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Cardiovascular and Pulmonary > Anatomy and Development of the Heart III > Flashcards

Anatomy and Development of the Heart III Flashcards

1
Q

The most common cyanotic heart defect

A

Tetralogy of Fallot (TOF)

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2
Q

Caused by a malpositioning of the aorticopulmonary septum

-the cyanosis frequently appears sometime after birth

A

TOF

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3
Q

In TOF, the aorticopulmonary septum forms in a displaced fashion toward the

A

Pulmonary side of the truncus arteriosus and conus cordis

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4
Q

This displacement is toward the right side of circulation, which means it is called

A

Dextrapositioning

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5
Q

The pulmonary trunk is anatomically anterior and to the left of the

A

Ascending aorta

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6
Q

The dextrapositioning of the aorticopulmonary septum in TOF results in

A
  1. ) Pulmonary stenosis
  2. ) Overriding aorta
  3. ) Ventricular septal defect
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7
Q

The aorta is abnormally wide and overrides both ventricles

A

Overriding aorta

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8
Q

Secondary to the major structural defects seen in TOF, we also see

A

Right ventricular hypertrophy

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9
Q

Because of the pulmonary stenosis, the pressure in the right ventricle is elevated causing right ventricular blood to shunt through the VSD into the overriding aorta. This right to left shunt results in

A

Cyanosis

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10
Q

When the aorticopulmonary septum does not form, the truncus arteriosus does not become the

A

Ascending aorta and pulmonary trunk (Persistent Truncus Arteriosus)

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11
Q

In persisten truncus arteriosus, both ventricles empty their blood into the same artery, thus oxygenated and deoxygenated blood are mixed and we see

A

Cyanosis

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12
Q

Because the absent aorticopulmonary septum would have contributed to the membranous ventricular septum, persistent truncus arteriosus is accompanied by

A

VSD

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13
Q

This defect is the most common cause of cyanosis presenting immediately at birth

A

Transposition of the great arteries

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14
Q

In the transposition of the great arteries, the aorticopulmonary septum, which normally forms in a spiral shape is not

A

Spiraled

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15
Q

What affect does the lack of spiraling have on the positioning of the aorta and pulmonary trunk?

A

Their positions are reversed

i.e. right ventricle flows to aorta instead of pulmonary trunk

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16
Q

Septal defects are common and PDA is typically seen in infants with

A

Transposition

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17
Q

The region within the thoracic cavity between the two pleural spaces

A

Meiastinum

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18
Q

What are the following borders of the mediastinum?

  1. ) Superior
  2. ) Inferior
  3. ) Anterior
A
  1. ) Thoracic inlet
  2. ) Diaphragm
  3. ) Sternum
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19
Q

What are the following borders of the mediastinum?

  1. ) Posterior
  2. ) Lateral
A
  1. ) Vertebral column

2. ) Mediastinal Pleura

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20
Q

The mediastinum is arbitrarily divided into a superior and inferior region by an imaginary horizontal plane at the level of

A

T4

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21
Q

Where does this plane interset

  1. ) Posteriorly
  2. ) Anteriorly
A
  1. ) Bottom of T4 vertebra

2. ) Manubriosternal junction (sternal angle)

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22
Q

Within the mediastinum this plane is at the level of

the

A

Tracheal bifurcation

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23
Q

The region above this plane is the

A

Superior mediastinum

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24
Q

The region below this plane is divided into which three regions?

A
  1. ) Middle mediastinum
  2. ) Anterior mediastinum
  3. ) Posterior mediastinum
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25
Q

The fibrous pericardium and everything within it comprise the

A

Middle mediastinum

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26
Q

Between the pericardium and sternum is the

A

Anterior mediastinum

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27
Q

Between the pericardium and the vertebral column is the

A

Posterior mediastinum

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28
Q

The structures in the superior mediastinum may be considered in layers. From posterior to anterior the
5 layers are:

A
  1. ) Digestive layer
  2. ) Respiratory layer
  3. ) Arterial Layer
  4. ) Venous layer
  5. ) Glandular layer
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29
Q

The digestive layer is made up of the

A

Esophagus

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30
Q

The respiratory layer is made up of the

A

Trachea

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31
Q

Bifurcates at T4 and therefore does not descend below the superior mediastinum

A

Trachea

32
Q

The arterial layer is made up of the

A
  1. ) aortic arch and its branches
  2. ) distal ascending aorta
  3. ) proximal descending aorta
33
Q

What are the 3 branches of the aortic arch?

