1.2 Anatomy of the CVS Flashcards
1
Q
What is mediastinum ?
A
region between the lungs, from the sternum to the bodies of the vertebrae & from the superior thoracic aperture (thoracic inlet) to the diaphragm
2
Q
what organ surrounds the mediastinum ?
A
lungs
3
Q
subdivisions of the mediastinum are what ?
A
- superior
- inferior : anterior, middle, posterior
4
Q
structures in the superior mediastinum ?
A
- Great vessels
- Nerves: vagus, phrenic
- Thymus
- Trachea
- Oesophagus
- Thoracic duct
- Muscles
5
Q
structures in the anterior mediastinum ?
A
- thymus (in children), thymus is not visible in adults
- lymph nodes
6
Q
Thymus :
1. primary what organ ?
2. produces ?
3. responsible for ?
4. in children size ?
5. can lead to what sign on CXR ?
A
- primary lymphatic
- T-lymphocytes (T cells)
- cell mediated immunity
- relatively large
- thymic sail sign
7
Q
structures in the middle mediastinum ?
A
- heart
- pericardium
- origins of the great vessels
- various nerves
8
Q
structures in the posterior mediastinum ?
A
- thoracic aorta
- oesophagus
- thoracic duct
- azygos system of veins
- sympathetic trunks
9
Q
Vagus nerves (CN X) run anterior to …1.. and descend through ..2..
A
- subclavian vessels
- mediastinum
10
Q
Recurrent laryngeal nerves position on R side ?
A
loops under right subclavian artery
11
Q
Recurrent laryngeal nerves position on L side ?
A
loops under aortic arch
12
Q
CN X travels posterior to ..1… on ..2.. sides
A
- lung root
- both
13
Q
Posterior mediastinum extends inferiorly to what vertebrae ?
A
12th thoracic
14
Q
Anterior mediastinum is ….1… and can contain part of the …2… gland
A
- narrow
- thymus
15
Q
The sternal angle/ plane aligns with what junction ?
A
T4/T5
16
Q
Abnormal silhoutte of mediastinum may suggest what pathology ?
A
- widening
- shift
- mediastinitis
17
Q
During development the heart is a ..1.. structure that rotates to the ..2..
A
- midline
- left
18
Q
5 surfaces of the heart ?
A
- anterior (sternocostal) - right ventricle
- posterior (base of the pyramid) - left atrium
- inferior (diaphragmatic) - left and right ventricles
- right pulmonary - right atrium
- left pulmonary - left ventricle
19
Q
4 borders of heart ?
A
- right - right atrium
- left - left ventricle and some of the left atrium
- inferior - left & right ventricle
- superior - right & left atrium and the great vessels
20
Q
Pericardium is a …1.. sac surrounding the ..2… and the ..3.. of the great vessels
A
- fibroserous
- heart
- roots
21
Q
2 components of the pericardium are what ?
A
- fibrous
- serous
22
Q
what is fibrous pericardium ?
A
tough connective tissue outer layer of heart that defines boundaries of the middle mediastinum
23
Q
Serous pericardium consists of what 2 parts ? which line to or adhere to what ?
A
- parietal layer : lines inner surface of the fibrous pericardium
- viscerla layer (epicardium) : adheres to heart and forms outer covering
24
Q
2 layers of seroud pericardium are continous at …. ?
A
the roots of the great vessels
25
small space between the 2 layers of serous pericardium is known as ? which contains what ?
pericardial cavity , which contains small amount of fluid
26
pericardium functions ? [add more info ! from annotate slides !]
* fixes the heart
* prevents overfilling
* lubrication
* protection from infeciton
27
Transverse pericardial sinus is what ?
a passageway between the arterial output and the venous input
28
Tranverse pericardial sinus location regarding following :
1. posterior
2. anterior
3. superior
1. to ascending aorta and pulmonary trunk
2. to the superior vena cava
3. to the left atrium
29
Transverse pericardial sinus is used for what ?
to identify and ligate arteries of the heart during coronary artery bypass grafting
30
heart valves ensures what ?
blood flows in only one direction
31
What are the heart valves of the heart and their location ?
Atrioventricular valves (tricuspid & mitral (bicuspid))
Semilunar valves (pulmonary & aortic)
32
Atrioventricular valves are formed by ....1.... anchored to the ventricular wall by ..2...
