Anatomy Flashcards
What is the hilum of the lung?
The root of the lung.
The point where the bronchus, pulmonary arteries, pulmonary veins, lymphatic vessels (and bronchopulmonary lymph nodes) and nerves enter the lung.
In relation to the pericardium, where is the phrenic nerve?
The phrenic nerve descends across the lateral border of the heart and into the diaphragm
What is the epicardium?
the thin external layer formed by the visceral layer of serous pericardium
What is meant by “haemopericardium”?
when the pericardial cavity if filled with blood following a penetrating injury or ruptures cardiac chamber following an MI
What is a cardiac tamponade?
A condition where the pressure around the heart prevents cardiac contraction
What is periocardiocentesis?
A procedure where the pressure of fluid within the pericardium is reduced
e..g. drainage of fluid from the pericardial cavity
must avoid parietal pleura so a needle is inserted via the infrasternal angle and directed superoposteriorly, aspirating continuously
What is the transverse pericardial sinus?
A “space” within the pericardial cavity, posterosuperiorly
It lies posterior to the ascending aorta and pulmonary trunk
It lies anterior to the SVC
What part of the heart forms the apex?
The inferolateral part of the left ventricle
What part of the heart forms the base?
The base is the posterior aspect of the heart.
Formed mainly by the left atrium and part of the right atrium
What part of the heart forms the anterior surface?
Mainly the right ventricle
What part of the heart forms the diaphramatic (inferior) surface?
Mainly the left ventricle and part of the right ventricle
What part of the heart forms the right border (right pulmonary surface?
Right atrium
What part of the heart forms the left (lateral) border (left pulmonary surface)?
Left ventricle (and slightly by the left auricle)
What are the three main branches off of the arch or the aorta?
brachiocephalic trunk
left common carotid
left subclavian artery
What are the branches of the SVC? (2)
right and left brachiocephalic vein
What do the brachiocephalic veins bifurcate to form?
subclavian vein and jugular vein
What does the coronary groove indicate?
What runs within it?
the surface markings for the tricuspid valve
right coronary artery runs within it
What does the anterior interventricular groove indicate?
the boundary between the two ventricles
left anterior descending (LAD) / anterior interventricular artery lies within it
What is the coronary sinus?
A short venous channel which runs in the posterior atrioventricular groove.
It separated the base from the diaphragmatic surface.
It receives deoxygenated blood from the cardiac veins and drains into the right atrium (near IVC)
What does the posterior interventricular groove indicate?
What runs within it?
It indicates the boundary between the 2 ventricles on the diaphragmatic surface of the heart.
Usually the posterior interventricular artery (branch of right coronary artery) along with the posterior interventricular vein
What is hypoxaemia?
A reduction in the oxygen content of the systemic arterial blood.
A condition where arterial oxygen tension or partial pressure of oxygen (PaO2) is below normal.
What is hypoxia?
The reduction of oxygen supply at the tissue level.
What are the cusps on the tricuspid valve?
anterior, posterior and septal cusps
What are the cusps on the mitral valve?
anterior and posterior cusps
What are the cusps on the pulmonary valve?
anterior, left and right cusps
What are the cusps on the aortic valve?
right, left and posterior cusps (and sinuses - coronary arteries arise from the right and left coronary sinuses)
What was the oval fossa called before birth?
foramen ovale
What is the function of the fibrous ring?
It is the fibrous part of the septum.
It acts as an electrical insulator.
What is the septomarginal trabecula?
It is the moderator band.
It carries fibres of the right bundle branch to the papillary muscle of the anterior cusp of the tricuspid valve.
Where do you auscultate the aortic valve?
2nd ICS, right sternal edge
Where do you auscultate the pulmonary valve?
2nd ICS, left sternal edge
Where do you auscultate for the tricuspid valve?
4th ICS, left sternal edge
Where do you auscultate for the mitral valve?
5th ICS, midclavicular line
What is the course of the phrenic nerve(s)?
Passes through neck on the anterior surface to the scalenus anterior
Passes through the chest to the diaphragm, between the mediastinal parietal pleura and the fibrous pericardium
What is the somatic sensory function of the phrenic nerves?
To innervate:
- the mediastinal parietal pleura
- the fibrous pericardium
- the diaphragmatic parietal pleura
- the diaphragm (muscle and central tendon)
- the diaphragm parietal peritoneum
What is the somatic motor function of the phrenic nerves?
To innervate the skeletal muscle of the diaphragm
What is the sympathetic function of the phrenic nerves?
To innervate arterioles
What sympathetic nerve passes straight to the organ it supplies without synapsing?
one of the abdominopelvic splanchnic nerve passes straight to the adrenal medulla without synapsing
What level of the spinal cord do sympathetic fibres leave?
T1-L2/3
What is the name of the nerves supplying sympathetic innervation to the heart and lung? At what level do these nerve leave the spinal cord?
Cardiopulmonary splanchnic nerves.
Formed from T1-T5 ganglia and cervical ganglia (superior, middle and inferior).
What does the cardiac plexus consist of?
Whereis the cardiac plexus found?
sympathetic fibres, parasympathetic fibres and visceral afferent fibres.
Stuck posteriorly on heart, between the heart and the trachea
In the parasympathetic nervous system where are the ganglia found (i.e. location of synapsing)?
There are 4 main ganglia in the head and neck.
The rest are in the walls of the organs (vagus and pelvic splanchnic nerves - post-synaptic fibres are very short)
What are the parasympathetic cranial nerves?
CN III (oculomotor) CN VII (facial) CN IX (glossopharyngeal) CN X (vagus)
Is the pelvic splanchnic nerve part of the sympathetic or parasympathetic system?
parasympathetic
What level of the spinal cord to parasympathetic nerves leave?
cranial sacral outflow
cranial nerve 3, 7, 9, 10
What nerves travel in the cardiopulmonary splanchnic nerves?
the postsynaptic sympathetic efferents and the cardiac visceral afferents
Where are the chemoreceptor nerve endings found?
in the root of the aorta and in the inter ventricular septum
Where are the visceral afferent nerve endings (for stretch any chemicals found?
inner aortic arch pulmonary trunk around the SA node outflow tracts from both ventricles papillary muscles vena cava
Where are the baroreceptors found?
Aortic arch
Carotid sinus
What part of the brain do somatic sensory action potentials arrive?
the post-central gyrus of the parietal lobe
What part of the brain of somatomotor action potentials originate from ?
the pre-central gyrus of the frontal lobe
Give some sources of somatic (sharp) central chest pain
Herpes zoster (shingles) developing in the T4/T5 dermatome
Pectorals major of intercostal muscle strain
dislocated costochondral joint
Costovertebral joint inflammation
Slipped thoracic intervertebral disc
Pleurisy
Pericarditis
- pain can be felt anywhere along the one dermatome
Give some sources of visceral (dull) chest pain
angina
MI
tracheitis
oesophagitis
What is found in the anterior mediastinum?
Mainly fatty tissue in adults.
The thymus gland in children.
How does the right vagus nerve pass through the thorax?
On the trachea then the oeophagus
What is the ligament arteriosum?
the remnant of the ductus arteriosus, connecting the pulmonary trunk to the arch of the aorta
How does the left vagus nerve pass through the thorax?
It crossed the left side of the aortic arch heading posterior to the lung hilum towards the oesophagus
Does the phrenic nerve pass anterior or posterior to the hilum of the lung?
anterior
