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Cardiovascular > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Pericardial Cavity

A

Between the two layers of the serous pericardium

Fills with blood, can prevent the heart from contracting = cardiac tamponade

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2
Q

Pericardiocentesis

A

Fluid is drained from a needle into the pericardial cavity

Needle inserted via the infrasternal angle, directed superoposteriorly, aspirating continuously

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3
Q

Transverse Pericardial Sinus

A

A space within the pericardial cavity posterosuperiorly, lies posterior to ascending aorta and pulmonary trunk
Used by surgeons to identify and isolate great vessels

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4
Q

Coronary Arteries

A

RIGHT - anterior surface, coronary groove (surface mark for tricuspid)
LEFT - found in anterior interventricular groove (between two ventricles)
Found just deep to the epicardium, first branch of aorta

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5
Q

Coronary Sinus

A

Short venous conduit in the atrioventricular groove posteriorly, receives deoxygenated blood

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6
Q

Aortic valve

A

2nd right intercostal space at the sternal edge

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7
Q

Pulmonary Valve

A

2nd left intercostal space at the sternal edge

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8
Q

Tricuspid Valve

A

4th left intercostal sternal at the sternal edge

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9
Q

Mitral Valve

A

5th left intercostal space in the midclavicular line

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10
Q

Autonomic Innervation

A

Sympathetic (increase heart rate and contractility)
Parasympathetic (decrease heart rate)
- These reach the heart via the cardiac plexus

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11
Q

Visceral Afferent Nerves

A
  • Pain fibres travel to the spinal cord alongside sympathetic nerves
  • Reflex afferents travel mainly in the vagus nerve
    Travel in cardiopulmonary splanchic nerves and cardiopulmonary plexus
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12
Q

Sympathetic Nerve Fibres

A
  • Presynaptic fibres travel down the spinal cord and exit in one of the thoracolumbar spinal nerves
  • Travel along the sympathetic chain either up, down or across to a ganglion
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13
Q

Nerves supplying the heart

A

The right and left vagus nerve
Cardiopulmonary splanchic nerves (from cervical and thoracic sympathetic chains)
Cardiac plexus

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14
Q

Cardiac plexus

A

Contains sympathetic, parasympathetic and visceral afferent fibres

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15
Q

Parasympathetic Nerves > Organ

A 
Oculomotor Nerve (CN III)
Facial Nerve (CN VII) 
Glossopharyngeal Nerve (CN IX)
Vagus Nerve (CN X)
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16
Q

Sacral Spinal Nerves

A

Carry messages to the lower abdomen, pelvis and peritoneum

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17
Q

Vagal Tone

A

Ensures a continuous background of action potentials to slow the heart rate

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18
Q

Cardiopulmonary Splanchic Nerves

A

Contain efferent and afferent sensory & motor functions

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19
Q

Pain (ANATOMICALLY)

A

Stimulation of sensory receptor
Afferent action potential
Reaches brain, pain felt according to the part stimulated

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20
Q

Somatic Central Chest Pain

A

SOMATIC STRUCTURES - muscular, joint, bony, intervetebral disc, fibrous pericardial and nerves
- Usually sharp, stabbing and well localised

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21
Q

Visceral Central Chest Pain

A

VISCERAL STRUCTURES - heart, great vessels, trachea, oesophagus, abdominal viscerae

  • Usually dull, aching, nauseating and poorly localised
  • Pain can also be radiating with pain felt in centre of chest and felt spreading from there to the upper limbs, back and neck
  • Can also be referred; felt only at an area remote to tissue damage
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22
Q

Pain Pathway in the cortex from somatic structures

A

Post central gyrus of parietal lobe (body wall sensations

Precentral gyrus of frontal lobe (contraction of skeletal muscle)

23
Q

Somatic Pain Sources

A 
Herpes Zoster = Shingles
Muscle Strain (pectoralis major, pericarditis, pleurisy, dislocated costochondral joint, costovertebral joint inflammation, slipped disc)
24
Q

Visceral Pain Sources

A

Tracheitis, Oesophagitis, Aorta (ruptured aneurysm), Gastritis, Cholecystitis, Pancreatitis, Hepatitis, Heart (angina, MI)

25
Q

Visceral Afferents from the heart

A

The visceral afferent enter the sympathetic trunks at cervical ganglia and the spinal cord from the heart at T1-T5 spinal nerves
This is what causes radiating and referred pain

26
Q

Radiating

A

Felt at the site of the pathology and radiating
If the pain is somatic wall pain, the pain will radiate along the affected dermatome
If from heart, the radiation is to the dermatomes supplied by spinal levels where the cardiac visceral afferents enter the sympathetic chain