1. flap-like cusps
2. tendons
33
What prevents AV valves cusps being blown into atrium during ventricular contraction (don't contract to open valves) ?
papillary muscles
34
Papillary muscle damage can lead to what ?
* valve incompetence
* cardiac murmur
35
What sits between the atria & ventricles ?
a fibrous tissue (skeleton)
36
what anchors to the fibrous tissue (skeleton) that sits between the atria & ventricles ?
atrioventricular valves
37
What does fibrous tissue prevent ?
'free' conduction of electrical signal from atria to ventricle
38
Structure of aortic pulmonary valves
semi-lunar (x3 cusps)
39
How does the semi-lunar valve structure contribute to preventing backflow of blood?
design includes three cusps that form pockets when blood flows backward during diastole.
The pockets fill with blood, which forces the cusps to close and prevent the backflow of blood into the ventricles
40
What would happen if the semi-lunar valves did not close properly during diastole?
result in backflow of blood into the ventricles, potentially leading to inefficient blood circulation and decreased oxygenation of tissues
41
How does ventricular systole affect the semi-lunar valves?
the forceful contraction of the ventricles pushes blood through the semi-lunar valves into the aorta and pulmonary artery.
This high pressure pushes the valve cusps toward the vessel walls, ensuring that the valves are open to allow blood flow.
42
where do coronary arteries arise from ?
the aortic sinus above the cusps of aortic valve
43
where do the left and right coronary artery arise from the cusps of aortic valve ?
* left CA from above left posterior cusp
* right CA from above above anterior cusp
44
Right CA normally supplies ?
* right atrium & ventricle
* SA node
* AV node
* posterior IV septum
45
Right CA dominant in ...1... %
it gives off ..2...
1. 60%
2. PIVA (posterior interventricular artery)
46
left coronary artery dominant in ..1... %
gives off ...2...
1. 40
2. PIVA (posterior interventricular artery)
47
left coronary artery normally supplies ?
* left atrium & ventricle
* anterior IV septum (majority)
* Av bundle right & left bundles
48
cardiac veins drain into the ..1... which empties into the ..2...
1. coronary sinus
2. right atrium
49
Heart surface anatomy is important for ?
* clinical examination
* injury
* guiding surgical approach
* x-ray & ultrasound
50
points of auscultation of the following valves:
1. aortic
2. pulmonary
3. tricuspid
4. mitral
1. 2nd R intercostal space
2. 2nd L intercostal space
3. 4/5th L ICS
4. 5th L ICS MCL (?)
51
1. Right ventricular wall comparison to left ?
2. cross section shape ?
3. useful for what identification ?
1. thinner
2. cresecent-shaped
3. CT/MRI
52
Right atrium internal features
* SA node
* crista terminalis
* Fossa ovalis
* coronary sinus
* Tricuspid vale
* appendage (rough walled)
[anki labelling !!]
53
1. approx how much thicker is left ventricular wall than right ?
2. shape of cross section
3. useful for what ?
1. 3x
2. relatively round
3. CT/MRI identification
54
Where do veins sit in relation to arteries ?
anterior
55
ventricular ..1... & ...2... can affect conduction ?
1. septal defects
2. infarctions
56
function of the parasympathetic supply to the heart ?
reduces the heart rate
57
where is the cardiac autonomic plexus located ?
between the aorta and the trachea
58
which cranial nerve provides the parasympathetic supply to the heart ?
vagus nerve (CN X)
59
where do the cardiac branches of the vagus nerve mainly arise ?
in the thorax
60
what path do the cardiac branches of the vagus nerve take to reach the heart ?
travel to the cardiac plexus
61
from where do the postganglionic fibres in the cardiac plexus arise ?
from ganglia located on the heart
62
Effect of the sympathetic supply on the heart ?
to increase the HR and contractility
63
From which spinal segments do the sympathetic nerves to the heart arise ?
T1-T4 spianl segments of the sympathetic chain
64
How do the cardiac sympathetic nerves reach the heart ?
they descend through the neck
65
what role do cardiac visceral sensory fibres travel back to the CNS with what ?
sympathetic nerves
66
(1) Referred cardiac pain is what ? (2) occurs commonly where ?
1. phenomenon where pain originating from the heart is perceived in different areas of the body
2. medial upper limb & superolateral thoracic wall
67
