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BLOCK C > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Position of the heart (limits)

A

Upper limit: sternal angle
Lower limit: xiphisternal joint

Left limit: left midclavicular line
Right limit: right parasternal line-ish

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2
Q

What does the mediastinum contain?

A

All extra-pulmonary (“non-lung”) organs.

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3
Q

Divisions of the mediastinum

A
  1. Superior mediastinum: from sternal angle to rib 1
  2. Middle mediastinum: holds the heart
  3. Posterior mediastinum: behind middle, bound by diaphragm and sternal angle
  4. Anterior mediastinum, front of middle, bound by sternal angle and diaphragm
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4
Q

Contents of the middle mediastinum

A
  1. Heart
  2. Roots of great vessels: aorta, pulmonary trunk and arteries, pulmonary veins, SVC and IVC
  3. Neurovasculature inside pericardium: coronary circulation, cardiac plexus
  4. Neurovasculature outside pericardium: phrenic nerves and pericardiacophrenic arteries and veins.
  5. Respiratory system: primary bronchi (L and R)
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5
Q

What type of neuro information travels through the phrenic nerves?

A

Motor efferent fibers
Sensory fibers

No ANS implication

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6
Q

Divide the pericardium and the pericardial cavity

A
  1. Fibrous pericardium, anchored to the roots of the great vessels
  2. Serous pericardium (parietal and visceral layers).
  3. Pericadial cavity situated betweem the two serious pericardial layers.
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7
Q

Where is epicardial vs pericardial fat located?

A

Pericardial: on the fibrous pericardium
Epicardial: on the visceral layer of the serous pericardium

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8
Q

What are 2 pericardial sinuses?

A
  1. Oblique sinus (posterior to the heart)
  2. Transverse sinus (posterior to aorta and PT)
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9
Q

Difference between pericardial effusion and cardiac tamponade?

A

Pericardial effusion: buildup of excess fluid in pericardial cavity. Slow, so fibrous pericardium stretches in response.

Cardiac tamponade: large and rapid pericardial effusion. HR goes up to maintain CO despite decreased SV. Intervention: pericardiocentesis.

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10
Q

2 sulci of the heart

A

Atrioventricular sulcus
Interventricular sulcus

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11
Q

What are the first two branches of the aorta?

A

Right and left coronary arteries.

Right coronary artery emerges from right aortic valve cusp.
Left coronary artery emerges from left aortic valve cusp.

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12
Q

Does the coronary circulation fill in systole or diastole?

A

Diastole.

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13
Q

3 branches of the right coronary artery

A
  1. Sinoatrial nodal artery
  2. Right marginal artery (towards apex on the right margin of heart). Branches off posterior interventricular.
  3. Posterior interventricular artery (supplies 1/3 of interventricular septum)
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14
Q

3 branches of the left coronary artery

A
  1. Anterior interventricular artery (2/3 of interventricular septum)
  2. Circumflex artery (supplies left atrium)
  3. Left marginal artery. Branches off circumflex, supplies most of left ventricle.
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15
Q

2 anastemoses in common coronary circulation?

A
  1. right coronary artery and circumflex artery
  2. posterior interventricular artery and anterior interventricular artery
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16
Q

What is heart dominance?

A

Which coronary artery gives rise to the posterior interventricular artery.

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17
Q

Prevalence of heart dominance

A

Right dominant = 70%
Left dominant = 15%
Codominant = 15%

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18
Q

What is the venous drainage of the coronary arteries?

A
  1. Great cardiac vein: runs with anterior interventricular artery, then circumflex, into coronary sinus. Drains anterior ventricles and left atrium.
  2. Middle cardiac vein: runs with posterior interventricular artery. Drains posterior interventricular septum.
  3. Small cardiac vein: runs with right marginal artery, then with right coronary artery. Drains right atrium and ventricle into coronary sinus.
  4. Anterior cardiac veins: run with local branches of RCA. Open directly into RA, drains anterior right ventricle.
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19
Q

What is the only vein that does not drain into the coronary sinus?

