Anatomy Flashcards
What is the name of the tough bag in the middle of the mediastinum?
Fibrous pericardium
Give a pro and a con of the fibrous pericardium
+ helps prevent cardiac overfilling
+ helps prevent cardiac injury
- if it fills with blood the pressure around the heart can prevent contraction
What is the name for blood in the pericardium?
Haemopericardium
What are the names of the two layers of serous pericardium?
Parietal and visceral pericardium
What does visceral mean?
Organ
What are the three layers of heart tissue?
Outside - epicardium (visceral serous)
Middle - myocardium (muscle layer)
Inside - endocardium (inner lining)
What is the name for cardiac cells?
Myocyctes
What are the four parts of the aorta?
- Ascending aorta
- Arch of the aorta
- thoracic aorta
- Abdominal aorta
What are the three branches of the arch of the aorta?
- Brachiocephalic trunk
- Left common carotid artery
- Subclavian artery
What does the brachiocephalic trunk bifurcate into?
The right subclavian artery and the right common carotid artery
What does the right common carotid artery bifurcate into?
The right internal and external carotid arteries
What are anastomoses?
Arteries connect with each other without an intervening capillary network. The provide alternative routes for blood flow to areas distal to an occlusion.
What does infraction mean?
Irreversible cell death due to hypoxia caused by a lack of arterial blood supply.
What nerves supply the diaphragm?
Phrenic nerves
What is the term given to drainage of fluid from the pericardial cavity?
Pericardiocentesis
Name the space used by cardiac surgeons to identify and isolate the great vessels for open heart surgery
Transverse pericardial sinua
What are the heart surfaces
Anterior (sternocostal) surface
Base (posterior) surface
Inferior (diaphragmatic) surface
Where do you palpate the apex beat?
5th left intercostal space in the midclavicular line (mitral area)
Define cardiomegaly
Abnormal enlargement of the heart
Where is the right coronary artery found?
In the coronary groove
Where is the anterior intraventricular artery found?
The anterior interventricular groove
What is the coronary sinus?
A short venous channel in the atrioventricular groove posteriorly.
Recieves deoxygenated blood from most of the cardiac veins and drains into the right atrium.
Name the coronary arteries in the heart
Right coronary artery Left coronary artery Right marginal artery Left marginal artery Circumflex artery Left anterior descending (LAD)/anterior interventricular artery Lateral branch Posterior interventricular artery
What is the septum?
Internal wall that divides the heart into a left and right side
What is the part of the septum between the two atria called?
Interatrial septum
What is the part of the septum between the two ventricles called?
Interventricular septum
What is an atrial septal defect?
A hole in the interatrial septum
What are the 2 most common valvular abnormalities encountered clinically?
Aortic stenosis
Mitral incompetence
Define stenosis
Abnormal narrowing of a passage in the body
What are murmurs associated with?
Abnormal valves
What are stenotic cardiac valves?
Tight valves that do not open properly
What do presynaptic fibers connect between?
CNS and ganglion
What is the neurotransmitter at the ganglia of the sympathetic chain?
Acetylcholine
What do postsynpatic fibers connect between?
Ganglia and an organ
What is a ganglion?
The synapse between the axon of presynaptic neurone and the cell body of postsynaptic neurone
What is the neurotransmitter for the postsynaptic fibre
Noradrenaline
What spinal nerves do the presynaptic sympathetic fibres from the brain exit the spinal cord?
T1-L2/3 spinal nerves
What is the name of the sympathetic nerves that go to the heart and the lungs?
Cardiopulmonary splanchnic nerves
What makes up the cardiac plexus?
Sympathetic fibres
Parasympathetic fibres
Visceral afferent fibres
What is the neurotransmitter in parasympathetic signalling?
Acetylecholine
What structures would create somatic central chest pain?
Muscle Joint Bone Intervertebal disk Fibrous pericardium Nerve
What is the nature of somatic pain?
Typically sharp, stabbing and well localised
What would be the cause of visceral pain?
