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Cardiovascular > Anatomy (Cardiovascular) > Flashcards

Anatomy (Cardiovascular) Flashcards

1
Q

Where is the transverse pericardial sinus?

A

Lies posterior to the ascending aorta and pulmonary trunk.

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2
Q

If you were to put your finger through the transverse pericardial sinus, where would the tip come out?

A

Anterior to the SVC.

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3
Q

What do cardiac surgeons use the transverse pericardial sinus to do?

A

Identify and isolate the great vessels in order to commence cardiopulmonary bypass.

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4
Q

What are the 3 surfaces of the heart?

A

Anterior (sternocostal), base (posterior), inferior (diaphragmatic).

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5
Q

What heart chambers make up the anterior surface of the heart?

A

Right atrium, right ventricle, a bit of left ventricle.

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6
Q

What is the coronary sinus?

A

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

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7
Q

What chamber forms most of the base of the heart?

A

The left atrium.

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8
Q

What 2 chambers form the diaphragmatic surface of the heart?

A

Left and right ventricle.

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9
Q

Name the branches of the right coronary artery.

A

The right marginal artery and the posterior interventricular artery.

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10
Q

Where is the right coronary artery found?

A

In coronary/right atrioventricular groove.

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11
Q

What are the first 2 branches of the aorta?

A

The right and left coronary arteries.

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12
Q

What is the first branch of the left coronary artery?

A

The left anterior descending (anterior interventricular artery).

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13
Q

What is the first branch of the LAD?

A

Lateral (diagonal) branch.

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14
Q

What are the 2nd and 3rd branches of the left coronary artery?

A

The circumflex artery and the left marginal artery.

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15
Q

What are the 3 openings into the right atrium?

A

The superior vena cava, the inferior vena cava and the coronary sinus.

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16
Q

Where is the oval fossa and what is it an embryological remnant of?

A

In the right atrium, the foramen ovale.

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17
Q

What is the crista terminalis?

A

Where the muscle bands of the wall of the auricle of the right atrium end.

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18
Q

What attach to the valve leaflets?

A

Tendinous cords and papillary muscles.

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19
Q

What are the 3 cusps of the tricuspid valve?

A

Anterior, posterior and septal cusps.

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20
Q

What are the 2 cusps of the mitral valve?

A

Anterior and posterior cusps.

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21
Q

What are the 3 cusps of the pulmonary valve?

A

Anterior, right and left.

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22
Q

What are the 3 cusps of the aortic valve?

A

Right, left and posterior cusps and sinuses.

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23
Q

Where do the coronary arteries arise from?

A

The right and left aortic sinuses.

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24
Q

What is the function of the moderator band (septomarginal trabecula) and where is it found?

A

Carries fibres of right bundle branch to the papillary muscle of the anterior cusp of the tricuspid valve. Right ventricle.

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25
Q

What are the openings into the left atrium?

A

The bilateral openings of superior and inferior pulmonary veins.

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26
Q

What is the neurotransmitter between the axon of a presynaptic sympathetic neurone and the cell body of a postsynaptic neurone?

A

Acetylcholine.

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27
Q

What does splanchnic mean?

A

Relating to the viscera or internal organs.

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28
Q

What about the heart means that it has bilateral sympathetic innervation?

A

It is midline.

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29
Q

What are the sympathetic nerves to the heart and lungs called?

A

The cardiopulmonary splanchnic nerves.

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30
Q

Where do the presynaptic cardiac parasympathetic efferent fibres in the vagus nerve synapse?

A

In the SA node.

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31
Q

What spinal nerves supply the sympathetic innervation of the heart?

A

The T1-T5 spinal nerves.

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32
Q

What part of the brain brings body wall (somatic) sensations into consciousness (somatosensory)?

A

The postcentral gyrus of parietal lobe.

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33
Q

What part of the brain brings about contraction of skeletal muscle (somatomotor)?

A

Precentral gyrus of frontal lobe.

34
Q

What are 3 possible origins of somatic central chest pain?

A

Herpes zoster (shingles); muscle, joint and bone; parietal pleura and fibrous pericardium

35
Q

Shingles in what dermatome may present with central chest pain?

A

T4/T5 dermatome.

36
Q

Give some examples of musculoskeletal problems that may cause central chest pain.

A

Pec major or intercostal muscle strain, dislocated costochondral joint, costovertebral joint inflammation, slipped disc.

37
Q

At what level does the superior mediastinum end?

A

Between T4 vertebrae and the sternal angle.

38
Q

Give some examples of visceral chest pain sources.

A

Trachea (tracheitis), oesophagus (oesophagitis), aorta (ruptured aneurysm of aortic arch), heart (angina and MI), abdominal viscera.

39
Q

Name all the structures that can be seen in the right side of the mediastinum.

A

Right vagus nerve (on trachea then oesophagus), right sympathetic chain, azygous vein, oesophagus, SVC, right phrenic nerve, IVC.

40
Q

Name all the structures that can be seen in the left side of the mediastinum.

A

Left phenic nerve (anterior to lung hilum), left vagus nerve (crossing left side of aortic arch heading posterior to the lung hilum towards to oesophagus), aorta, thoracic duct, left sympathetic chain, recurrent laryngeal branch of left vagus nerve, ligamentum arteriosum.

41
Q

Define radiating pain.

A

Pain that is felt both at the actual site of the pathology and also radiating.

42
Q

Where does the pain radiate if it originates in a somatic structure?

A

Along the affected dermatome.

43
Q

To what dermatomes does heart pain radiate to?

