Anatomy

Question 1

Label the following arteries

Answer 1

Question 2

Summary of the Carotid arteries

Answer 2

Question 3

Branches of the external carotid artery:

Answer 3

https://quizlet.com/218408009/innervation-and-vasculature-of-the-face-flash-cards/

Question 4

Brances of the abdominal aorta:

Answer 4

Question 5

What are the four branches of the subclavian artery?

Answer 5

Verterbal artery

Internal thoracic artery

Costocervical trunk

Thyrocervical trunk

Question 6

Why can eating a large meal cause angina?

Answer 6

Blood is shunted away from the heart to the GI system.

Question 7

What vessels are sometimes used in coronary arterial bypass surgery?

Answer 7

Great saphenous vein because diameter is equal to or greater than coronary vessels, easy to dissect out and has lengthy portions that don’t have any valves in.

Radial artery

Internal thoracic

Question 8

What are the functions of the pericardium?

Answer 8

diameter is equal to or greater than coronary vessels, easy to dissect out and has lengthy portions that don’t have any valves in

Question 9

What is the nervous innervation of the pericardium?

Answer 9

Phrenic nerve

Question 10

Read summary of cardiac tamponade?

How can it be diagnosed?

How is it treated?

Answer 10

: When pericardial effusion becomes too large and the pressure hinders the function of the heart. The heart is not able to fill properly (it can’t enlarge due to the outside pressure) and therefore the cardiac output is reduced. It can be initially diagnosed by dyspnea, low BP and distant heart sounds. It is usually confirmed with an ultrasound. Ewart’s sign is also a good indication – a dullness to percussion in the left subscapular region, due to the effusion being large enough to compress the left lower lobe of the lung. It is treated by way of pericardiocentisis, a large needle that is inserted into the pericardial cavity to reduce pressure. This can be done in two places – the left 5th or 6th intercostal space, as the cardiac notch means the lung or pleura won’t be hit. Or just to the left side of the xiphoid process, this route passes through the diaphragm and again avoids the pleura, care needs to be taken to not hit the internal thoracic vessels. If time allows an emergency thoracotomy can be carried out as an alternative to pericardiocentesis.

Question 11

What causes varicose veins? Why does it occur more commonly in the superficial veins rather than the deep veins?

Answer 11

Answer: This occurs as veins become inelastic. This can cause the valves to become incompetent. The blood will therefore not return to the heart as efficiently leading to pooling of the blood. This causes dilation of the veins (which itself causes the veins to become less elastic so a vicious circle begins). The superficial veins do not have the luxury of neighbouring muscles to help move blood back to the heart, thus already at risk for blood pooling.

Question 12

Heart valves

• understand vaguely about cusps for each valve:

Answer 12

Question 13

What causes filling of the coronary arteries?

Answer 13

Backflow of blood during diastole due to aortic elastic recoil – closes valve and causes filling of coronary arteries.

Question 14

What is meant by coronary dominance?

Answer 14

Dominance typically defined by which coronary artery gives rise to the posterior interventricular artery.

In the general population about 70% of the people have right dominant

Question 15

Summary of the cardiac skeleton:

Answer 15

Question 16

Summarise cardiac innervation:

Answer 16

• Sympathetic T1-T5 (loss causes bradycardic symptoms). Increase heart rate & contractile force & cardiac output.
• Parasympathetic Vagus n. (loss causes tachycardic symptoms). Decrease heart rate & contractile force & decreased cardiac output.

• Afferent (sensory) T1-T5. Carried in sympathetic cardiac nerves. Referred pain to chest and upper limb.

Question 17

What are the clinical implications of a patent foramen ovale?

Answer 17

This means deoxygenated blood returning from the systemic circulation can to the right atrium can pass into the left atrium and mix with the oxygenated blood returning from the pulmonary circulation. Causing cyanosis in infants, reduced exercise tolerance in adults, severe migraines and headaches, and increased risk of stroke.

Question 18

What does mitral valve regurgitation lead to?

Answer 18

Mitral valve insufficiency – regurgitation of blood back into the left atrium, increased pre-load, hypertrophy of the LV, hypertrophy and dilatation of left atrium, increased pulmonary pressure and pulmonary oedema.

Question 19

What is aortic valve stenosis and what would be the effect on ventricular anatomy? How would a patient present, describe suitable clinical intervention?

Answer 19

Answer Stenosis - stiffening of the valve, the valve is unable to open fully causing a narrowing of the affected orifice, and thus restricted blood flow.

This causes pressure overload of the LV, the LV is forced to work harder to pump blood through the valve, and thus the LV undergoes concentric hypertrophy.

Patient may present with Angina, shortness of breath during exercise, syncope, oedema.

Possible interventions- initially intra-aortic balloon pump, but ultimately a valve replacement.

Question 20

What is atrioventricular block (AV block) and what can cause it?

Answer 20

AV block is when conduction between the atria and ventricles is impaired, usually the result of ischaemia, infarction, fibrosis, or structural remodelling in HF (for example dilatation).

Question 21

What is meant by 1st, 2nd and 3rd degree AV block?

Answer 21

1st degree- increase in PR interval.

2nd degree- progressive elongation or loss of PR interval leading to loss of beat.

3rd degree- total heart block, no P wave or QRS complex.

Question 22

Umbilical arteries

Umbilical vein

Ductus Venosus

Ductus arteriosus

Foramen ovale

Answer 22

Medial umbilical ligaments

Ligamentum teres

Ligamentum venosum

Fossa ovalis

Ligamentum arteriosum

Question 23

Describe the anatomy of an atrial septal defect (ASD), how does this affect blood flow?

And how will the anatomy of the heart be remodelled?

Answer 23

Failure of the interatrial septum to close completely, not to be mistaken with patent foramen ovale (PFO).

It produces a left-to-right shunt, meaning oxygenated blood from the left side of the heart mixes with the deoxygenated blood of the right side.

Many patients are asymptomatic, however, increased blood flow into the right atrium can cause hypertrophy of the RA and RV, and enlargement of the pulmonary trunk, resulting in pulmonary artery hypertension.

Question 24

What is meant by a patent ductus arteriosus (PDA), and what is the clinical implication of this defect and how could you treat this?

Answer 24

The conduit between the pulmonary artery and aorta persists, due to the increased pressure in the aorta blood passes back into the pulmonary artery and can cause pulmonary hypertension.

Surgery- ligation Pharma- indomethacin Percutaneous intervention (avoiding open heart surgery)- Coil embolization, deployed via a catheter through the femoral vein or femoral artery.

Question 25

How does a VSD affect the right ventricle?

Answer 25

Increased pressure in the LV compared to RV, blood flows down pressure gradient causing RV hypertrophy and pulmonary arterial hypertension.

Question 26

What is the name of the shunt between the left umbilical vein and the inferior vena cava in the foetus?

Answer 26

Ductus venosus

Question 27

Identify the structure and other structures shown in this CT.

Answer 27

Question 28

Paradoxical embolus

Answer 28

Embolus that moves through a patent foramen ovale, crossing into the left atrium where it can cause stroke.

Question 29

Summarise the embryological development of the heart:

Answer 29

1. Foramen primum
2. Septum primum grows down towards endocardial cushions.
3. Top of septum primum dies off - forming osteum secundum.
4. Septum secundum grows covering the osteosecundum forming the foramen ovale.

Question 30

What causes the ductus arteriosus to close at birth?

Answer 30

Drop in prostaglandin levels at birth, which causes the ductus arteriosus to spasm and close. This then fibroses closing permanently.

Question 31

SAD mnemonic for aortic stenosis symptoms.

Answer 31

Syncope

Angina

Dyspnea