Thorax 3 Flashcards

1
Q

What is the pericardium?

A

Fibroserous sac that
encloses the heart and
roots of great vessels

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2
Q

What are the 2 types of pericardium?

A

-Fibrous pericardium
-Serous pericardium

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3
Q

What are the 2 layers of the serous pericardium?

A

-Parietal layer
-Visceral layer

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4
Q

What is the shape of the fibrous pericardium?

A

Cone-shaped

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5
Q

What does the fibrous pericardium surround?

A

Surrounds the heart and roots of great vessels

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6
Q

What is the base of the fibrous pericardium attached to?

A

Its base is attached to middle part
of diaphragm’s central tendon and to
part of the left muscular dome

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7
Q

What is the apex of the fibrous pericardium continuous with?

A

Its apex is continuous with the
adventitia of the great vessels

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8
Q

How is the fibrous pericardium attached to sternum’s posterior surface?

A

Attached to sternum’s posterior
surface via sternopericardial
ligaments

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9
Q

What ligament attaches the fibrous pericardium to the xiphoid process?

A

Xipho-pericardial ligament

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10
Q

Where does the parietal layer of the pericardium lie?

A

Lies against the
internal surface of
the fibrous
pericardium

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11
Q

Where does the visceral later of the pericardium lie?

A

Lies against the
external surface of the
heart

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12
Q

What is the pericardial cavity?

A

Space between
parietal and visceral
layers

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13
Q

What fluid does the pericardial cavity contain

A

Contains minimal serous fluid

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14
Q

What layers make up the heart wall?

A

-Visceral serous
-Myocardium
-Endocardium

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15
Q

What is the course of the phrenic nerve within the thorax?

A

The phrenic nerve descends
anterior to the pulmonary
hilum between the fibrous
pericardium and mediastinal
pleura, accompanied by the
pericardiacophrenic vessels

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16
Q

What does fibrous pericardium and parietal serous pericardium receive sensory innervation from?

A

Fibrous pericardium &
parietal serous
pericardium receive
sensory innervation from
the phrenic nerve

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17
Q

What can irritation of fibrous pericardium lead to?

A

referred pain to dermatomes of
phrenic nerve’s roots

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18
Q

How many surfaces does the heart have and what are they?

A

The heart has 4 surfaces:
* Sternocostal surface
(anteriorly)
* Right pulmonary surface
-Faces the right lung
* Left pulmonary surface
-Faces the left lung
* Diaphragmatic surface
(inferiorly)

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19
Q

Where is the base of the heart located?

A

Directed posteriorly

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20
Q

Where is the apex of the heart positioned?

A

The apex of the heart is positioned
deep to the left 5th intercostal space

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21
Q

What does the coronary sulcus seperate?

A

Separates the atria from the ventricles

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22
Q

What does the right atrium form?

A

Forms the entire right border of the
heart

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23
Q

What nodes does the right atrium contain?

A
  • Contains the SA node
  • Contains the AV node
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24
Q

What does the right atrium open into and via what valve?

A

Opens in the right ventricle via the
right atrioventricular valve (tricuspid
valve)

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25
Q

What 3 veins does the right atrium receive blood from?

A
  • Superior vena cava (SVC)
  • Inferior vena cava (IVC)
  • Coronary sinus
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26
Q

Where does the right atrium project from?

A

Projects anteriorly from the right atrium’s superior corner

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27
Q

What are pectinate muscles?

A

Irregular horizontal muscle ridges

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28
Q

What are crista terminalis?

A

C-shaped ridge

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29
Q

What is the crista terminalis important in locating?

A

Important landmark
in locating the sites
where veins enter the
right atrium

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30
Q

Where is the opening of the superior vena cava located in relation to the crista terminalis?

A

Opening of SVC is
posterior to crista
terminalis’ superior
bend

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31
Q

Where is the opening of IVC located in relation to crista terminalis?

A

Opening of IVC is
posterior to crista
terminalis’ inferior
bend

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32
Q

Where is the opening of the coronary sinus located in relation to the crista terminalis?

