Anatomy Flashcards
where is the heart situated?
middle mediastinum in the pericardial sac
the fibrous pericardium is lined internally by what?
parietal serous pericardium
the pericardial cavity is between what two serous layer?
parietal pericardium (on the internal side of the fibrous pericardium) and the epicardium.
the epicardium secretes what?
pericardial fluid lubricant
what is it called when the pericardial cavity fills with blood?
haemopericardium
what is it called when there is pressure around the heart preventing cardiac contraction? (ie during a haemopericardium)
cardiac tamponade
what is the name of the process where you drain fluid from the pericardial cavity?
pericardiocentesis
what is the space within the pericardial cavity, that lies posterior to the ascending aorta and the pulmonary trunk?
transverse pericardial sinus
usually, where is the apex of the heart?
5th left intercostal space in the midclavicular line
what is it called when the apex beat is shifted to the left?
cardiomegaly
the right coronary artery is located where?
in the coronary groove
indicates tricuspid valve
the LAD branch of the left coronary artery is located where?
the anterior interventricular groove (indicates septal between ventricles)
what is located in the posterior atrioventricular groove?
coronary sinus
what is the coronary sinus?
a short venous conduit which receives deoxygenated blood from the cardiac veins
what is located in the posterior interventricular groove?
posterior interventricular artery of the right coronary artery
what takes up the majority of the base of the heart?
left atrium
what lies in the left atrioventricular groove?
left main stem coronary artery?
where do the coronary arteries arise from?
right and left aortic sinuses
Coronary arteries are embedded within what type of tissue?
adipose tissue, just deep to the epicardium
what is the name of the structure which divies the heart into a right and a left side?
septum
what name is given to the condition where there is a hole in the interatrial septum?
atrial septal defect
what name is given to the condition where there is a hole in the interventricular septum?
ventricular septal defect
what is the life-threatening problem that can occur due to a septal defect?
mixing of arterial and venous blood
how does the heart muscle pump ensure unidirectional flow?
the 4 cardiac valves- one valve at exit from the cardiac chamber
what carries the fibres of the right bundle branch to the papillary muscle of the anterior cusp of the tricuspid?
moderator band
incompetent valves are leaky and cause?
regurgitation
valves that are too tight are known as?
stenotic
what is the thoracic inlet bounded by?
rib 1, T1 and the jugular notch
what plane is between the sternal angle and T4/5?
transverse thoracic plane
where is the thymus?
anterior mediastinum
what is the function of the thymus?
a lymphoid gland that produces T lymphocytes in children.
after puberty, what does the thymus become replaced with?
adipose tissue
what 7 important structures lie within the posterior mediastinum?
- oesophagus
- azygos vein
- sympathetic trunks
- thoracic duct
- vagus nerves
- thoracic aorta
- trachea and 2 main bronchi
where do the intercostal veins drain?
posteriorly into the azygos vein
the azygos vein arches anteriorly and drains into what structure?
superior vena cava
what are the three branches of the aortic arch?
brachiocephalic, left common carotid, left subclavian?
name 5 branches from the thoracic aortas anterior surface.
- bronchial arteries
- oesophageal arteries
- mediastinal arteries
- pericardial arteries
- phrenic arteries
the right lymphatic duct drains lymph to where?
the right venous angle
the thoracic duct drains lymph to where?
the left venous angle
what is the swollen area of the start of the thoracic duct called?
cisterna chyli
what is the opening in the diaphragm to allow the aorta to pass through called?
aortic hiatus
the right phrenic nerve passes the diaphragm with what blood vessel in order to supply the diaphragm from the inferior aspect?
Inferior vena cava
what is the name of the remnant of the ductus arteriosus?
ligamentum arteriosum
what nerve passes under the ligamentum arteriosum and back to the larynx?
recurrent laryngeal branch of the left vagus nerve
name the 3 nerves that pass through the mediastinum?
lateral to medial
phrenic
vagus
recurrent laryngeal
what are the 8 central veins?
internal jugular veins subclavian veins brachiocephalic veins superior vena cava right atrium inferior vena cava iliac veins femoral veins
what are the name of large veins close enough to the heart that they approx reflex the pressure in the right atrium?
central veins
the right recurrent laryngeal nerve hooks under which artery before returning to the larynx?
right subclavian
the left recurrent laryngeal nerve hooks under which artery before returning to the larynx?
arch of the aorta
what 3 types of nerves does the vagus nerve contain?
somatic sensory, somatic motor, parasympathetic
What body parts do the somatic sensory nerve fibres of the vagus supply?
the palate
laryngopharynx
larynx
what body part do the somatic motor nerve fibres of the vagus supply?
pharynx
larynx
what body parts do the parasympathetic nerve fibres of the vagus supply?
thoracic and abdominal organs
Once the vagus nerves have given off their recurrent laryngeal branch what nerve fibres do the contain?
only parasympathetic fibres
the phrenic nerves supply somotatic motor to?
the diaphragm
the phrenic nerves supply somatic sensory to?
the mediastinal parietal pleura, the fibrous pericardium, the diaphragmatic parietal pleura, the diaphragmatic parietal peritoneum
pain from the diaphragm can often be referred to what body part?
