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Cardiovascular > Anatomy > Flashcards

Anatomy Flashcards

1
Q

what is haemopericardium?

A

if the pericardial cavity fills with blood

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2
Q

what is cardiac tamponade?

A

when haemopericardium occurs and the pressure around the heart prevents cardiac contraction

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3
Q

what is a pericardiocentesis?

A

drainage of fluid from the pericardial cavity

needle is inserted via the infrasternal angle and directed superoposteriorly, aspirating continuously

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4
Q

what is the transverse pericardial sinus?

A

a space within the pericardial cavity, posteorsuperiorly

surgeons use it to isolate and identify the great vessels for open heart surgery

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5
Q

where is the transverse pericardial sinus?

A

it lies posterior to the ascending aorta and pulmonary trunk

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6
Q

what are the surfaces of the heart?

A

anterior (sternocoatsal) surface
base (posterior) surface
inferior (diaphragmatic) surface

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7
Q

what are the borders of the heart?

A

right (lateral) border
left (lateral) border
inferior border
superior border

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8
Q

where can the apex beat be palpated?

A

5th left intercostal space in the midclavicular line

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9
Q

when would the apex beat be shifted?

A

cardiomegaly often shifts it to the left

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10
Q

what does the coronary groove indicate?

A

the surface marking for the tricuspid valve

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11
Q

what does the anterior interventricular groove indicate?

A

the boundary between the two ventricles

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12
Q

where are the nerves of the heart?

A

the vagus nerves are closer the the heart and the phrenic nerves are further away

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13
Q

what does the right common carotid artery and the right subclavian artery come together to form?

A

the brachiocephalic trunk

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14
Q

what does the interatrial groove indicate?

A

the boundary between the 2 atria

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15
Q

what are the coronary arteries and their branches?

A

the arterial blood supply to the epicardium and myocardium

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16
Q

where can the coronary arteries be found?

A

they course just deep to the epicardium, usually embedded in adipose tissue and arise from the ascending aorta

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17
Q

describe the right coronary artery

A

in the coronary (right atrioventricular) groove

forms the right marginal artery and the posterior interventricular artery

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18
Q

describe the left (main stem) coronary artery

A

in the left atrioventricular groove between the pulmonary trunk and the left auricle

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19
Q

name the branches of the left coronary artery

A

circumflex artery
left marginal artery
lateral (diagonal) branches
posterior interventricular artery

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20
Q

what is the coronary sinus?

A

a short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

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21
Q

what divides the heart into a right and left side

A

a septum

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22
Q

what is the part of the septum between the 2 atria?

A

interatrial septum

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23
Q

what is the part of the septum between the 2 ventricles?

A

interventricular septum

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24
Q

describe a septal defect

A

it can allow the mixing of arterial and venous blood in the heart
can be life threatening because it reduces the oxygen content of systemic arterial blood in the aorta causing hypoxaemia

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25
Q

describe the interior of the right atrium

A 
opening of the superior vena cava 
location of the SA node
crista terminalis 
oval fossa 
opening of the coronary sinus 
opening go the inferior vena cava
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26
Q

how does the heart ensure unidirectional flow?

A

the 4 cardiac valves

one valve at the exit from each cardiac chamber

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27
Q

describe the tricuspid valve

A

between the right atrium and the right ventricle

has anterior, posterior and septal cusps

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28
Q

describe the mitral valve

A

between the left atrium and left ventricle

has anterior and posterior cusps

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29
Q

describe the pulmonary valve

A

between the right ventricle and the pulmonary trunk

has anterior right and left cusps

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30
Q

describe the aortic valve

A

between the left ventricle and the aorta

has right, left and posterior cusps and sinuses

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31
Q

describe the interior of the left atrium

A

the left auricle
bilateral openings of superior and inferior pulmonary veins
remains of the valve of foramen ovale may be visible
cusps of mitral valve

32
Q

what is the 1st heart sound?

A

the closure of the tricuspid and mitral valves

33
Q

what is the 2nd heart sound?

A

closure of pulmonary and aortic valves

34
Q

how do sympathetic nerve fibres get from the CNS to the organs?

A

a presynaptic fibre connects between CNS and ganglion
the ganglion is aceytlcholine (neurotransmitter)
the post synaptic fibre is noradrenaline

35
Q

describe the route of presynaptic fibres from the brain

A

they travel inferiorly within spinal cord tracts and then exit the spinal cord in one of the T1-L2/3 spinal nerves

36
Q

describe the T1-T5 ganglia and cervical ganglia

A

cardiopulmonary splanchnic nerves which are the sympathetic nerves to the heart and lungs

37
Q

how do postsynaptic sympathetic fibres reach the heart?

A

there is bilateral sympathetic innervation (preodminalty left sided)

38
Q

how do parasympathetic signals from the CNS reach the organs?

