Anatomy Flashcards
What travels through the hilum of the lungs?
Pulmonary arteries, Pulmonary veins, Main bronchus, Pulmonary lymphatic vessels, Bronchopulmonary lymph nodes, Pulmonary visceral afferents, Autonomic motor nerves
Which part of the thorax is the heart and pericardium in?
Middle mediastinum
Is the phrenic nerve a unilateral or bilateral structure?
Bilateral
Which is anterior to the hilum, the phrenic or vagus nerves?
Anterior = phrenic (posterior = vagus)
What are the layers of the pericardium?
Outer layer = fibrous pericardium
Inner = serious (split into visceral and parietal)
What occurs if the pericardial cavity fills with abnormal quantities of fluid?
Cardiac tamponade (if blood = haemopericardium)
How is fluid in the pericardium released?
Pericardiocentesis:
aspiration superoposteriorly under xyphoid process
What is the transverse pericardial sinus?
A space posterior to the ascending aorta and pulmonary trunk - finishes anteriorly to SVC
What are the 3 surfaces of the heart?
Anterior,
Base (the most posterior surface),
Inferior
Where is the apex normally and what can it indicate if it has shifted?
5th intercostal space, left mid-clavicular line
If shifted to left = cardiomegaly
Which is more lateral, the phrenic or vagus nerves?
Lateral = phrenic Medial = vagus
Which vein drains the head and neck?
Left and right internal jugular veins
Which vein drains the upper limbs?
Left and right subclavian veins
Describe the venous drainage into the SVC
Left internal jugular + subclavian ==> Left brachiocephalic, Left + right brachiocephalic ==> SVC Azygous vein also drains into the SVC just above the right atrium
What structure of the surface of the atria allow them to fill with more blood?
Auricles
What is the order or branches on the arch of the aorta?
Brachiocephalic trunk, left common carotid, left subclavian
Which veins drain into the right atrium?
SVC, IVC, coronary sinus
Which artery supplies the head and neck?
Common carotid arteries
What are the important borders of the heart?
Right and left lateral borders
Inferior border
Superior border
Which chambers make up the base, apex, anterior and inferior surfaces?
Base: left atrium
Inferior: right and left ventricles
Anterior: right ventricle
Apex: left ventricle
What are the first branches of the ascending aorta?
The right and left coronary arteries
Describe the right coronary artery and its branches
Right coronary artery (in coronary groove),
Has a right marginal branch
Describe the left coronary artery and its branches
Left main stem, left anterior descending (LAD), diagonal, left marginal and circumflex
Where does all the venous drainage from the heart drain into?
The coronary sinus (in the atrioventricular groove)
What divides the heart into a left and right side?
Septum:
interatrial septum + interventricular septum
What is an atrial or ventricular septal defect?
A hole in the interatrial or interventricular septum that allows mixing of the blood - can be life threatening
How many cusps does each valve have:
Tricuspid: 3
Pulmonary: 3
Bicuspid/mitral: 2
Aortic: 3
What kind of valves are the aortic/pulmonary or the tricuspid/mitral?
Aortic/pulomary: semi-lunar
Tricuspid/mitral: leaflet
What prevents reflux of the tricuspid/mitral valves during ventricular contraction?
Leaflets connected to papillary muscles via tendinous cords
What gives the heart valves structural integrity?
Fibrous skeleton (made of connective tissue)
Where dot he right common carotid and the right subclavian arise from?
The brachiocephalic trunk
How does sympathetic/parasympathetic stimulation affect the heart?
Symp: Increases heart rate and force
Parasympathetic: decreased heart rate
Is there a cardiac plexus?
Yes, behind the heart by the bifurcation of the trachea
What is a ganglia?
A collection of nerve cell bodies outside of the CNS
Describe the course and neurotransmitters of sympathetic fibres
Pre-synaptic fibre (from CNS to ganglion in sympathetic chain)
Acetyl choline neurotransmitter
Post-synaptic fibre (from ganglion to organ)
Noradrenaline neurotransmitter
Which spinal cords is the sympathetic outflow from?
T1-L2 (thoracolumbar)
What sympathetic nerves supply the heart and lungs?
Cardiopulmonary splanchnic nerves
Describe the course and neurotransmitters of parasympathetic fibres
Pre-synaptic fibre (from CNS to ganglion on structure)
Acetyl choline neurotransmitter
Post-synaptic fibre (from ganglion to organ)
Acetyl choline neurotransmitter
Where is parasympathetic outflow from?
CN III, VII, IX, X (3,7,9,10) (3,7,9 remain within the head and neck, 10 = vagus travels down to supply most of the upper body)
Sacrum
(craniosacral outflow)
Which nerve do the baroreceptor signals (afferents) act upon?
Parasympathetic = vagus nerve
What divides the brain the parietal and frontal lobe and what type of sensation is on either side?
Central sulcus
Parietal: somatosensory
Frontal: somatomotor
Which side is the azygous vein on?
right
What is the route of the right and left vagus nerves?
Right: surface of the trachea and then follows the oesophagus
Left: Follows the aorta and directly touches the hilum
What is the difference between radiating and referred pain?
Radiating: pain felt at site of injury + at site elsewhere
Referred: pain only felt at site remote from the injury
Which arteries supply the anterior, inferior or inferiolateral surfaces of the heart (are blocked in an MI in these areas)
Anterior: LAD
Inferior: Right
Lateral: Left
Which coronary artery is more often dominant?
Right
Which coronary artery supplies the SA and AV nodes?
Right
What is CABG and what vessels are more commonly used?
Coronary artery bypass grafting (if atheroma etc)
Radial or internal thoracic
What are the divisions of the mediastinum?
Superior and inferior
Inferior = anterior, middle, posterior
What is in the anterior mediastinum?
In children, thymus gland
In adults, adipose tissue
What is in the middle mediastinum?
Heart and the start of the great vessels
Where does the azygous vein drain into the SVC?
Superiorly to the hilum
What is the main lymphatic drainage of the body, where does it drain and what does it drain into?
Thoracic duct, drains all but the upper right quadrant of the body
Into the left venous angle (where internal jugular vein meets the subclavian to from brachiocephalic)
What is the lymphatic drainage of the last quarter of the body?
Right lymphatic duct, drains upper right quadrant
Drains into the right venous angle (where the internal jugular vein meets the subclavian to form he brachiocephalic vein)
Where is the thoracic duct in the mediastinum?
Between the azygous vein and the oesophagus (only structure there)
Where is pain from the diaphragm referred to?
Right shoulder
Where does the phrenic nerve provide sensory supply to?
Parietal pleura,
Fibrous pericardium
Diaphragmatic parietal peritoneum
What are the named arteries down the arm?
Brachial artery
Radial artery
What are the named arteries down the leg?
Femoral artery,
Popliteal artery,
Posterior tibial,
Dorsalis pedis
What drains the anterior and posterior intercostal spaces?
Anterior: Internal thoracic vein
Posterior: Azygous vein