A

The anterior cardiac vein.

20
Q

Is the pulmonary trunk giving rise to pulmonary arteries or pulmonary veins?

A

Pulmonary arteries.
Emerges from right ventricle

21
Q

Describe walls of the right atrium.

A

Posterior wall, where vessels enter: smooth
Anterior wall: pectinate muscle extending into right auricle

22
Q

Are auricles on the anterior or posterior portion of the heart?

A

Anterior

23
Q

What is the fossa ovalis?

A

An embryological remnant of the opening in the interatrial wall (foramen ovale). Used to allow oxygenated blood from the IVC to bypass pulmonary circulation

24
Q

What is patent foramen ovale?

A

Developmental defect in which fossa ovalis fails to seal (25% of population).

25
Q

What is trabeculae carnae?

A

“meaty struts” on the ventricular walls assisting pumping into pulmonary trunk in the RV.

26
Q

3 cusp names of the tricuspid valve

A

anterior, posterior and septal

27
Q

which auricle is smaller?

A

left

28
Q

2 cusp names of the mitral valve

A

anterior and posterior

29
Q

what is ductus arteriosus?

A

Shunt from pulmonary trunk to aorta during embryological development.

30
Q

What does the foramen ovale become? What does the ductus arteriosus become?

A

Formane ovale –>fossa ovalis
Ductus arteriosus –>Ligamentum arteriosum

31
Q

What is the function of papillary muscles?

A

Prevent cusp prolapse into atria upon ventricular contraction.

32
Q

From where do sympathetic and parasympathetic cardiac innervation arise?

A

Sympathetic: cervical ganglia and sympathetic chain (T1-T4)

Parasympathetic: cardiac branches of the vagus nerve (cranial nerve X)

33
Q

What is the cardiac plexus? Where is it located?

A

The meshwork between SNS and PSNS fibers. Located in front of the aorta and pulmonary trunk.

34
Q

What is the septomarginal band?

A

It is a bridge across inferior right ventricle. Allows for better conductance to right anterior papillary muscle.

35
Q

Where is referred cardiac pain felt?

A

Dermatomes T1-T4 (left upper chest and left arm posterior).

36
Q

Where does sensory innervation come from in the heart?

A

General visceral fibers.

37
Q

What does the superior mediastinum contain?

A
  • Esophagus
  • Trachea
  • Thymus depending on the individual
  • Vessels: aortic arch and first 3 branches, L and R brachiocephalic veins, SVC, pericardiacophrenics, arch of the azygos
  • Thoracic duct
  • Left recurrent laryngeal, phrenics, vaguses, sympathetic chain, cardiac and pulmonary plexuses
38
Q

Does the vagus nerve give rise to recurrent laryngeal nerve?

A

Yes

39
Q

Anterior mediastinum contents

A

Thymus gland.
Larger in youth and shrinks to fibro-fatty tissue in adults.

40
Q

Vertebrae between which the posterior mediastinum is found

A

T5-T12

41
Q

Posterior mediastinum contents

A

Esophagus, thoracic aorta, thoracic duct, azygous venous system, vagus nerves, vagal trunks, sympathetic chain.

42
Q

Main lymphatic collecting duct

A

Thoracic duct (left side).

43
Q

Other lymphatic collecting duct

A

Right lymphatic duct

44
Q

Position of esophagus relative to thoracic aorta as we move down in the mediastinum

A

First: to the right of the aorta
Then moves anterior to it

45
Q

What does the left vagus become as we move down in the mediastinum?

A

Anterior vagal trunk

46
Q

What does the right vagus become as we move down in the mediastinum?

A

Posterior vagal trunk

47
Q

How does SNS travel to abdomniopelvic area?

A

Preganglionic fibers travel to ganglia in abdomen via splanchnic nerves. No sympathetic chain synapse.

BLOCK C (7 decks)

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