Anatomy Flashcards
What is the landmark of the apex of the heart?
As far as midclavicular line
What are the landmarks on the left for the heart?
Runs between the 2nd and 5th intercostal space
In how many parts is the mediastinum divided & what are they?
- Superior mediastinum 2. Anterior mediastnum 3. MIddle mediastinum 4. Posterior mediastinum
Which mediastnum fits with this definition?
Contains the big pipes and vessels, esophagus, thymus.
Which mediastinum contains the heart?
The middle mediastinum - it is the pericardial cavity.
What does the thorax contain?
2 pleural cavities and 1 mediastinum
T or F, the thymus is important in adult life.
False, it is important in early childhood developments and shrinks after.
Identify those structures.
Green: posterior mediastinum
Green fluo (on top): anterior mediastinum
Blue: middle mediastinum
What are the 3 layers of the pericardial sac and a brief description plz?
Fibrous pericardium - gives resistance to the sac, stop expansion
Parietal serous pericardium - secrets fluif to lubricaate the surface of the heart when it contracts in the sac
Visceral serous pericardium - creates a closed space called pericardial cavity with dead-end.
What is the oblique sinus?
Blockage when we hit the dead-end of visceral & partietal pericardium
What is the transverse sinus?
Sinus separating the arteries from the veins. To find it, put your finger under the pulmonary artery & the aorta.
Identify these structures.
In order: 2 black arrows, 3 bue arrows, 4 red arrows.
- Esophagus
- Trachea
- Right subclavian vein
- Right internal jugular vein
- Superior Vena Cava
- Left common carotid artery
- Left subclavian artery
- Right brachiocephalic trunk
- Arch of the aorta
What is the coronary sulcus?
Divides the ventricles from the atria, full circle around the heart.
Identify those structures
In order: 2 left arrows, 4 right arrows top to bottom.
- Left coronary artery
- Right coronary artery
- Circumflex branch
- LAD (or anterior interventricular branch)
- Posterior interventricular branch
- Marginal branch
Where is the sino-atrial node?
Junction of SVC and Right Atrium.
What is the artery that supplies the sino-atrial node?
The sino-atrial nodal artery lolz
Where does the Sino-atrial nodal artery come from?
It can come from the right or the left.
Right –> a very quick branch that exists in the right coronary and loops around the SVC.
Left –> as soon as the left coronary branches off from the aorta, small artery that loops around the aorta and SVC.
85% of people are right or left dominant? What does it mean?
Right dominant.
Interventricular artery and marginal artery come from the right coronary artery.
Describe the blood vessels for someone who is left coronary artery dominant.
The left coronary artery supplies the LAD, the circumflex AND the circumflex leeps running and gives an ex-tra branch that is the psoterior inter-ventricular artery.
What happens in the RARE conditiion of extreme right coronary dominancy?
Everything comes from the right coronary (marginal, circumlex, posterior inter-ventricular) except the LAD.
What happen s in RARE conditions of left coronary dominancy?
Everything comes from the left. Not sustainable because if obstruction –> everything becomes ischemic.
What can be done if the original left/right arteries have obstruction and creates ischemic tissue distal to the obstruction?
Coronary Artery Bypass GRAFT
Vessels from other parts of the body come and connect the aorta, and reconnect distal to the obstruction to re-establish a circulation.
Identify these structures.
black arrow
blue arrow
3 blue arrows
- Opening of the coroary sinus into RA
- Small Cardiac Vein
- Coronary sinus
- Great cardiac vein
- Middle cardiac vein
Which ventricle is the thickest (oui oui ca se dit)?
Left, leading to a high BP in the aorta
Describe the pathway of the blood starting from an organ in the ssytemic circulation.
Systemic circulation - SVC ou IVC - right atrium - right ventricle - pulmonary artery - lungs - pulmonary veins - left atrium - left ventricle - aorta - GOING BACK TO THE ORGANZ with bioutiful o2
Identify those shnitzels.
Les 4 a gauche + les 4 a droite dans l’ordre
- SVC
- Fossa ovalis
- IVC valve
- Valve of coronary sinus
- Right auricle (appendage of RA)
- Tricuspid valve (or right atrio-ventricular valve)
- Pecinate muscle (help ejecting blood towards ventricle)
- Crista terminalis (transition between smooth wall and pectinate muscle)
Identify.
- Sino-atrial node
- Intermodal bundle
- Bundle of his
- Atrio-ventricular node
- Moderator (septo-marginal) band to anterior papillary muscle
What is the fossa ovalis?
The remanant of the opening that made the atriums communicate in embryogenesis. A membrane closes this space but not muscle.
RIGHT VENTRICLE
Identify these structures.
