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Cardiovascular > Anatomy 3 > Flashcards

Anatomy 3 Flashcards

1
Q

Where is the thoracic inlet? Transverse thoracic plane?

A
  • In thorax - bounded by ribs 1, T1 vertebra and jugular notch
  • Between sternal angle and T4/5 intervertebral disc
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2
Q

What is anterior mediastinum? What exists in anterior mediastinum? What diseases can affect this lymphoid organ? (3)

A
  • Between sternum & the fibrous pericardium
  • Thymus in CHILDHOOD (becomes replaced with adipose tissue after puberty)
  • Thymoma, thymic carcinoma, lymphoma
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3
Q

What is present in middle mediastinum? (3)

A

1) pericardium
2) heart
3) parts of the great vessels that connect with the heart:

  • inferior part of SVC
  • superior part of IVC
  • pulmonary trunk & pulmonary arteries
  • pulmonary veins
  • ascending aorta
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4
Q

What separates superior and inferior mediastinum? Is trachea part of posterior mediastinum?

A
  • Sternal angle

* Posterior mediastinum is division of inferior mediastinum so trachea not part of it but primary bronchi are

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5
Q

What structures located within posterior mediastinum? (7)

A
  • Primary bronchi
  • Oesophagus
  • Thoracic aorta
  • Vagus nerves (difficult to isolate as form plexus on surface of oesophagus)
  • Thoracic duct
  • Azygous vein
  • Sympathetic chains
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6
Q

Where is azygous vein located in relation to hilum? What can happen to azygous vein in trauma?

A
  • Passes posterior to root of lung and drains anteriorly into SVC passing OVER root of lung
  • Can be ruptured in trauma
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7
Q

What is thoracic aorta the same as? When does thoracic aorta become abdominal aorta?

A
  • Descending aorta

* When passes through diaphragm

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8
Q

What are the mediastinal branches of the aorta?

A
  • Ascending aorta - coronary arteries
  • Arch of aorta - brachiocephalic trunk, left common carotid, left subclavian artery
  • Thoracic aorta - bilateral posterior intercostal arteries, anterior branches of thoracic aorta
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9
Q

What are the anterior branches of thoracic aorta? (5)

A
  • bronchial arteries (arterial blood for the lung tissue)
  • oesophageal arteries
  • mediastinal arteries
  • pericardial arteries
  • phrenic arteries (for the diaphragm
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10
Q

Where do anterior intercostal arteries arise from?

A

Internal thoracic arteries

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11
Q

What drains into right venous angle? Left venous angle?

What is a venous angle?

A
  • right lymphatic duct drains lymph into right venous angle
  • thoracic duct drains lymph into left venous angle
  • Venous angle is formed between 2 veins - internal jugular and subclavian veins (form brachiocephalic vein)
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12
Q

How does lymph drain from the lungs? Exception?

A
  • Lymph from bronchopulmonary/hilar lymph nodes drain into tracheo-bronchial lymph nodes into thoracic duct
  • Exception - left lower lobe can sometimes drain back via right lymphatic duct rather than thoracic duct
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13
Q

Where are bronchopulmonary/hilar lymph nodes located? Tracheo-bronchial lymph nodes?

A
  • Surround main bronchus at lung root

* Around bifurcation of trachea

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14
Q

What is specific position of thoracic duct in mediastinum? How is thoracic duct affected by trauma?

A
  • Wedged between azygous vein and oesophagus

* Can be ruptured in trauma

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15
Q

What can mass in posterior mediastinum cause? (2)

A
  • Can compress oesophagus causing dysphagia

* Can affect recurrent laryngeal nerves causing hoarseness

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16
Q

What is cisterna chyli?

A

Swollen start of throacic duct in abdomen

17
Q

What is the difference between position of right vagus nerve and left vagus nerve in mediastinum?

A
  • Right vagus nerve will pass on lateral surface of trachea, posterior to lung root, and follows oesophagus
  • Left vagus nerve will cross arch of the aorta, posterior to lung root, then follows oesophagus
18
Q

What is the recurrent laryngeal nerve? Where is left recurrent laryngeal nerve located? Right recurrent laryngeal nerve? What is the purpose of recurrent laryngeal nerves?

