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Cardiovascular > Anatomy 1 > Flashcards

Anatomy 1 Flashcards

1
Q

Describe surface anatomy

A

The ability to visualise how anatomical structures in the thorax are related to surface features is fundamental to physical examinations

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2
Q

What structures lie at the sternal angle?

A
  • rib 2
  • aortic arch
  • tracheal bifurcation (carina)
  • pulmonary trunk
  • ligamentum arteriosum
  • azygous vein drains into SVC
  • nerves (cardiac plexus, loop of recurrent laryngeal etc.)
  • thoracic duct (right to left movement before exiting thoracic inlet)
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3
Q

Describe the location of the heart

A
  • usually between ribs 2 and 5th intercostal space
  • extends from right medial border of sternum to having its apex at the midclavicular line on the left
  • vertebral levels T4- T9
    • when supine:T4/5 - T8
    • when standing:T6 - T9
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4
Q

Why can heart location change?

A
  • pathology e.g. cardiomegaly or displaced by mediastinal or lung conditions
  • when displaced, heart moves inferiorly and laterally towards axilla
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5
Q

What is heart attached to diaphragm via?

A

its pericardium

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6
Q

What is the rough weight of an adult heart and what are the dimensions?

A

250-350 grams
roughly size of a fist
12cm length, 8cm width, 6cm thickness

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7
Q

Why might heart size vary?

A
  • based on individual factors e.g. fitness
  • athletes may have larger hearts due to muscle growth from exercise
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8
Q

What three compartments can the thoracic cavity be divided into and which one is the heart located in?

A
  • right and left pleural cavities
  • mediastinum (heart located here)
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9
Q

Where is the mediastinum located and what does it contain? (6)

A
  • in between pleural cavities
  • heart
  • oesophagus
  • trachea
  • major nerves
  • major blood vessels
  • thymus gland
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10
Q

What are the locations of the different parts of the mediastinum?

A
  • anterior to posterior: extends from sternum to the bodies of the vertebrae (T1 - T12)
  • superior to inferior: superior thoracic aperture to the diaphragm
  • laterally (R & L): mediastinal pleurae
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11
Q

At what location is the mediastinum divided?

A
  • at transverse plane extending from sternal angle to intervertebral disc between T4 and T5 vertebrae
  • divides mediastinum into superior and inferior mediastinum
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12
Q

What is the inferior mediastinum further subdivided into and what is it relative to?

A
  • anterior, middle, posterior
  • relative to pericardial sac
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13
Q

What is the cardiothoracic ratio (CTR)?

A
  • ratio of maximal horizontal cardiac diameter to maximal horizontal thoracic diameter (inner edge of ribs/ edge of pleura)
  • a normal measurement should be <0.5
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14
Q

What is the clinical significance of the CTR?

A
  • aids in detection of enlargement of the heart which is most commonly from cardiomegaly
  • could also be due to pericardial effusion
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15
Q

What structures does the superior mediastinum contain? (4)

A
  • thymus gland
  • trachea
  • oesophagus
  • major systemic blood vessels
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16
Q

What structures does the anterior mediastinum contain?

A

just the thymus gland :(

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17
Q

What structures does the middle mediastinum contain? (4)

A
  • pericardium
  • heart
  • origins of great blood vessels
  • nerves and smaller vessels
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18
Q

What structures does the posterior mediastinum contain? (3)

A
  • oesophagus
  • descending aorta
  • thoracic duct (major lymphatic vessel)
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19
Q

What is the name of the inferior surface of the heart and what is it in contact with?

A
  • diaphragmatic surface
  • in contact with diaphragm via the pericardium
  • projects from base of heart towards apex
20
Q

What is the name of the anterior face of the heart and what is it orientated towards?

A
  • sternocostal
  • orientated towards anterior thoracic cage (sternum and ribs) and costal cartilage
  • some parts have contact with pleura and lungs
21
Q

What is the right pulmonary surface of the heart in contact with?

A

right pleura and lung

22
Q

What is the left pulmonary surface of the heart in contact with?

A

left pleura and lung

23
Q

Where do the base of the heart and the apex face?

A
  • base faces posteriorly
  • apex points forwards and downwards to the left
24
Q

What does the base of the heart contain?

A
  • left atrium
  • pulmonary veins
  • part of right atrium
  • parts of SVC and IVC
25
Q

What acts as a landmark to divide the base of the heart from the inferior surface?

