Anatomy

Question 0

What is the role of the epicardium?

Answer 0

Secretes pericardial fluid lubricant

Question 1

What border of the heart do the phrenic nerves descend across?

Answer 1

The lateral borders

Question 2

What happens when the pericardial cavity fills with blood - haemopericardium?

Answer 2

The pressure around the heart increases and can prevent cardiac contraction (a condition known as cardiac tamponade).

Question 3

What is pericardiocentesis?

Answer 3

Drainage of fluid from the pericardial cavity

Question 4

What does the pulmonary trunk divide into?

Answer 4

Left and right pulmonary arteries

Question 5

Where do you palpate for the apex beat?

Answer 5

5th left intercostal space in the midclavicular line (mitral area)

Question 6

What three structures come from the aortic arch (right to left)?

Answer 6

Brachiocephalic trunk, left common carotid artery, left subclavian artery

Question 7

What does the brachiocephalic trunk bifurcate into?

Answer 7

Right subclavian artery and right common carotid artery

Question 8

The superior vena cava divides into three structures as it moves upwards - what are they from inferior to superior?

Answer 8

Left brachiocephalic vein, right subclavian vein, right internal jugular vein

Question 9

Which coronary artery descends in the anterior interventricular groove?

Answer 9

The left anterior descending (LAD)

Question 10

Which coronary artery descends in the coronary groove?

Answer 10

Right coronary artery - the groove indicates the surface marking for the tricuspid valve (boundary between right atrium and right ventricle).

Question 11

Which branch of the SVC branches out posteriorly?

Answer 11

Azygous vein

Question 12

What is the coronary sinus and what does it do?

Answer 12

It is a short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from msot of the cardiac veins and drains into the right atrium.

Question 13

What artery is a branch of the right coronary artery and travels transversely along the anterior inferior aspect of the heart?

Answer 13

The right marginal artery

Question 14

Which two arteries does the left main coronary artery branch into?

Answer 14

Circumflex artery and LAD

Question 15

What is an atrial septal defect?

Answer 15

A hole in the interatrial septum

Question 16

What is a ventricular septal defect?

Answer 16

A hole in the interventricular septum

Question 17

What does having mixed arterial and venous blood do? What is this called?

Answer 17

Reduces the oxygen content of systemic arterial blood in the aorta - this is called hypoxaemia

Question 18

What three openings does the right atrium have?

Answer 18

Superior vena cava
Coronary sinus
Inferior vena cava

Question 19

Where is the tricuspid valve?

Answer 19

Between the right atrium and right ventricle

Question 20

Where is the pulmonary valve?

Answer 20

Between the right ventricle and the pulmonary trunk

Question 21

Where is the mitral valve?

Answer 21

Between the left atrium and the left ventricle

Question 22

Where is the aortic valve?

Answer 22

Between the left ventricle and the aorta

Question 23

What does the moderator band in the heart do?

Answer 23

Carries fibres of right bundle branch to the papillary muscle of the anterior cusp

Question 24

Where would you listen for the aortic valve?

Answer 24

2nd right intercostal space, sternal edge

Question 25

Where would you listen for the pulmonary valve?

Answer 25

2nd left intercostal space, sternal edge

Question 26

Where would you listen for the tricuspid valve?

Answer 26

5th/6th left ICS, lower left sternal edge

Question 27

Where would you listen for the mitral valve?

Answer 27

5th left ICS, midclavicular line

Question 28

What is the first heart sound caused by?

Answer 28

Closure of the tricuspid and mitral valves

Question 29

What is the second heart sound caused by?

Answer 29

Closure of pulmonary and aortic valves

Question 30

How do the sympathetic nerves and the parasympathetic nerves reach the heart?

Answer 30

Via the cardiac plexus

Question 31

Where do presynaptic sympathetic fibres from the brain exit the spinal cord?

Answer 31

In one of T1 - L2/3 spinal nerves (thoracolumnar)

Question 32

Once the presynaptic sympathetic fibres have exited the spinal cord in either T1-L2/3 spinal nerves what are the five following options?

