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Anatomy Flashcards

1
Q

What nerves innervate the diaphragm and where are they found in relation to the heart?

A

C3,4,5

Descend across the lateral aspect of the heart within the pericardium

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2
Q

What is the pericardium?

A

sac that surrounds the heart

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3
Q

State the layers of the pericardium

A
  • Fibrous

- Serous (visceral & parietal)

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4
Q

State the term used to describe blood in the pericardium what disease can it lead to?

A

Haemopericardium if the pressure around the heart prevents cardiac contraction it is known as cardiac tamponade

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5
Q

Describe the procedure used to relieve cardiac tamponade

A

pericardiocentesis - needle is inserted via the infrasternal angel just below the costal margin and directed superoposterioly

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6
Q

Describe the position of the great vessels in comparison to the transverse pericardial sinus

A

aorta and pulmonary trunk lie anteriorly and the superior vena cava lies posterior

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7
Q

Name the three heart surfaces

A
  • anterior
  • base
  • inferior
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8
Q

Name four heart borders

A
  • right
  • left
  • inferior
  • superior
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9
Q

Where can the apex beat be found?

A

5th intercostal space in the midclavicular line

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10
Q

What can displace the apex beat?

A

Enlargement of the heart - cardiomegaly

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11
Q

How can you tell the difference between the phrenic and vagus nerve?

A

Phrenic nerve is anterior to the lung root whereas the vagus nerve is medial and posterior to the lung root

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12
Q

Name the vein that carries blood back from the head and neck

A

Internal jugular vein

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13
Q

Name the vein that carries blood back from the upper limbs

A

subclavian vein

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14
Q

What do the internal jugular vein and subclavian vein combine to form?

A

brachiocephalic vein

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15
Q

What do the right and left BCV combine to form?

A

superior vena cava which carries deoxygenated blood to the right atrium

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16
Q

Name the branches of the pulmonary trunk

A

right & left pulmonary artery - carry deoxygenated blood to the lungs

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17
Q

How does the blood travel back from the lungs?

A

Through the pulmonary veins into the left atrium

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18
Q

Name the three parts of the aorta

A
  • ascending
  • arch
  • descending
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19
Q

What is the first branch of the aorta?

A

ascending - coronary arteries

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20
Q

What does the aortic arch branch into?

A
  • brachiocephalic trunk

- common carotid & subclavian artery

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21
Q

What does the descending aorta lead to?

A

lower limbs

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22
Q

Describe auricles

A

extensions of the atria, when the atria fill with blood so do the auricles and this allows expansion of the atria

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23
Q

Describe the coronary groove

A

contains the right coronary artery and marks the separation between the right atria and ventricle

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24
Q

Describe the anterior interventricular groove

A

contains the left coronary artery and marks the separation of the right and left ventricle