A

The dermatomes supplied by the spinal cord levels at which cardiac visceral afferents enter the sympathetic chain/spinal cord i.e. bilaterally to cervical and upper thoracic dermatomes.

44
Q

Describe what visceral pain radiating to the body wall feels like?

A

Still feels dull, aching and poorly localised.

45
Q

Describe referred pain?

A

The sensation of pain is felt only at a site remote from the actual area of injury or disease.

46
Q

What causes radiating and referred pain?

A

Due to afferent fibres from soma and afferent fibres from viscera entering the spinal cord at the same levels.

47
Q

What are the 3 types of MI (based on area)?

A

Anterior, inferior, anterolateral.

48
Q

What are the commonest sites of coronary atherosclerosis (most common to least common)?

A
  1. LAD. 2. Right coronary artery. 3. Circumflex branch of left coronary artery. 4. Left coronary artery.
49
Q

What are the most common places that grafts are taken for CABG?

A

Radial artery, internal thoracic (internal mammary) artery and the great saphenous vein.

50
Q

What is the blood supply of the SA and AV nodes?

A

SA: SA nodal branch from right coronary artery near its origin in most patients. AV: AV nodal branch from RCA near origin of posterior interventricular artery in most patients.

51
Q

What is the arterial blood supply of the interventricular septum?

A

The posterior interventricular artery and the left anterior descending artery.

52
Q

What is the function of the thymus?

A

Gland/lymphoid organ producing T lymphocytes in childhood (replaced by adipose tissue after puberty).

53
Q

What is in the middle mediastinum?

A

Pericardium, heart, parts of great vessels that connect with the heart.

54
Q

What is the function of the azygous vein?

A

Conveys blood from the intercostal veins to the SVC.

55
Q

Where does the trachea bifurcate?

A

At level of sternal angle so is in the superior mediastinum.

56
Q

What is in the posterior mediastinum?

A

Azygous vein, vagus nerves, thoracic duct, thoracic aorta, oesophagus.

57
Q

Where does the thoracic duct carry lymph to?

A

The left venous angle.

58
Q

How can the azygous vein be ruptured?

A

In chest trauma.

59
Q

What is the order of the branches of the arch of the aorta?

A

Brachiocephalic trunk, left common carotid, left subclavian.

60
Q

What are the branches of the thoracic aorta’s anterior surface?

A

Bronchial arteries, oesophageal arteries, mediastinal arteries, pericardial arteries, phrenic arteries.

61
Q

Where does the right thoracic duct drain lymph into?

A

The right venous angle.

62
Q

What are the venous angles?

A

Where the internal jugular and subclavian veins form the brachiocephalic trunk.

63
Q

In some patients, where does lymph from the left inferior lobe drain into?

A

The right lymphatic duct.

64
Q

What is the path of lymph drainage in the lungs?

A

Bronchopulmonary lymph nodes -> tracheo-bronchial lymph nodes -> right lymphatic/thoracic duct.

65
Q

What is the swollen start of the thoracic duct in the abdomen called?

A

The cisterna chyli.

66
Q

Where does the left phrenic nerve go through the diaphragm?

A

It pierces through the left dome to supply it from the inferior aspect.

67
Q

Describe the structure of the superior mediastinum from anterior to posterior.

A

Brachiocephalic veins and SVC, arch of aorta, trachea, oesophagus, thoracic duct.

68
Q

Describe the nerves of the superior mediastinum from lateral to medial?

A

Phrenic nerves, vagus nerves, recurrent laryngeal nerves.

69
Q

What are all the central veins?

A

Internal jugular, subclavian, brachiocephalic, SVC, IVC, ilial, femoral.

70
Q

What 2 veins are the most common access points in central venous cannulation/catheterisation?

A

Internal jugular, femoral.

71
Q

What is the venous path into the superior vena cava?

A

Internal jugular vein and sublclavian veins combine to form brachiocephalic veins which then combine to form the SVC.

72
Q

Where does the right recurrent laryngeal nerve hook under and does it enter the chest?

A

Right subclavian artery, no.

73
Q

Where does the left recurrent laryngeal nerve hook under and does it enter the chest?

A

Arch of the aorta, yes.

74
Q

What somatic sensory innervation does the phrenic nerve provide?

A

Mediastinal parietal pleura, fibrous pericardium, diaphragmatic parietal pleura, diaphragmatic parietal peritoneum.

75
Q

In what conditions might you get referred pain from the diaphragm?

A

Liver abscess or inflammation of the gallbladder (due to irritation of the parietal peritoneum).

76
Q

What spinal nerves are the supraclavicular nerves and what dermatomes do they supply?

A

C3 and 4, the dermatomes over the shoulder tip.

77
Q

Where does diaphragmatic pain radiate to and why?

A

It radiates to the shoulder tip as the supraclavicular nerves enter the spinal cord at the same levels as the phrenic nerve.

78
Q

To what structures does the vagus nerve supply somatic sensory and motor nerves to and what branch of the vagus does this?

A

Sensory: palate, laryngopharynx and larynx. Motor: pharynx and larynx. The recurrent laryngeal nerves.

79
Q

What types of nerve fibres does the vagus contain when it has given off its recurrent laryngeal branch?

A

Only parasympathetic fibres.

80
Q

Where does the azygous vein arch?

A

Superior to the lung root to drain into the SVC.

81
Q

Where is the thoracic duct located?

A

Wedged between the azygous vein and the oesophagus.

82
Q

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

A

Phrenic nerve is anterior to lung root, vagus is anterior (both left and right).

Cardiovascular (32 decks)

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