Answer 32

1. Go into ganglion of that level and synapse 2. Travel superiorly in the sympathetic chain to another ganglion and synapse 3. Travel inferiorly in the sympathetic chain to another gangion and synapse 4. Pass straight through the sympathetic chain ganglion without synapsing, as abdominopelvic splanchnic nerves, to synapse in one of the prevertebral ganglia of the abdomen (e.g. celiac ganglion) 5. Pass straight to the adrenal medulla without synapsing as an abdominopelvic splanchnic nerve (directly stimulating adrenaline release)

Question 33

What do the cardiopulmonary splanchnic nerves supply?

Answer 33

Sympathetic nerves to the heart and lungs

Question 34

What do cardiopulmonary splanchnic nerves contain?

Answer 34

Post-synaptic fibres from cervical and upper thoracic sympathetic chains

Question 35

What does the cardiac plexus contain?

Answer 35

Sympathetic fibres Parasympathetic fibres Visceral afferents

Question 36

What do spinal sacral nerves supply?

Answer 36

Organs of the lower abdomen, pelvis and perineum (pelvic splanchnic nerves are parasympathetic)

Question 37

How do parasympathetic signals reach the organs?

Answer 37

Via cranial nerves III, VII, IX and X (occulomotor, facial and glossopharyngeal + vagus)

Question 38

The aortic arch innervation is done by what?

Answer 38

Baroreceptor reflex afferents in the vagus nerve

Question 39

What is vagal tone?

Answer 39

Continuous background action potentials in CN X to slow the heart rate

Question 40

Where are chemoreceptor nerve endings found?

Answer 40

In the root of the aorta and IV septum

Question 41

Where are the 6 locations of visceral afferent nerve endings?

Answer 41

1. inner aortic arch 2. pulmonary trunk 3. around the SA node 4. outflow tracts from both ventricles 5. papillary muscles 6. vena cavae

Question 42

What happens at the postcentral gyrus of parietal love (somatosensory)?

Answer 42

Action potentials arriving here bring body wall (somatic) sensations into "consciousness"

Question 43

What happens at the precentral gyrus of the frontal lobe (somatomotor)?

Answer 43

Action potentials originating here bring about contractions of body wall (somatic) skeletal muscle

Question 44

What divides the postcentral gyrus of the parietal lobe and the precentral gyrus of the frontal lobe?

Answer 44

The central sulcus

Question 45

What causes herpes zoster (shingles) and describe/explain the pain?

Answer 45

Reactivation of dormant virus in posterior root ganglion. Pain can be felt anywhere in that dermatome - pain precedes blisters Patient with shingles developing in T4/T5 dermatome may present with central chest pain

Question 46

What two muscles could cause central chest pain if strained?

Answer 46

Pectoralis major and intercostal muscles

Question 47

What joint dislocation can cause central chest pain?

Answer 47

Costochondral joint

Question 48

Dull (visceral) central chest pain can be caused by what in relation to the trachea?

Answer 48

Tracheitis

Question 49

Dull (visceral) central chest pain can be caused by what in relation to the aorta?

Answer 49

Ruptured aneurysm of aortic arch

Question 50

Dull (visceral) central chest pain can be caused by what in relation to the abdominal viscerae?

Answer 50

Gastritis Cholecystitis Pancreatitis Hepatitis

Question 51

Dull (visceral) central chest pain can be caused by what in relation to the oesophagus?

Answer 51

Oesophagitis

Question 52

Dull (visceral) central chest pain can be caused by what in relation to the heart?

Answer 52

Angina | Myocardial infarction

Question 53

The thoracic duct courses down which side of the medastinum?

Answer 53

The left

Question 54

The azygous vein courses down which side of the mediastinum?

Answer 54

The right

Question 55

What is the ligamentum arteriosum?

Answer 55

Remnant of ductus arteriosus connecting pulmonary trunk to arch of the aorta

Question 56

Where is the most common place for coronary atherosclerosis to occur?

Answer 56

LAD

Question 57

What is the thoracic inlet bounded by?

Answer 57

Ribs 1, T1 vertebra and the jugular notch

Question 58

Where is the transverse thoracic plane?

Answer 58

Between the sternal angle and T4/T5 intervertebral disc

Question 59

What - beginning with T - is present in the anterior medastinum?