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25
What is the difference between the base and the inferior of the heart?
base - left atrium | inferior - ventricles
26
What separates the base and the inferior of the heart?
coronary sinus which drains deoxygenated blood from the heart to the right atrium
27
Name two branches of the right coronary artery
- right marginal artery supplies the right ventricle | - posterior interventricular artery moves round the back of the heart
28
Name four branches of the left coronary artery
- left anterior descending/anterior interventricular artery - lateral diagonal branch comes off the LAD - circumflex artery branches off the main stem to join the PIA - left marginal artery
29
What veins drain into the coronary sinus?
Cardiac veins
30
What divides the right and left side of the heart?
Septum (inter atrial & inter ventricular)
31
What happens if there is a hole in the septum?
Results in a mix of deoxygenated & oxygenated blood causing hypoxaemia
32
Name the three openings of the right atrium
- Superior vena cava - Inferior vena cava - Coronary sinus
33
Where can the SA node be found?
Just below the SVC opening
34
What is the oval fossa?
Depression on the septal wall formed by the fetal heart
35
Name the structure that divides the rough auricle and smooth part of the atria
crista terminalis
36
Name the four heart valves
- tricuspid (RA & RV) - pulmonary (RV & pulmonary trunk) - mitral (LA & LV) - aortic (LV & aorta)
37
What type of valve separates the atria and ventricles?
leaflet - tendinous cords extend from the valve to papillary muscles which attach to chamber walls
38
As well as leaflet what other types of valve design is there?
Semilunar
39
How do semilunar valves shut?
The pockets catch blood as it begins to reflux back filling of these causes the valves to shut after contraction
40
Name the structure that allows all cusps to close at the same time
Moderator band
41
In sympathetic innervation what happens to the presynaptic fibres from the brain?
1. Travel inferiorly within spinal cord tracts | 2. exit the spinal cord in a thoracolumbar nerve (T1-L2/3)
42
State five things that can happen to the nerve after it leaves the spinal cord
- travel up to a ganglion - travel down to a ganglion - go into the ganglion at that level - pass through to synapse at abdominal pre vertebral ganglia - pass straight to the adrenal medulla
43
What nerves supply the heart?
Cardiopulmonary splanchnic nerves
44
What kind of fibres does the cardiac plexus contain?
- sympathetic - parasympathetic - visceral afferent
45
What nerves carry parasympathetic signals?
CIII - Occulomotor CVII - Abjucant CIX - glossopharyngeal CX - vagus
46
Where are the ganglia of parasympathetic nerves?
CIII, VII, IX are in the head | CX are in the organ walls
47
State six sources of somatic chest pain
- muscular - joint - bony - intervertebral disc - fibrous pericardium - nerve
48
How may a patient describe somatic pain?
sharp, stabbing, localised
49
Give three examples of conditions that present with somatic pain
- shingles - dislocated joint - pericarditis
50
State four sources of visceral pain
- heart & great vessels - trachea - oesophagus - abdominal viscerae
51
How may a patient describe visceral pain?
dull, aching, nauseating
52
Give examples of causes of visceral pain
- ruptured aortic aneurysm - angina - MI - oesophagitis
53
Define radiating pain
pain felt in the chest and felt spreading from there to upper limbs, back and neck
54
Define referred pain
pain only felt at site remote from area of tissue damage in the chest
55
Where does radiating pain spread to from the heart?
Dermatomes supplied by the spinal cord levels at which the cardiac visceral afferents enter the sympathetic chain
56
Explain the 'delusion of the mind' theory
due to afferent fibres from soma and visceral entering the spinal cord at the same level the brain choses to believe the pain signals are coming from the organ are actually from the soma e.g. upper limbs, back & jaw
57
Define myocardial infarction
irreversible death of part of the myocardium due to occlusion of tis arterial supply
58
State the three types of MI
- anterior - inferior - anterolateral
59
Describe the dominant blood supply of most patients
70% right dominant 15% left dominant Unusual to have extreme right dominance
60
Name four common sites of occlusion
- Left anterior descending - Right coronary artery - circumflex branch - left coronary artery
61
Where are CABG grafts taken from?
superficial vein from arms or legs
62
What does the RCA supply?
SA and AV node
63
What does the LAD & posterior inter ventricular artery supply?
inter ventricular septum & purkinje fibres
64
How does a CABG work?
grafts are anastomosed proximally to the ascending aorta and distal to the narrowing on coronary artery
65
What is the purpose of the azygous vein?
Carries blood from the intercostal spaces to the SVC found on the right of the trachea
66
How is the lymph system drained?
The right lymphatic duct drains into the right venous angle & the thoracic duct drains into the left venous angle
67
Name the structure that represents the start of the thoracic duct in the abdomen
Cisterna chyli
68
What is significant about the left vagus nerve?
It splits into the left recurrent laryngeal nerve which loops round the arch of the aorta & back up to supply the larynx
69
Name the ligament which is the remainder of the ductus arteriosus
Ligamentum arteriosum
70
Where can the JVP be found?
Underneath the sternocleidomastoid
71
Does the right recurrent laryngeal nerve enter the heart?
No, it hooks under the right subclavian artery

Cardiovascular (19 decks)

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