A

a presynaptic fibre connects between CNS and ganglion
the ganglion is acetylcholine
the postsynaptic fibre is acetyl choline

39
Q

what is a ganglion?

A

a synapse between the axon of the presynaptic neurone and the cell body of the postsynaptic neurone

40
Q

what is a postsynaptic fibre?

A

connects between the ganglion and the organ

41
Q

how do parasympathetic signals reach the organs?

A

through the cranial nerves III, VII, IX + X

42
Q

how do parasympathetic signals reach the heart?

A 
CN X (the vagus nerve) 
presynaptic parasympathetic fibres in vagus nerve then synapse onto postsynaptic neurones
43
Q

describe the nature of somatic pain

A

sharp
stabbing
well localised

44
Q

sources of somatic pain

A 
muscular 
joint
bony
intervertebral disc
fibrous pericardial 
nerve
45
Q

nature of visceral pain

A

dull
aching
nauseating
poorly localised

46
Q

sources of visceral pain

A

heart and great vessels
trachea
oesophagus
abdominal viscerae

47
Q

nature of radiating pain

A

felt in centre of chest and felt spreading from there

48
Q

sources of radiating pain

A

upper limbs
back
neck

49
Q

nature of referred pain

A

only felt at site remote from area of tissue damage in the chest

50
Q

sources of referred pain

A

upper limbs
back
neck

51
Q

describe acute or chronic pain

A

repeated acute episodes vs chronic pain

52
Q

where in the brain does the sensation of pain reach consciousness?

A

the cerebral cortex

53
Q

where do APs arrive to bring body wall sensations into consciousness?

A

postcentral gyrus of the parietal lobe

somatosensory

54
Q

where do APs originate to bring about contractions of skeletal muscle?

A

precentral gyrus of the frontal lobe

somatomotor

55
Q

what are somatic central chest pain sources?

A 
herpes zoster (shingles)
muscle, joint and bone 
parietal pleura and fibrous pericardium
56
Q

what is herpes zoster (shingles)?

A

reactivation of dormant virus in posterior root ganglion
pain can be felt anywhere in that dermatome
pain precedes shingles
patient with it developing in T4/T5 dermatome may present with central chest pain

57
Q

what are muscle, joint and bone causes of chest pain?

A

pectorals major or intercostal muscle strain
dislocated costochondral joint
costovertebral joint inflammation
‘slipped’ thoracic intervertebral disc

58
Q

what can cause chest pain associated with the parietal pleura and the fibrous pericardium?

A

pleurisy

pericarditis

59
Q

what are visceral central chest pain sources?

A 
oesophagus
heart 
abdominal visceral 
aorta 
trachea
60
Q

what causes chest pain from the oesophagus?

A

oesophagitis

61
Q

what causes chest pain from the heart?

A

angina

MI

62
Q

what causes chest pain from the abdominal viscerae?

A

gastritis
cholecystitis
pancreatitis
hepatitis

63
Q

what causes chest pain from the aorta?

A

ruptured aneurysm of aortic arch

64
Q

what causes chest pain from the trachea?

A

tracheitis

65
Q

what are the sub divisions of the mediastinum?

A

superior inferior
anterior
middle (heart location)
posterior

66
Q

how do pain signals from the organs reach the brain?

A

cardiopulmonary splanchnic nerves plus pain afferents from chest organs
visceral afferent action potentials pass bilaterally to thalamus and hypothalamus then diffuse areas of the cortex

67
Q

where is radiating pain originating from a somatic structure?

A

along the affected dermatome(s)

68
Q

where is radiating pain from the heart?

A

to the dermatomes supplied by the spinal cord levels at which the cardiac visceral afferents enter the spinal cord ie bilaterally to cervical and upper thoracic dermatomes

69
Q

what is visceral radiating pain?

A

although it is felt in a dermatomal pattern, it is still dull, aching nd poorly localised in nature

70
Q

what causes referred pain?

A

due to afferent fibres from soma and afferent fibres from viscera entering the spinal cord at the same levels
the brain chooses to believe that the pain signals coming from the organ are actually coming from the soma

71
Q

what is cardiac referred pain?

A

the brain chooses to believe the pain signals are coming from the upper limbs (especially left side) or from the back, neck or jaw

72
Q

where is the most common site of coronary atherosclerosis?

A

anterior interventricular branch of LCA

73
Q

where is the second most common site of coronary atherosclerosis?

A

RCA

74
Q

where is the third most common site of coronary atherosclerosis?

A

circumflex branch of LCA

75
Q

where is the least common site of coronary atherscelrosis?

A

LCA

76
Q

where are commonly used grafts for coronary arteries?

A

radial artery/ internal thoracic artery

great saphenous vein

77
Q

what is the arterial blood supply of the interventricular septum?

A

left anterior descending or anterior interventricular artery
left and right bundle branches
posterior interventircular artery

Cardiovascular (31 decks)

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