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Cardiovascular > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Anterior mediastinum key points

A

Potential space

Only really contains thymus

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2
Q

Posterior mediastinum key points

A

Contains aorta and oesophagus

Everything behind pulmonary trunk

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3
Q

4 rough borders of the heart

A

Left: mid-clavicular line
Right: parasternal
Top: sternal angle
Bottom: normally no lower than 5th rib

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4
Q

The apex of the heart sits in the:

A

5th intercostal space

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5
Q

Fibrous pericardium key points

A

Blends with collagen of diaphragm
innervated by phrenic nerve
Referred pain to brachial plexus areas

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6
Q

Serous pericardium key points

A

Made of mesothelium
Consists of parietal and visceral pericardium with pericardial cavity between the two
Parietal pericardium innervated by phrenic nerve
Visceral pericardium innervated by sympathetic chain

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7
Q

The base of the heart is at the:

A

Top

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8
Q

The base of the pericardium is at the:

A

Bottom

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9
Q

Transverse pericardial sinus

A

Gap that separates arteries from veins

Useful for bypass surgery

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10
Q

Oblique pericardial sinus

A

Formed by reflection onto pulmonary veins due to cardiac looping
Underneath transverse pericardial sinus

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11
Q

Specific borders of the heart

A

Right: right atrium
Bottom: right ventricle
Left: left ventricle and auricle

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12
Q

The coronary sinus is also called:

A

The atrioventricular groove

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13
Q

Right coronary artery branches from top to bottom

A

Sinoatrial nodal branch
Marginal branch
Atrioventricular nodal branch
Posterior interventricular branch

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14
Q

Marginal branch supplies:

A

Right ventricle

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15
Q

Posterior interventricular branch supplies:

A

Posterior interventricular groove

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16
Q

Left coronary artery branches from top to bottom

A

Left circumflex branch

Anterior interventricular branch

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17
Q

Left circumflex branch supplies:

A

Left ventricle and interventricular groove

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18
Q

Venous drainage of heart

A

Coronary sinus
Posterior, anterior, great, small, middle cardiac veins
Also oblique vein of left atrium
CS pumps blood back into right atrium

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19
Q

Sinus venarum

A

Smooth muscle wall space of right atrium that veins drain into

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20
Q

Musculi pectinati

A

Bundles of cardiac muscle arranged in parallel fashion

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21
Q

Valve of inferior vena cava

A

Channels blood from placenta through foramen ovale before birth

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22
Q

Fossa ovalis

A

Closed over hole, remnant of foramen ovale

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23
Q

Foramen ovale

A

Hole between right atrium and left atrium before birth

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24
Q

Tricuspid valve

A

Atrioventricular

Between right atrium and right ventricle

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25
Q

Right auricle origin

A

Muscular piece of atrium from primitive atrium

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26
Q

Chordae tendineae

A

Tethered, but only to inlet valves

With papillary muscles, responsible for pushing AV valve up to close it

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27
Q

Pulmonary valve

A

Semilunar
3 cusps
Between right ventricle and pulmonary trunk

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28
Q

Moderator band

A

Also called septomarginal trabecula
Runs from septum, which is the wall between two ventricles, to margin
Only in right ventricle
Allows papillary muscles to contract just before ventricles fully activate

29
Q

Mitral valve

A

Bicuspid
Atrioventricular
Between left atrium and left ventricle

30
Q

Coronary ostia

A

2 holes right by the cusps of the aortic valve which ascend into left and right coronary arteries

31
Q

Stenosis

A

Narrowing of blood vessels
Generates turbulence downstream
Causes noise and potentially regurgitation

32
Q

1st heart sound

A

Lub

Generated by inlet valves closing

33
Q

2nd heart sound

A

Dub

Generated by outlet valves closing

34
Q

Best place to hear the mitral valve sound

A

5th intercostal space medial

Away from bones and other turbulence

35
Q

Best place to hear the tricuspid valve sound

A

5th intercostal space

Left edge of sternum

36
Q

Best place to hear the aortic valve sound

A

2nd intercostal space, just below sternal angle

Right edge of sternum

37
Q

Best palce to hear pulmonary valve sound

A

2nd intercostal space, just below sternal angle

Left edge of sternum

38
Q

Laminar flow

A

Normal blood flow
Silent
Velocity occurs in layers, with fastest blood flow in the middle of the vessel

39
Q

Interventricular septum function

A

Stiffens before left ventricle contracts to protect right ventricle from the power of the left ventricle

40
Q

3 nervous supplies of the heart

A

Somatic
SNS
PSNS

41
Q

Somatic nervous supply

A

Phrenic nerve supplies outer pericardium

Pain refers to C3, 4 and 5 which can be felt in the upper shoulder and upper neck

42
Q

SNS nervous supply

A

Sympathetic chain
Heart by T1 - T4
Angina felt in the chest, nipple line and running down arms
Functions to increase heart rate, contraction of heart, systemic blood pressure and coronary artery vasodilation

