Anatomy

Question 1

What is cardiac tamponade?

Answer 1

When the pericardial cavity fills with blood and the pressure around the heart can prevent cardiac contraction

Question 2

What invisible layer covers the anterior surface of the heart?

Answer 2

Epicardium

Question 3

What is pericardiocentesis?

Answer 3

Drainage of fluid from the pericardial cavity

Question 4

Where and how is the needle inserted in pericardiocentesis?

Answer 4

Needle inserted via imfrasternal angle and directed superoposteriorly, aspirating continuously

Question 5

Where is the transverse pericardial sinus?

Answer 5

Posterior to the ascending aorta and pulmonary trunk

Question 6

What direction does cardiomegaly shift the apex?

Answer 6

Left

Question 7

What does the right coronary groove indicate?

Answer 7

Surface marking for the tricuspid valve

Boundary between right atrium and right ventricle

Question 8

What vessels are found on the right side of the heart?

Answer 8

Right common carotid artery 
Right subclavian artery 
Brachiocephalic trunk 
Right pulmonary arteries 
Right pulmonary veins 
SVC 
IVC 
Right brachiocephalic vein   
Right jugular vein

Question 9

Vessels found on the left side of the heart?

Answer 9

Left common carotid artery 
Left vagus nerve 
Left subclavian artery 
Left phrenic nerve 
Left BCV 
Left pulmonary artery 
Left pulmonary veins 
Branching of left coronary artery (LAD)

Question 10

What is the coronary sinus?

Answer 10

Short venous conduit
(In atrioventricular groove posteriorly)
Which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

Question 11

What are the branches of the left (main stem coronary artery)?

Answer 11

Circumflex artery
LAD
Left marginal artery
Lateral (diagonal) branch

Question 12

Where do th coronary arteries arise from?

Answer 12

The ascending aorta

Question 13

What are the branches of the right coronary artery?

Answer 13

Right marginal artery

Question 14

What life threatening problem does a septal defect cause?

Answer 14

Mixing of arterial and venous blood
This reduces the oxygen content of systemic arterial blood in the aorta
(Hypoxaemia)

Question 15

What is the tricuspid valve between?

Answer 15

Right atrium & right atrium

Question 16

What is the aortic valve between?

Answer 16

Left ventricle & the aorta

Question 17

What is the mitral valve in between?

Answer 17

Left atrium & left ventricle

Question 18

What is the pulmonary valve between?

Answer 18

Right ventricle and pulmonary trunk

Question 19

Why do you not auscultate valves over where they actually are?

Answer 19

Can’t hear through bone

Question 20

Where do you auscultate the aortic valve?

Answer 20

2nd right ICS sternal edge

Question 21

Where do you auscultate the pulmonary valve?

Answer 21

2nd left ICS sternal edge

Question 22

Where do you auscultate the mitral valve?

Answer 22

5th left ICS midclavicular line

Question 23

Where do you auscultate the tricuspid valve?

Answer 23

5/6th left ICS sternal edge

Question 24

What are the 2 most common valvular abnormalities encountered clinically?

Answer 24

Aortic stenosis

Mitral regurgitation

Question 25

What causes the sound in a murmur?

Answer 25

Turbulent blood flow

Question 26

When a valve is incompetent what does this mean?

Answer 26

Doesn't close properly "Leaky" (Can't adequately supply tissues/organs with oxygenated blood)

Question 27

If a valve is stenosis what does this mean?

Answer 27

Not opening properly "Tight" Causes back pressure behind them and can lead to heart failure

Question 28

What is haemopericardium?

Answer 28

When the pericardial cavity fills with blood

Question 29

How do the sympathetic, parasympathetic and visceral afferent nerves reach the heart?

Answer 29

Via cardiac plexus

Question 30

What is the presynaptic neurotransmitter in sympathetic stimulation?

Answer 30

Acetyl choline

Question 31

What is the post synaptic neurotransmitter in sympathetic nerves?