A
  1. ) Brachiocephalic trunk
  2. ) Left common carotid artery
  3. ) Left subclavian artery
34
Q

The venous layer is made up of the

A

SVC and its tributaries: the right and left brachiocephalic veins

35
Q

Formed by the union of the internal jugular and subclavian veins

A

Brachiocephalic veins

36
Q

Has a vertical course in line with the SVC

A

The right brachiocephalic vein

37
Q

Has an oblique course downward and to the right across the midline

A

The left brachiocephalic vein

38
Q

The glandular layer is made up of the

A

Thymus

39
Q

Enters the superior mediastinum with the left common carotid artery

A

Left vagus nerve

40
Q

The left vagus nerve passes anterior to the aortic arch and gives off the

A

Left recurrent laryngeal nerve

41
Q

Passes under the aortic arch distal to the ligamentum arteriosum

A

Left recurrent laryngeal nerve

42
Q

Enters the superior mediastinum after already having given off the right recurrent laryngeal nerve in the neck

A

Right vagus nerve

43
Q

Passes under the right subclavian artery and courses upward to the larynx

-never in the mediastinum

A

Right recurrent laryngeal nerve

44
Q

The descending aorta, thoracic duct, azygos vein, hemiazygous vein, esophagus, vagus nerves and sympathetic trunks are all located in the

A

Posterior mediastinum

45
Q

Enters the posterior mediastinum to the left of the esophagus and gradually moves behind the esophagus as they descend

A

Descending aorta

46
Q

In the inferior part of the posterior mediastinum, the aorta is posterior to the

A

Esophagus

47
Q

Arises below the diaphragm as the cisterna chyli and ascends from the diaphragm in a vertical course slightly to the right of the midline

A

Thoracic Duct

48
Q

The thoracic duct shifts to the left and continues its vertical ascent to the left of the midline at about the

A

T6 level

49
Q

The thoracic duct drains into the junction of the

A

Left subclavian and internal jugular veins

50
Q

The only significant structure in the anterior mediastinum is the

A

Inferior portion of the thymus

51
Q

The diaphragm is composed of a

A

Muscular portion and a central tendon

52
Q

Dome shaped and upon contraction of its muscular portion it descends

A

Diaphragm

53
Q

The diaphragm is innervated by the

A

Phrenic nerve (C3-C5)

54
Q

The lumbar portion of the diaphragm has which three region of origin?

A
  1. ) Lumbar origin
  2. ) Costal origin
  3. ) Sternal origin
55
Q

The lumbar origin is comprised of three things, what are they?

A
  1. ) 2 crura
  2. ) Medial arcuate ligament
  3. ) Lateral arcuate ligament
56
Q

A thickening of the deep fascia covering the anterior surface of the psoas major

A

Medial arcuate ligament

57
Q

A thickening of the deep fascia covering the anterior

surface of the quadratus lumborum

A

Lateral arcuate ligament

58
Q

Diaphragm muscle fibers that originate from the inner surfaces of the lower 6 ribs are said to be part of the

A

Costal origin

59
Q

Muscle fibers of the diaphragm arising from the inner surface of the xyphoid process are part of the

A

Sternal origin

60
Q

What are 4 aperatures in the diaphragm?

A
  1. ) Caval Hiatus (T8)
  2. ) Esophageal Hiatus (T10)
  3. ) Aortic Hiatus (T12)
  4. ) Sternocostal Hiatus (T10)
61
Q

Transmits the IVC and some branches of the right phrenic nerve

-within the central tendon to the right of the midline

A

Caval Hiatus

62
Q

Transmits the esophagus and the anterior and posterior vagus nerves

-within the muscle of the right crus to the left of the midline

A

Esophageal hiatus

63
Q

The skeletal muscle of the right crus serves as a sphincter for the

A

Esophagus

64
Q

Transmits the aorta, the azygos vein, and the thoracic duct

-behind the two crura in the midline

A

Aortic Hiatus

65
Q

Transmits the superior epigastric vessels

-between the muscle of the sternal origin and the costal origin

A

Sternocostal Hiatuses

66
Q

The sympathetic trunk, the thoracic splanchnic nerves, the hemiazygos vein and most branches of the phrenic nerves pass through the diaphragm without a specific

A

Hiatus

67
Q

Any muscle that has one of its attachments on the ribs can assist with

A

Inspiration

68
Q 
Because the innervation to the diaphragm (motor and sensory) is primarily from C3-5, pain arising from
the diaphragm (e.g. subphrenic abscess) is referred to these dermatomes in the
A

Shoulder region

69
Q

What is an important landmark at T2?

A

Jugular notch

70
Q

What is an important landmark at T3?

A

Base of scapular spine and top of aortic arch

71
Q

What is an important landmark at T7?

A

Inferior angle of scapula

72
Q

What is an important landmark at T8?

A

Caval Hiatus

73
Q

What is an important landmark at T9?

A

Xyphoid process

74
Q

What is an important landmark at T10?

A

Esophageal Hiatus

75
Q

What is an important landmark at T12?

A

Aortic Hiatus

76
Q

The Sternal angle, second costal cartilage, tracheal bifurcation, and upper end of the ascending aorta are located at

A

T4

Cardiovascular and Pulmonary (25 decks)

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