A

coronary sinus

26
Q

What does the anterior surface of the heart consist of? (4)

A
  • right ventricle
  • partially the right atrium
  • partially the left ventricle
  • roots of vessels entering and exiting the heart
26
Q

What does the inferior surface of the heart consist of? (3)

A
  • left ventricle including apex
  • small portion of right ventricle
  • coronary vessels (including posterior interventricular groove)
27
Q

What are the left and right pulmonary surfaces made up of?

A

LEFT
- mainly left ventricle
- partially left atrium
RIGHT
- mainly right atrium

28
Q

What does the heart’s pulmonary surface do to the lungs?

A

forms a cardiac impression on the medial surface of the lungs

29
Q

What is the apex of the heart a part of and where is it located?

A
  • part of the inferolateral portion of the left ventricle
  • lies deep to the 5th intercostal space along the midclavicular line
30
Q

What is the clinical importance of the apex?

A
  • palpating the apex beat: it is the outermost and lowermost palpable cardiac impulse on the chest wall
  • a displaced apex beat may indicate possible pathology e.g. cardiomegaly (enlarged heart) apex beat will be displaced more towards the axilla
31
Q

What do sulci/ grooves of the heart do?

A
  • structures that separate the chambers of the heart that internally create impressions in the external surface of the heart
  • provide external demarcations that correspond to the internal partitions that divide the heart into its chambers
  • creates a passageway for the coronary arteries and veins and their main branches
32
Q

What are the three main sulci?

A
  • coronary sulcus (atrioventricular sulcus)
  • anterior interventricular sulcus
  • posterior interventricular sulcus
33
Q

What are the components of the pericardium?

A
  • fibrous pericardium (outer)
  • serous pericardium (inner)
    • parietal layer (lines the fibrous pericardium)
    • visceral layer (or epicardium) lines the heart itself
  • these two layers are continuous with one another
34
Q

What is the function of the pericardial cavity?

A
  • potential space between serous layers which contains approx 25ml of pericardial fluid
  • lubricates the layers and allows movement of the heart
35
Q

Describe the fibrous pericardium and its attachments

A
  • tough, connective tissue layer which is continuous with the outer layer of the blood vessels (tunica adventitia)
  • attached anteriorly to the sternum by sternopericardial ligaments
  • attached inferiorly to the diaphragm by pericardiacophrenic ligaments
36
Q

What does the toughness of the fibrous pericardium do?

A

limits how much the heart can distend (stretch)

37
Q

What is pericardial effusion?

A

fluid (including blood) build up in the pericardial sac
the pericardial activity should only contain small amount of serous fluid

38
Q

What can pericardial effusion arise from?

A
  • aortic aneurysms
  • heart attacks
  • penetrating injuries (most common)
  • puts pressure on heart and hence heart functions impaired
39
Q

In extreme cases what can pericardial effusion lead to, what are the symptoms and what is the treatment?

A
  • cardiac tamponade
  • when fluid accumulates too fast, increases pericardial pressure and compresses heart
  • leads to rapid breathing and shortness of breath, sharp stabbing chest pains and cyanosis
  • treatment is pericardial tap/ pericardiocentesis
40
Q

What do the two pumps of the heart do and what are they separated into?

A
  • left pump receives oxygenated blood from lungs and sends it to body
  • right pump receives deoxygenated blood from body and sends it to lungs
  • divided into atria and ventricles, separated by valves
41
Q

What are the muscular septa in the heart and what do they separate?

A
  • interatrial septum separates left and right atria
  • interventricular septa separates left and right ventricles
42
Q

How does blood pass through chambers? (simple answer)

A

veins (pulmonary or vena cava) –> atria –> ventricles

43
Q

Why do atria have thinner walls than ventricles?

A

blood is not pumped far

44
Q

What has a thicker wall out of the ventricles and why?

A

left ventricle as it must pump blood further than the right

45
Q

What are the right side of the heart and left side known as?

A
  • right side is pulmonary circuit (deoxygenated blood from body sent to lungs for oxygen)
  • left side is systematic circuit (oxygenated blood from lungs sent to rest of body)
46
Q

How does blood flow through the heart? (long answer)

A
  • right atrium collects deoxygenated blood from body via SVC, IVC and coronary sinus
  • right atrium contracts to pass blood through right AV valve/ tricuspid valve into right ventricle
  • right ventricle contracts and blood passes through semi lunar valves at the entrance of the pulmonary trunk and goes to lungs to be oxygenated
  • left atrium receives oxygenated blood from lungs via the four pulmonary veins
  • left atrium contracts to pass blood through the left AV valve/ bicuspid valve into left ventricle
  • left ventricle contracts and blood passes through semilunar valves at the entrance of the aorta as it continues towards the rest of the body

Cardiovascular (2 decks)

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