Heart and great vessels
Trachea
Oesophagus
Abdominal viscerae
What is the nature of visceral pain?
Typically dull, aching, nauseating and poorly localised
What does the sensory homunculus show?
Illustrates the areas of the cerebral neocortex where sensations from different body wall structures reach consciousness
What is Herpes Zoster
Shingles
Reactivation of dormant virus in posterior root ganglion
Pain can be found anywhere in that dermatome and preceded blisters.
Give injuries that could result in somatic central chest pain
Pectoralis major or intercostal muscle strain
Dislocated costochondral joint
Costovertebral joint inflammation
‘Slipped’ thoracic intervertebral disc
In regard to the parietal pleura and firbous pericardium what could cause somatic central chest pain?
Pleurisy and pericarditis
What are causes of visceral central chest pain?
Tracheitis Oesophagitis Ruptured aneurysm or aortic arch Angina Myocardial infarction Gastritis Cholecystitis Pancreatitis Hepatitis etc.
In referred pain where is the pain felt?
Only at a site remote from the actual area of injury or disease
How does referred pain arise?
The brain chooses to believe that the pain signals coming from the organ are actually coming from the soma. This happens because the afferent fibres from the soma and viscera enter the spinal cord at the same levels
What is a myocardial infraction?
Irreversible cell death (necrosis) of part of the myocardium due to occlusion of it’s arterial blood supply
Give the three types of MI
Anterior MI
Inferior MI
Anterolateral MI
Where do the left and right coronary arteries lie?
In the left and right atrioventricular grooves
What is another name for the anterior interventricular artery?
left anterior descending (LAD)
What does CABG stand for?
Coronary Artery Bypass Grafting
What artery provides blood supply to the sinoatrial node?
Branch from the right coronary artery near its origin
What artery provides blood supply to the atrioventricular node?
Branch of the right coronary artery near the origin of the posterior interventricular artery
What is the mediastinum?
The area that lies between the lungs
What structures is in the anterior mediastinum?
Thymus
What structures lie in the middle mediastinum?
Pericardium, heart, parts of the great vessels that connect with the heart
What structures lie in the posterior mediastinum?
The azygous vein, sympathetic chains, vagus nerves, trachea and the 2 main bronchi, thoracic aorta, the oesophagus and the thoracic duct
What does the azygous vein do?
Drains blood from the intercostal veins to the SVC
What are the 4 parts of the aorta?
Arch, ascending, thoracic and abdominal
What branches come off the ascending aorta?
The coronary arteries
What branches come off the arch of the aorta?
The brachiocephalic trunk, THe left common carotid artery and the left subclavian artery
What branches come off the thoracic aorta’s anterior surface?
Bronchial arteries (arterial blood for the lung tissue) Oesophageal arteries Mediastinal arteries Pericardial arteries Phrenic arteries (for the diaphragm)
What is the name for the hole in the diaphragm where the aorta goes through?
Aortic hiatus
Where does the right lymphatic duct drain lymph into?
Right venous angle
Where does the thoracic duct drain lymph into?
The left venous angle
Name the lymph nodes around the lungs
Tracheobronchial lymph nodes (around the bifurcation of the trachea)
Bronchopulmonary lymph nodes (surround the main bronchus at the lung root)
What is the cisterna chyli?
Swollen start of the thoracic duct in the abdomen
Is the right phrenic nerve more medial or lateral to the right vagus nerve?
The phrenic nerve is more lateral than the vagus nerve (the phrenic nerve is on the outside)
What is the path of the right recurrent laryngeal nerve?
Hooks under the right subclavian artery and does NOT enter the chest
What is the path of the left recurrent laryngeal nerve?
Hooks under the arch of the aorta and DOES enter the chest
What are the nerves of the superior mediastinum?
The phrenic and vagus nerves
What nerves are the recurrent laryngeals a branch of?
The vagus nerve
Where is a common place for referred pain from the diaphragm?
Shoulder tip pain
