Anatomy Middle Mediastinum Flashcards
Fibrous sac that surrounds the heart
Pericardium
Dense connective tissue cone-shaped bag with its base on the diaphragm and its apex continuous with the adventitia of the great vessels
Fibrous pericardium
Attaches the fibrous pericardium to the diaphragm
pericardiacophrenic ligament
Attaches the fibrous pericardium to the sternum
Sternopericardial ligament
Layers of the serous pericardium
Parietal and visceral layers
What layer of the serous pericardium is fused with the fibrous pericardium?
Parietal layer of the serous pericardium
What layer of the serous pericardium is fused with the the heart?
Visceral layer of the serous pericardium (aka epicardium)
Closed space between the parietal and visceral layer of the serous pericardium
Pericardial cavity
Excessive fluid in the pericardial cavity
Pericardial effusion
Subdivisions of the pericardial sinus
Transverse and oblique
Sinus of the pericardial sac that lies posterior to the ascending the aorta and pulmonary trunk
Transverse Sinus
Sinus of the pericardial sac that is J shaped cul-de-sac behind the heart surrounded by reflection of serous pericardium around the right and left pulmonary veins/IVC
Oblique sinus
Area for auscultating the mitral valve
5th intercostal space 7-9cm from the midline
Anterior surface of the heart and it’s associated portion of the heart
Sternocostal and mainly the right ventricle
Inferior surface of the heart and its associated portion of the heart
Diaphragmatic and mainly left ventrical (some right)
Portion of the heart that faces the left lung and its associted portion of the heart
Left pulmonary and left ventricle
Portion of the heart that faces the right lung and its associated portion of the heart
Right pulmonary and right ventricle
Base of the heart and its primary portion of the heart
Posterior surface and mainly the left atrium (part of the right)
Margin formed by the right ventricle (small part of the left vent), is the sharp boundary b/t the anterior and diaphragmatic surfaces
Inferior (acute) margin
Margin formed primarily by the left ventricle, boundary b/t anterior and left pulmonary surfaces
Obtuse margin
Boundary b/t the base and left pulmonary surfaces, formed by the left ventricle and left auricle
Left margin
Boundary b/t the sternocostal and right pulmonary surfaces, formed by right atrium
Right margin
Which layer of the heart wall contains the conducting system?
Endocardium
Sulcus that circles the heart and separates the atria from the ventricles
Coronary sulcus
Contents of the coronary sulcus
RCA, small cardiac vein, circumflex branch of the LCA, coronary sinus
Demarcates the boundary b/t the left/right ventricles
Interventricular sulcus
Contents of the anterior interventricular sulcus
Anterior interventricular artery and great cardiac vein
Contents of the posterior interventricular sulcus
Posterior intervantricular artery and middle cardiac vein
Spaces of the right atrium
Sinus of venae cavae and the atrium proper
Separated by the crista terminalis
Sinus of venae cavae and the atrium proper
What valve is in the right atrioventricular orifice?
Tricuspid
Circular depression in the interatrial septum
Fossa ovalis
Prominent margin of the fossa ovalis
Limbus fossae ovalis
Ear-like conical muscular pouch
Right auricle
Muscular ridges on the walls of the inflow portion of the right ventricle
Traveculae carneae
What separates the inflow/outflow of the right ventricle
Supraventricular crest
Muscle that attaches to the tricuspid valve
Papillary muscles
Connects the papillary muscle the the tricuspid valve
Chordae Tendineae
Largest and most constant papillary muscle
Anterior papillary muscle
Which papillary muscle extends to the posterior and septal valves of the tricuspid valves?
Posterior papillary muscle
Isolated band or trabeculae carnae that forms a bridge b/t the base of the anterior pap muscle and IV septum
Septomarginal trabecula
What does the septmarginal trabecula carry?
Right limb of the AV bundle
What secures each of the 3 cusps to the
Fibrous ring
What part of the outflow tract of the right ventricle contains the pulmonary valve?
Conus arteriosus
What makes up the pulmonary valve?
3 semilunar cusps
Congential defect in which the tricuspid valve is displaced towards the apex of the heart
Ebstein’s anomaly
Parts of the Interventricular spetum
Muscular part and mebranous part
Originates from the right aortic sinus of the ascending aorta
Right coronary artery
What does the right coronary artery supply?
Right atrium/ventricle
What does the right coronary atery pass thru?
thru the right auricle and pulmonary trunk
Branches of the right coronary artery
Sinu-atrial nodal branch, right marginal branch, posterior interventricular branch, atrioventricular nodal branch
Branch of the RCA that arises off of the acute margin and continues toward the apex of the heart
Right marginal branch
Branch of the RCA that its continuation onto the posterior surface, lying in the posterior interventricular sulcus
Posterior interventricular branch
Originates from the left aortic sinus of the ascending aorta
Left coronary artery
Major branches of the LCA
Anterior interventricular branch, circumflex
Branch of the LCA that supplies the left ventricular wall
Diagonal branch
Path of the circumflex branch
Goes in the coronary culcus onto the diaphramatic surface of the heart
Branch off of the circumflex
left arginal artery
Most common variation of the coronary arteries
Right dominant pattern (posterior interventricular branch originates from RCA)
Top 3 sites of coronary artery occlusion
Anterior interventricular branch of the LAC, RCA, Circumflex of LCA
Where do the cardiac veins empty to?
Coronary sinus
Path of great cardiac vein
Begins at apex, ascends thru anterior interventricular sulcus, is associated with the cricumflex at the coronary sulcus, gradually enlarges to become the coronary sinus
Path of middle cardiac vein
Begins near apex and ascends within the posterior interventricular sulcus
Path of small cardiac vein
Begins near the lower anterio section of the coronary sulcus b/t right atrium and right ventricle, accompanies the marginal branch of the RCA along the acute margin
Path of posterior cardiac vein
On posterior surface of left ventricle, to the left of the middle cardiac vein
Location of the SA node
superior end of the crista terminalis athe junction of the SVC and the right auricle
Location of the AV node
Near the opening of the coronary cinus withing the AV septum.
Nerve bundle in the membranous portion of the septum
Bundle of His (AV bundle)
What does the RBB pass thru?
Moderator band (septomarginal trabecula)
Found between the endocardium and the myocardium and is formed by Purkinje fibers continuous with the BBs
Subendocardial plexus
Parasymp to the heart
Vagus nerve
Symp to the heart
T1-4
Where are the heart’s pain nerve endings?
Deep myocardium