the shoulder
what do the recurrent laryngeal nerve muscles supply?
the muscles of the larynx
what does the cephalic vein drain?
upper limb
superficial vein
peripheral pulse:
brachial artery
medial to the biceps brachii tendon, in the cubital fossa
peripheral pulse:
radial artery
lateral to the tendon of flexor carpi radialis
peripheral pulse: bifurcation of the common carotid
anterior to the sternocleiodomastoid, at the level of the superior border of the thyroid cartilage
peripheral pulse: femoral artery
inferior to midpoint of the inguinal ligament
peripheral pulse: popliteal artery
in the popliteal fossa
peripheral pulse: posterior tibial artery
between the posterior border of the medial malleolus and the achilles tendon
peripheral pulse: dorsalis pedis artery
medial to tendon of extensor hallicus longus on the dorsum of the foot
Sympathetic nervous control of the heart do what 2 things?
- increases heart rate
2. increases contractility
Parasympathetic nervous control of the heart does what 1 thing?
- decreases heart rare
what plexus do the autonomic nerves reach the heart via?
the cardiac plexus
Pain fibres travel to spinal cord alongisde what type of autonomic nerves?
sympathetic nerves
Visceral reflex afferents from baroreceptors travely mainly in what crainial nerve?
Vagus nerve (CN X)
What type of fibre connects the CNS to the ganglion?
Presynaptic fibre
What is the synapse between axon of presynaptic neurone and the cell body of postsynaptic neurone called?
ganglion
What type of fibre connects the ganglion to the organ?
Postsynaptic fibre
Presynaptic sympathetic fibres from the brain travel inferiorly within the spinal cord and exit the spinal cord at what vertebrae?
T1-L2/3
Once the sympathetic presynaptic fibres leave the spinal cord what FIVE options can they take?
- go into the ganglion of that level and synapse in the sympathetic chain
- travel superiorly in the sympathetic chain to synapse at another ganglion
- travel inferiorly in the sympathetic chain to synapse at another ganglion
- pass straight through the sympathetic chain ganglion without synapsing and synapses at a prevertebral ganglia
- pass straight to the adrenal medulla without synapsing at the sympathetic chain or the prevertebral ganglia
What is the collective name of the sympathetic nerve fibres which don’t synapse at the sympathetic chain but at the prevertebral ganglia?
abdominopelvic splanchnic nerves
what do the sympathetic fibres which pass straight to the adrenal medulla without synapsing in the sympathetic chain of the prevertebral ganglia stimulate?
the release of adrenaline
what type of nerve fibres are involved in the cardiac plexus?
sympathetic fibres
parasympathetic fibres
visceral afferents
cardiopulmonary splanchnic presynaptic nerves synapse where?
sympathetic nerve fibres
cervical and upper thoracic sympathietic chains
What cranial nerves have parasympathetic functions?
III, VII, IX, X
what type of autonomic function do pelvic spanchnic nerves have?
parasympathetic
Parasympathetic nerve fibres synapse onto ganglia where?
within the walls of the organs
what does vagal tone within the heart do?
slows the resting heart rate
postsynaptic cardiac sympathetic efferent and cardiac visceral afferent travel in what type of nerves?
cardiopulmonary splanchnic nerves
Where are visceral afferent chemoreceptor nerve endings found in the heart?
root of the aorta and IV septum
Where are 6 places visceral afferent nerve endings that detect stretch and chemicals in the heart located?
- inner aortic arch
- pulmonary trunk
- around the SA node
- outflow tracts from both ventricles
- papillary muscles
- vena cava
what is pain in an anatomical way?
stimulation of sensory receptor, afferent action potential travels to the brain
where do somatosensory APs bring body wall sensations into consciousness?
postcentral gyrus of the parietal lobe
posterior rootlets are for what type of somatic function?
somatic sensory
anterior rootlets are for what type of somatic function?
somatic motor
Where do somatomotor APs that cause contractions of skeletal muscle originate?
precentral gyrus of the frontal lobe
Where does the reactivation of herpes zoster (shingles) occur?
posterior root ganglion
In herpes zoster (shingles), what precedes the classic blisters?
pain in the dermatome of the reactivation of dormant virus
Do the phrenic nerves descend anteriorly or posteriorly to the lung root?
anteriorly
what is the name of feeling pain at a site remote to the actual area of injury?
referred pain
where does the left coronary artery arise from?
the left aortic sinus
where does the right coronary artery arise from?
the right aortic sinus
what type of coronary blood supply dominancy is the most common?
right dominant pattern (ie right coronary artery supplies more areas of the heart than the left coronary artery)
What are the 4 most common sites within the coronary arteries for narrowing due to atherosclerosis?
(in descending order of likelihood)
- anterior interventricular branch of the left coronary artery
- right coronary artery
- circumflex branch of the left coronary artery
- left main stem coronary artery.
In the majority of patients from which coronary artery does the SA node obtain its blood supply?
right coronary artery near its origin
In the majority of patients from which coronary artery does the AV node obtain its blood supply?
right coronary artery, near origin of posterior interventricular artery.