Answer 31

Noradrenaline

Question 32

Where do presynaptic nerve fibres leave the spinal cord to innervates the heart?

Answer 32

T1 to L2/3

Question 33

What is the cranial nerve that supplies the heart?

Answer 33

CNX - vagus nerve

Question 34

What is the presynaptic neurotransmitter in parasympathetic nerve fibres?

Answer 34

Acetyl choline

Question 35

What is the post synaptic neurotransmitter in parasympathetic nerve fibres?

Answer 35

Acetyl choline

Question 36

What do post synaptic cardiac sympathetic efferent and cardiac visceral afferent travel in to reach heart?

Answer 36

Cardiopulmonary splanchic nerve

Question 37

Where are visceral afferent nerve endings found in the heart?

Answer 37

``` Inner aortic arch Pulmonary trunk Around the SA node Outflow tracts from both ventricles Papillary muscles Vena Cavae ```

Question 38

Muscle causes of sharp chest pain?

Answer 38

Pectoral is major or intercostal muscle strain

Question 39

Joint causes of sharp central chest pain?

Answer 39

Dislocated costochondral joint | Slipped thoracic intervertebral disc

Question 40

Diseases of the parietal pleura and fibrous pericardium that can causes sharp central chest pain?

Answer 40

Pleurisy | Pericarditis

Question 41

Which arteries supply the inter ventricular septum?

Answer 41

LAD | Posterior inter ventricular artery

Question 42

Where is the thymus found?

Answer 42

Anterior mediastinum

Question 43

What does the thymus do?

Answer 43

Produces T lymphocytes in childhood then becomes adipose tissue after puberty

Question 44

What does the azygous vein do?

Answer 44

Take blood from intercostal veins to SVC

Question 45

What does the thoracic duct do?

Answer 45

Carry lymph to the left venous angle

Question 46

What superior branches come off the arch of the aorta?

Answer 46

Brachiocephalic trunk (right) Left common carotid artery Left subclavian artery

Question 47

Where does the right lymphatic duct drain?

Answer 47

Right venous angle

Question 48

What nerve passes through the diaphragm with the IVC?

Answer 48

Right phrenic nerve

Question 49

What is the ligamentum arteriosum the remnant of?

Answer 49

Ductus Arteriosus

Question 50

What is the arrangement of nerves in the superior mediastinum from lateral to medial?

Answer 50

Phrenic nerves Vagus nerves Recurrent laryngeal nerves

Question 51

What does the brachiocephalic trunk split into?

Answer 51

Right subclavian artery | Right common carotid artery

Question 52

What 3 veins drain into the SVC?

Answer 52

Right subclavian vein Right internal jugular vein Left brachiocephalic vein

Question 53

Do the recurrent laryngeal nerves enter the chest?

Answer 53

No

Question 54

What do the recurrent laryngeal nerves supply?

Answer 54

The larynx

Question 55

What are the phrenic nerves formed from?

Answer 55

Combined anterior rami of cervical spinal nerves 3, 4, & 5

Question 56

What does the phrenic nerve supply somatic motor innervation to?

Answer 56

The diaphragm

Question 57

What does the phrenic nerve supply somatic sensory innervation to?

Answer 57

Mediastinal parietal pleura Fibrous pericardium Diaphragmatic parietal pleura Diaphragmatic parietal peritoneum

Question 58

What does the vagus nerve provide somatic sensory innervation for?

Answer 58

Laryngopharynx & larynx

Question 59

What does the vagus nerve provide somatic motor innervation for?

Answer 59

Pharynx and larynx

Question 60

What does the vagus nerve provide parasympathetic innervation for?

Answer 60

Thoracic and abdominal organs

Question 61

What are the recurrent laryngeal nerves?

Answer 61

Branches of the vagus nerve that supply the pharynx and larynx

Question 62

Why does gallbladder/liver pain refer to the shoulder?

Answer 62

Irritates parietal peritoneum Which is supplied by phrenic nerve (C3, 4, 5) Supraclavicular nerves (C3, 4) supply dermatome son tip of shoulder