A

Anterior to the
inferior end of crista
terminalis

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33
Q

What is the fossa ovaus?

A

Depression in interatrial septum

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34
Q

What spot does the fossa ovaus mark?

A

Marks the spot where
foramen ovale existed

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35
Q

What is the most anterior surface of the heart?

A

Right ventricle

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36
Q

What ate trabeculae carnae?

A

Irregular muscular ridges
on the walls of the
ventricle

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37
Q

How do chordae tendineae project?

A

Project superiorly from
papillary muscles to tricuspid
valve’s cusps

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38
Q

What are papillary muscles?

A

Trabeculae carnae with only
one end attached to the
ventricular surface

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39
Q

What do papillary muscles serve as?

A

Serve as a point of
attachment for the chordae
tendinaeq

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40
Q

What are the 3 groups of papillary muscles in the right ventricle?

A

-Anterior
-Posterior
-Septal

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41
Q

What are papillary muscles named relative to?

A

Named relative to their point
of origin on the ventricular
surface

42
Q

Where is the right atrioventricular valve located?

A

Located at junction between
right atrium and ventricle

43
Q

How many cusps does the right atrioventricular valve have?

A

3 cusps

44
Q

How many cusps does the pulmonary valve have?

A

Has 3 semilunar cusps

45
Q

What forms almost entirely posterior surface of the heart?

A

Left atrium

46
Q

What does the left atrium receive and from where?

A

Receives oxygenated blood
from the 4 pulmonary veins

47
Q

What shape is the left auricile?

A

Triangular shaped

48
Q

What lines the left auricle?

A

Pectinate muscles line the left auricle
only

49
Q

What does the left atrium open into the left ventricle via?

A

Via the bicuspid valve

50
Q

What does the left ventricle form?

A

Forms heart’s apex

51
Q

What does the left ventricle dominate?

A

Dominates heart’s inferior surface

52
Q

What does the left ventricle dominate?

A

Dominates heart’s inferior surface

53
Q

What does the left ventricle contribute to?

A

Contributes to anterior and left
pulmonary surfaces

54
Q

Where does the left ventricle lie?

A

Lies anterior to left atrium

55
Q

What are the 2 groups of papillary muscles in the left ventricle?

A

-Anterior
-Posterior

56
Q

How many cusps does the bicuspid valve have?

A

2 cusps

57
Q

What does the aortic valve facilitate?

A

Facilitates the passage of blood
from left ventricle to ascending
aorta

58
Q

Where do you auscultate for the tricuspid valves?

A

Left of the lower part of sternum
near 5th intercostal space

59
Q

Where do you auscultate for the bicuspid valves?

A

Over heart’s apex in the left
fifth intercostal space at the
midclavicular line.

60
Q

Where do you auscultate for the pulmonary valve?

A

Medial end of left
2nd intercostal
space

61
Q

Where do you ascultate for the aortic valve?

A

Medial end of
right 2nd intercostal
space

62
Q

What is the cardiac silhouette?

A

Outline of the heart as
seen on frontal and lateral
chest radiographs

63
Q

What can the cardiac silhouette be divided into?

A

-Right and left borders

64
Q

What is the right border of the cardiac silhouette formed by?

A

The right border is formed by
the right atrium
* Superior vena cava
entering superiorly and the
inferior vena cava often
seen at its lower margin

65
Q

What is the left border of the cardiac silhouette formed by?

A

The left border is formed by
the left ventricle and left
auricle
* Pulmonary artery

66
Q

What are the 5 great vessels of the heart?

A
  • Superior vena cava
  • Inferior vena cava
  • Pulmonary Trunk
  • Ascending Aorta
  • Arch of Aorta
67
Q

What is the superior vena cava formed by the union of?

A

Formed by the union of the
right & left brachiocephalic
veins

68
Q

Where does the superior vena cava receive its systemic blood from?

A

Receives systemic blood from
all body regions superior to the
diaphragm excluding the heart
wall

69
Q

What does the inferior half of the superior vena cava lie within?

A

Its inferior half lies within the
fibrous pericardium

70
Q

What is the inferior vena cava formed by the union of?