27
Q

Referred Pain

A

The pain is only felt at the site remote from the actual area of injury or disease

  • Due to sensory fibres from the somatic and visceral area entering the spinal cord at the same level
  • The brain choses to believe that pain is coming from the organs when it’s actually coming from the soma
28
Q

Myocardial Infarction

A 
Irreversible death (necrosis) of part of the myocardium due to occlusion if it's arterial blood supply
Right dominant pattern usually seen, can have extreme right dominant pattern (unusual)
29
Q

Right Coronary Artery

A

Right Marginal Artery

Posterior Interventricular Artery

30
Q

Left Coronary Artery

A

Circumflex Artery
Left Anterior Descending/Anterior Interventricular Artery
Left Marginal Artery

31
Q

Mediastinum

A

A thoracic inlet that is bound by Ribs 1, T1 vertebra and the jugular notch

32
Q

Transverse Thoracic Plane

A

Between the sternal angle and T4/5 intervertebral disc

33
Q

Anterior Mediastinum

A

Located between the sternum and fibrous pericardium

Contains the thymus (thyoma, thymic carcinoma, lymphoma)

34
Q

Middle Mediastinum

A

Contains the heart and pericardium & adjoining structures

35
Q

Posterior Mediastinum

A

Contains: thoracic aorta, oesophagus, vagus nerves, thoracic duct, right/left sympathetic chains, azygous vein (intercostal veins > SVC)

36
Q

Mediastinal Branches of the Aorta

A

Coronary Arteries > Brachiocephalic Trunk > Left Common Carotid Artery > Left Subclavian Artery

37
Q

Branches from the thoracic aorta

A

Bronchial arteries > Oesophageal arteries > Mediastinal arteries > Pericardial arteries > Phrenic arteries

38
Q

Lymphatic Vessels of the Mediastinum

A

Right lymphatic duct drains lymph into the right venous angle
Thoracic duct drains into the left venous angle

39
Q

Lymph from lungs

A

Drains into the tracheo-bronchial lymph nodes and bronchopulmonary lymph nodes

40
Q

Thoracic Duct

A

Continues posterior to the oesophagus, at the start in the abdomen is a swelling = cisterna chyli

41
Q

Nerves on the Right

A

Right vagus nerve

Right phrenic nerve

42
Q

Nerves on the Left

A

Left phrenic nerve

Recurrent laryngeal branch of left vagus

43
Q

Superior Mediastinum

A

Brachiocephalic veins, SVC, Arch of Aorta, Trachea, Oesophagus, Thoracic Duct
ANTERIOR > POSTERIOR
Phrenic nerves, vagus nerve, recurrent laryngeal nerve
LATERAL > MEDIAL

44
Q

Central Veins

A

Large veins close enough to the heart that the pressure reflects that of the right atrium
Internal jugular veins, subclavian veins, brachiocephalic veins, S/IVC, iliac and femoral veins

45
Q

Sternal Angle

A

Angle of Louis

46
Q

Recurrent Laryngeal Nerve

A 
RIGHT = hooks under the right subclavian artery - doesn't enter the chest
LEFT = hooks under the arch of the aorta - does enter the chest
47
Q

Phrenic Nerves

A

Formed from combined anterior rami of C3-5

  • Form somatic motor to the diaphragm
  • Form somatic sensory to mediastinal and diaphragmatic parietal pleura/peritoneum and fibrous pericardium
48
Q

Vagus Nerve Fibres

A
  • Somatic sensory nerves (palate, laryngopharynx, larynx)
  • Somatic motor nerves (pharynx, larynx)
  • Parasympathetic nerves (thoracic and abdominal organs)
  • Once of recurrent laryngeal branch off, only contain parasympathetic fibres
49
Q

Referred pain from the diaphragm

A

example. liver abscess
- Irritates the parietal peritoneum lining the inferior surface of the diaphragm
- Supraclavicular nerves (C3,4) supplying the dermatomes over the shoulder tip and enter the spinal cord at the same levels of the phrenic nerve
- Refers the pain to the more superficial structure (skin over the shoulder tip)

50
Q

Arterial Access

A 
Femoral artery
Radial artery (cannulation for arterial BP/ABG)
Subclavian artery (cardiac pacing wire)
51
Q

Venous Access

A 
Internal Jugular Vein (insertion of central line - ultrasound)
Femoral Vein (central line)
52
Q

Epicardium (alternative name)

A

Visceral Serous Pericardium

53
Q

Layers of the heart

A

Epicardium
Myocardium
Endocardium

54
Q

Venous Angle

A

Between the subclavian and internal jugular vein

Cardiovascular (7 decks)

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