus venosus
59
The pectinate muscles are found on which wall of the right atrium?
Rough wall
60
What are the surface anatomy marking of the heart edges?
3rd R CC 6th R CC 2nd L CC 5th L ICS (slightly medial to MCL)

Block 2 Anatomy (8 decks)

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