A

Formed by the union of the
right & left common iliac veins
at L5

71
Q

Where does the inferior vena cava receive its blood flow from?

A

Returns blood to the heart
from all regions of the body
inferior to the diaphragm

72
Q

At what vertebrae level does the inferior vena cava pass through the diaphragm?

A

Passes through the diaphragm
at the vertebral level of T8

73
Q

Where does the superior half of the inferior vena cava lie?

A

Its superior half lies within the
fibrous pericardium

74
Q

Where does the pulmonary trunk lie?

A

Lies anterior and to the
left of the ascending
aorta

75
Q

What does the pulmonary trunk divide into?

A

Divides into right and left pulmonary arteries

76
Q

Where does the right pulmonary artery lie?

A

Right pulmonary
artery lies posterior to
ascending aorta &
superior vena cava

77
Q

Where does the left pulmonary artery lie?

A

Left pulmonary artery
lies inferior to arch of aorta

78
Q

Where does the ascending aorta arise from and how many cm does it ascend?

A

Arises from the left
ventricle and ascends
~5cm

79
Q

Where does the ascending aorta begin?

A

Begins posterior to the
pulmonary trunk

80
Q

What are the 3 branches the aortic arch gives off?

A

-Brachiocephalic trunk
-Left common carotid artery
-Left subclavian artery

81
Q

What does the brachiocephalic trunk further branch off to?

A

-Right subclavian artery
-Right common carotid

82
Q

What do the coronary arteries arise from?

A

Arise from the aortic sinuses in
the ascending aorta

83
Q

Where does the right coronary artery originate from?

A

Originates from right aortic sinus of
ascending aorta

84
Q

What does the right coronary artery run in?

A

Runs in the coronary sulcus

85
Q

How does the right coronary artery run at the inferior margin of the heart?

A

At the inferior margin of the heart, it
turns posteriorly and continues onto the
diaphragmatic and base of of the heart

86
Q

What does the right coronary artery supply?

A

-Right atrium
-Right ventricle
-SA and AV nodes
-Interatrial septum
-Parts of left atrium and ventricle
-Posteroinferior 1/3rd of interventricular septum

87
Q

What are the branches of the right coronary artery?

A

-Atrial branch
-Right marginal branch
-Posterior interventricular branch
-

88
Q

What does the atrial branch of the right coronary artery branch into and what does it supply?

A

Atrial branch branches to SA nodal
branch
*Supplies SA node

89
Q

What does the right marginal branch supply?

A

Supplies right ventricle

90
Q

What does the posterior interventricular branch supply?

A

Supplies posteroinferior 1/3rd
of interventricular septum

91
Q

What are the branches of the left coronary artery?

A

-Anterior interventricular artery
-Left marginal artery

92
Q

What is the anterior interventricular artery also known as?

A

Left anterior descending(LAD)

93
Q

How does LAD run?

A

Runs in the anterior
interventricular sulcus

94
Q

What does LAD supply?

A

Supplies anterior walls of
both ventricles &
interventricular septum

95
Q

What is the left marginal artery also known as?

A

Left circumflex artery

96
Q

What does the left circumflex artery supply?

A

Supplies left atrium and posterior part of left ventricle

97
Q

What are the cardiac veins?

A
  • Coronary sinus
  • Great cardiac vein
  • Middle cardiac vein
  • Small cardiac vein
  • Anterior cardiac veins
  • Posterior cardiac vein
98
Q

What does the anterior cardiac vein drain into

A

Directly into the right atrium

99
Q

What does the coronary sinus receive blood from?

A
  • Great cardiac vein
  • Middle cardiac vein
  • Small cardiac vein
  • Posterior cardiac veins
100
Q

What cardiac veins run in the anterior interventricular sulcus?

A

-Anteriorinterventricular artery
-Great cardiac vein

101
Q

What cardiac veins run in the posterior interventricular sulcus?

A

Posterior ventricular artery
& Middle cardiac vein
running in the posterior
interventricular sulcus

102
Q

What determines coronary dominance?

A
  • The coronary artery giving rise to
    the posterior interventricular artery