Answer 59

Thymus (gland/lymhpoid organ producing T lymphocytes in childhood - involutes and becomes replaced by adipose tissue after puberty)

Question 60

Where do the intercostal veins drain posteriorly into?

Answer 60

The azygous vein

Question 61

What is the opening in the diaphragm where the aorta passes through called?

Answer 61

The aortic hiatus

Question 62

Where does the right lymphatic duct drain lymph into?

Answer 62

The right venous angle

Question 63

Where does the thoracic duct drain lymph into?

Answer 63

Left venous angle

Question 64

What lymph nodes are congregated around the bifurcation of the trachea?

Answer 64

Tracheo-bronchial lymph nodes

Question 65

What lymph nodes surround the main bronchus at the lung root?

Answer 65

Bronchopulmonary lymph nodes

Question 66

What is the surface anatomy of the left venous angle?

Answer 66

Left sternoclavicular joint

Question 67

What is the swollen start of the thoracic duct in the abdomen called?

Answer 67

Cisterna chyli

Question 68

What structure does the phrenic nerve pass through the diaphragm with?

Answer 68

The IVC

Question 69

What special branch comes from the left vagus nerve, near the lung roots?

Answer 69

The recurrent laryngeal branch of the left vagus nerve

Question 70

What rib does the subclavian vein cross?

Answer 70

Rib 1

Question 71

What postition should the patient be in to view the jugular venous pressure (JVP)?

Answer 71

head/neck/chest raised to 45 degrees, head turned to the left (At 45 the JVP should be no more than 3cm to the sternal angle)

Question 72

What causes the JVP to be seen?

Answer 72

Atrial contraction then filling of the right atrium against a closed tricuspid valve causes a "double pulsation" (pressure wave) conducted in a retrograde direction into the central veins that can be observed in the internal jugular vein.

Question 73

What test can you do to view the JVP?

Answer 73

Abdominojugular test (increases venous return)

Question 74

Which is more medial - the vagus nerve or phrenic nerve?

Answer 74

The vagus

Question 75

What artery does the right recurrent laryngeal nerve hook under?

Answer 75

Right subclavian artery (nerve doesnt enter chest)

Question 76

What structure does the left recurrent laryngeal nerve hook under?

Answer 76

The arch of the aorta (nerve enters chest)

Question 77

Once the vagus nerves have given off their recurrent laryngeal branches what fibres are they left containing (only fibres left)?

Answer 77

parasympathetic fibres

Question 78

What nerves supply the dermatomes over the shoulder tip?

Answer 78

Supraclavicular nerves (C3 and C4)

Question 79

What nerves enter the spinal cord at the same level as the phrenic nerve?

Answer 79

Supraclavicular nerves

Question 80

What muscles does the left recurrent laryngeal nerve supply?

Answer 80

The muscles of the larynx

Question 81

What is the cephalic vein?

Answer 81

Superficial vein of the upper limb

Question 82

What great vein courses down the inside of the leg?

Answer 82

The great saphenous vein and the musculo-venous pump

Question 83

Where will you find the pulse in the neck?

Answer 83

Bifurcation of common carotid artery - anterior to sternocleidomastoid muscle at the level of the superior border of thyroid cartilage

Question 84

Where will you find the brachial artery pulse?

Answer 84

Medial to biceps brachii tendon in the cubital fossa

Question 85

Where will you find the radial artery pulse?

Answer 85

Lateral to the tendon of flexor carpi radialis

Question 86

Where will you find the pulse of the femoral artery?

Answer 86

Inferior to the midpoint of inguinal ligament

Question 87

Where will you feel the popliteal artery?

Answer 87

In the popliteal fossa (immediately posterior to the knee joint)

Question 88

Where will you feel the pulse of the posterior tibial artery?

Answer 88

Between the posterior border of the medial malleolus and the achilles tendon

Question 89

Where will you feel the pulse of the dorsalis pedis artery?

Answer 89

Medial to the tendon of extensor hallucis longus on the dorsum of the foot

Question 90

What makes up the brachial plexus?

Answer 90

Anterior rami of C5-T1 spinal nerves - supplies the upper limb

Question 91

What two vessels is the scalenus anterior muscle between?

Answer 91

On the right - subclavian artery and right subclavian vein