43
Q

PSNS nervous supply

A

Vagus nerve
General referred pain, nausea and malaise
Decreases heart rate and systemic blood pressure
Increases coronary artery vasoconstriction

44
Q

7 structures in the transthoracic plane

A 
Carina
Arch of aorta
Arch of azygous vein
Thoracic duct
Cardiac plexus
Ligamentum arteriosum
Pulmonary trunk bifurcation
45
Q

Great veins of the thorax

A

Superior vena cava
Branches into left and right brachiocephalic veins
Each branches off internal and external jugular veins
Both continue as right and left subclavian veins

46
Q

Branches of the aorta

A 
To the right: 
Brachiocephalic trunk
Branches into right common carotid
Continues as right subclavian
Branches into right internal thoracic with small anterior intercostal branches
To the left:
Branches into left common carotid
Branches into left subclavian which branches into left internal thoracic with small posterior intercostal branches
47
Q

Phrenic nerve position

A

C3 and 4 from cervical plexus
C5 from brachial plexus
Both come through ribcage
Right phrenic nerve around the side of right atrium
Left phrenic nerve around the side of left ventricle
Both give off pericardial branches

48
Q

Vagus nerve position

A

Right vagus comes down over right subclavian artery
Branches off into right recurrent laryngeal nerve which loops around right subclavian artery
Left vagus comes down to the left of aorta
Branches off into left recurrent laryngeal nerve which comes around aorta then back up towards neck
Vagus nerves link back into plexus at lower oesophagus which goes on to supply abdominal viscera

49
Q

Muscle between subclavian artery and subclavian vein

A

Anterior scalene muscle

50
Q

Things to consider when inserting a central line

A 
Access
Risk of puncture
Lungs
Risk of bleeding
Risk of infection
Short or long term placement
51
Q

4 places you could put a central line

A

External jugular vein
Internal jugluar vein
Femoral vein
Subclavian vein

52
Q

Central line in external jugular vein +ves and -ves

A 
\+ve:
Easy access
Low risk of pneumothorax
-ve:
Small vessel
Uncomfortable for patient
53
Q

Central line in internal jugular vein +ves and -ves

A 
\+ve:
Won't get in the way
Easy to find and thread
-ve:
High risk of carotid artery puncture
High risk of pneumothorax
54
Q

Central line in femoral vein +ves and -ves

A 
\+ve:
Fast, easy access
No risk of pneumothorax
-ve:
High risk of infection
High risk of embolism
55
Q

Central line in subclavian vein +ves and -ves

A 
\+ve:
Comfortable for patient
Good for long term
-ve:
High risk of subclavian artery puncture
High risk of damage to brachial plexus
56
Q

Azygous vein

A

When the right superior intercostal vein moves from the superior mediastinum into the thorax it becomes the azygous vein
Past the thorax it is known as the right ascending lumbar vein

57
Q

Hemiazygous vein

A

Branches from the azygous around the T8/9 vertebral level and crosses vertebral column to left hand side
Descends down and leaves thorax, becoming ascending lumbar vein

58
Q

Accessory hemiazygous vein

A

Branches from the azygous around the T8/9 vertebral level and crosses vertebral column to left hand side
Ascends up, ends around the T4 level

59
Q

Thoracic duct

A

Between azygous and hemiazygous veins, exits between left internal jugular vein and left subclavian vein
Valves prevent venous backflow
Gets extra fluid back into blood system
Main lymphatic drainage

60
Q

Cisterna chylii

A

Goes over azygous/hemiazygous connections

‘Water reservoir’ of thoracic duct

61
Q

4 major constrictions of oesophagus

A

1) junction of oesophagus with pharynx
2) where oesophagus is crossed by arch of aorta
3) where oesophagus is compressed by left main bronchus
4) at the oesophageal hiatus

62
Q

Aortic coarctation

A

Diagnosed on a 6 week baby check
Take radial and femoral pulse - should be in sync and same strength
If below left subclavian artery branch it can be fixed by anastamosing posterior and anterior intercostal arteries to resupply legs

63
Q

Coarctation after branching of left subclavian artery

A

Radial pulses will be in sync but femoral pulse will be out of sync and weaker

64
Q

Coarctation before branching of left subclavian artery (after branching of left common carotid)

A

Left radial pulse will be weaker and out of sync with the right radial pulse

65
Q

Two anastamoses to alleviate aortic coarctation

A

Between posterior and anterior intercostal arteries

Between superior and inferior epigastric arteries

66
Q

Oesophageal arterial supply

A

Superior: inferior thyroid artery
Middle: branches of the aorta
Inferior: left gastric aftery

67
Q

Venous drainage of oesophagus

A

Superior: brachiocephalic trunk
Middle: azygous system
Inferior: left gastric vein

68
Q

3 areas for portosystemic shunts

A

Oesophageal varices
Anorectal varices
Caput medusae

69
Q

Portal hypertension

A

Cirrhotic liver causes blockages and blood flows back through the portal and gastric veins, joining back up with inferior mesenteric vein and azygous vein
Vessels too small to handle large backflow so they become distended and can rupture

Cardiovascular (6 decks)

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