A
  • Branch of the vagus nerve
  • Hooks under arch of aorta (at ligamentum arteriosum) - DOES enter the chest
  • Hooks under right subclavian artery - does NOT enter the chest
  • Responsible for phonation (supplies the larynx)
19
Q

How do phrenic nerves supply diaphragm? (2)

A
  • Right phrenic nerve - passes through diaphragm with IVC to supply diaphragm from inferiro aspect
  • Left phrenic nerve - pierces through left dome of diaphragm to supply it from inferior aspect
20
Q

List branches in superior mediastinum from anterior to posterior (5)
Lateral to medial? (3)

A

Anterior to posterior

  • brachiocephalic veins & SVC
  • arch of aorta
  • trachea
  • oesophagus
  • thoracic duct

Lateral to medial

  • phrenic nerves
  • vagus nerves
  • recurrent laryngeal nerves
21
Q

What are central veins? Examples? (7) What can they be used for?

A

Large veins close enough to the heart so the pressure within them reflects the pressure within the right atrium

  • Internal jugular veins (JVP)
  • Subclavian veins
  • Brachiocephalic veins
  • SVC
  • IVC
  • Iliac veins
  • Femoral veins

Can be used for central venous cannulation (esp IJV)

22
Q

What is normal range for JVP?

A
  • At 45o JVP should be no more than 3cm superior to sternal angle
23
Q

What nerves make up phrenic nerves? What are they somatic motor supply to? Somatic sensory? (4)

A
  • Cervical spinal nerves C3, 4, 5
  • Somatic motor to diaphragm

Somatic sensory

  • mediastinal parietal pleural
  • fibrous pericardium
  • diaphragmatic parietal pleura
  • diaphragmatic parietal peritoneum
24
Q

What nerves make up phrenic nerves? What are they somatic motor supply to? Somatic sensory? (4)

A
  • Cervical spinal nerves C3, 4, 5
  • Somatic motor to diaphragm

Somatic sensory

  • mediastinal parietal pleural
  • fibrous pericardium
  • diaphragmatic parietal pleura
  • diaphragmatic parietal peritoneum
25
Q

Can can cause referred pain from the diaphragm? How does it cause diaphragmatic pain?

A
  • Liver abscess or inflammation of gallbladder

* Irritates parietal peritoneum lining surface of diaphragm supplied by phrenic nerve C3, 4 and 5

26
Q

Where is diaphragmatic pain often referred? Why?

A

Shoulder tip

  • Supraclavicular nerves C3 and 4 supply dermatomes of shoulder tip and enter spinal cord at same level as phrenic nerve (C3, 4, 5)
  • Brain refers pain to more superficial structure - skin over shoulder tip
27
Q

Wat do vagus nerves contain? What do recurrent laryngeal nerves supply?

A
  • Somatic sensory nerves - for plate, laryngopharynx + larynx
  • Somatic motor nerves - for pharynx + larynx
  • Autonomic parasympathetic nerves - for thoracic and abdominal organs

Recurrent laryngeal nerves - branches of vagus nerve that supply pharynx + larynx

28
Q

What structures does cephalic vein drain? Axillary artery and vein drain/supply? Subclavian artery/vein? Internal thoracic artery/vein? Anterior and posterior intercostal arteries?

A
  • Cephalic vein - upper limbs
  • Axillary artery/vein - axilla
  • Subclavian artery and vein - arms
  • Internal throacic artery/vein - anterior body wall
  • Anterior and posterior intercostal arteries - intercostal spaces
29
Q

What structures does great saphenous vein drain? Internal iliac? External iliac? Femoral artery/veins?

A
  • Great saphenous - leg
  • Internal iliac - pelvis
  • External iliac - lower limb
  • Femoral - thigh and leg
30
Q

What does ophthalmic artery supply? Central artery of retina?

A
  • Ophthalmic artery - eye

* Retina

31
Q

Where is bifurcation of common carotid auscultated? What is it auscultated for?

A
  • Anterior to sternocleido-mastoid muscle at level of superior border of thyroid cartilage
  • Bruits - indicate turbulent blood flow due to carotid artery disease
32
Q

Where is brachial artery palpated? Radial artery? Femoral artery? Popliteal artery?

A
  • Medial to biceps brachii tendon in cubital fossa
  • Lateral to tendon of flexor carpi radialis
  • Inferior to midpoint of inguinal ligament
  • In popliteal fossa
33
Q

Where is posterior tibial artery palpated? Dorsalis pedis artery?

A
  • Posterior border of medial malleolus

* Medial to tendon of extensor hallicus longus

34
Q

What is subclavian artery used medically for? Radial artery? IJV? Femoral vein?

A
  • Subclavian artery - insertion of cardiac pacing wire under ultrasound guidance
  • Radial artery - cannulation for arterial blood pressure monitor/ABG sampling
  • IJV - insertion of central line under ultrasound guidance
  • Femoral vein - insertion of central line

Cardiovascular (28 decks)

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