- Septal cusp of the tricuspid
- Posterior cusp of the tricuspid
- Anterior cusp of the tricuspid
- Trabeculae carnae (muscle to eject blood toward pulmonary trunk)
- Right cusp (of the pulmonary valve)
- Anterior cusp (of the pulmonary valve)
- Left cusp (of the pulmonary valve)
8&9. Papillary muscles to pull cusp (in order to prevent prolapse of cusps in atrium when V contracts)
Which ventricle has only 2 papillary muscles instead of 3?
Left ventricle
LEFT VENTRICLE - identify plz.
- Posterior Cusp of mitral valve
- Anterior Cusp of mitral valve
- Chordae tendinae
- Left Atrium
- Papillary muscle (with shared corda tendinae between 2 cusps)
Identify those structures (aussi celle en haut a gauche en bleu)
Bleu : superior vena cava
Rouge: aorta
Yellow: vagus nerve
Black: esophagus
Green: thoracic duct
Blue on the right image: azygous vein
What happens if you damage a papillary muscle of the mtiral valve?
The cusps of the mitral valve (the 2 of them) can still move because both of them are also attached with the other papillary muscle.
By what mechanism does the blood enter the RV?
By negative pressure –> vacuum effect from the right atrium to the right ventricle.
What happens to the mitral valve and tricuspid valve during systole?
They close.
Why does the aortic valve close when the blood is passing from RA to RV?
So the blood that has just been pumped does not come back in RV.
During the filling of the ventricle (diastole), are the papillary muscles relaxed or contracted?
Relaxed.
What is the role of papillary muscles during systole?
Since the blood now in the ventricle wants to go back to the atrium, the papillary muscles will opposite the effect of blood and pull the cusps toward the apex of the heart.
How does the blood go from the aorta to the coronary arteries?
When the aortic valve is closed, it opens up the small openings from the coronary arteries - that were hidden by the parts of the valve when it is open.
SO, coronary arteries have flow during the diastole & do not have flow during systole.
Concerning the speed of the HB: what do the para & sympa systems do
Para: slow down
Sympa: increase
What are the 3 segments of the aorta?
Ascending aorta
Arch of the aorta
Descending aorta (thoracic segment and abdominal segment)
When talking about the conduction system of the heart, what is the only thing visible with the eye?
Moderator band.
What is the ligamentum arteriosum?
What the shunt was during embryogenesis.
What are those structures?
- Aortic arch
- Thoracic descending aorta
- Ascending aorta
- Ligamentum arteriosum
- Esophagus
What are the 3 normal compressions of the esophagus?
Left bronchus or trachea compression
Compression by arch of the aorta
Compression by the diaphragm
Name a pathologic compression of the esophagus.
If swelling in the atrium, accumulation of bood and compression of the esophagus.
What does the right thoracic duct drain? Where does it drain itself?
Right hemichest, right side of the head and right arm. Drains in the right subclavian vein.
Where does the fluid drained from all lower limbs accumulate before going to the thoracic duct?
Cisterna chyli
What is the biggest lymphatic vessel in the body?
Thoracic Duct
Vagus nerve belongs to which system?
Parasympathetic
Is it the left or right vagus nerve who comes anterior to the aorta, anterior to the esophagus? What name does it change to when it becomes anterior to the esophagus?
Left vagus nerve, and it becomes the anterior vagal trunk
Where does the right vagus nerve run?
Posterior to the right stem bronchus, and then posterior to the esophagus
Where does the recurrent laryngeal nerve run on the left?
On the surface of the arch of the aorta (anterior) and then under it until it goes back paratracheally to the larynx.
Where does the recurrent laryngeal nerve run on the right?
Anterior to the brachiocephalic trunk, then under it, goes back up paratracheally to the larynx.
What nerve is formed from nerves from T5 to t9?
Great splanchnic nerve
What nerve origins from T10-11?
Lesser splanchnic nerve
Identify those structures.
- Right phrenic nerve
- Sympathetic chain
- Trachea
- Azygos vein
- Right vagus nerve
- Esophagus
- Left phrenic nerve
- Sympathetic chain
- Hemi-azygos vein
- Left vagus nerve
- Descending thoracic aorta
- Ligamentum arteriosum
What are the targets of Sympathetic system?
T1 to L2
What is the pathway of a fiber until it reaches the ganglion for the sympathetic system?
Fiber travels with the intercostal nerve
Leaves it to synapse with a ganglion
White ramus communications
Modulation in the ganglion
Goes back to the intercostal nerve by the grey ramus communications
Why would someone have referred pain if injury to the heart?
Cardiac nerve concerns dermatome t1-2-3-4. The brain does not know if the pain is coming from the heart or the skin - the pain is traveling through the automnic fibers and then in the same pathway as fibers of the corresponding dermatome.
