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HDT 2.2 > Anatomy of heart and its vessels > Flashcards

Anatomy of heart and its vessels Flashcards

1
Q

what can cause a block in the vertebral artery?

A

an occlusion in the middle cerebral artery

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2
Q

where is the hilum of the kidney found? and where is the right kidney?

A

on L1 in the abdomen

right kidney is located posteriorly to the liver

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3
Q

what can be seen to be posterior to the kidney?

A

Rib 12

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4
Q

what nerves are responsible for causing bladder emptying and relaxation of the internal sphincter?

A

the parasympathetic nerves

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5
Q

what are the medullary pyramids and what are they made up of?

A

formed of the Loop of Henle and the collecting duct

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6
Q

where is the kidney placed in relation to the diaphragm ?

A

kidneys are anterior and inferior to the diaphragm

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7
Q

where is the ureters and the bladder situated in relation to the abdomen?

A

the bladder is posterior to the pubic symphysis at the pelvic brim
ureters are anterior to the posterior muscular wall

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8
Q

where are the abdominal wall muscles and where are they located?

A

they are in the quadrates lumborum and located between vertebrae L1-L5 and rib 11 and 12

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9
Q

where is the transplyoric plane?

A

it is halfway between jugular notch and the pubic symphysis

- site of anatomical relations to the kidneys

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10
Q

what is the greater omentum?

A

it is a double sheet of peritoneum folds

It has two layers

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11
Q

where is the duodenum?

A

it is the first part of the small intestine and it helps to digest food that comes from the stomach and absorb any nutrients

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12
Q

how are the small and large intestine connected?

A

the last part of the small intestine, called the ileum, is connected to the cecum which is the first part of the colon (large intestine)

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13
Q

where is ascending and descending part of the colon?

A

ascending is on the right side of the abdomen and descending on the left

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14
Q

what is the kidney anterior and posterior to?

A

kidney is anterior to the diaphragm and posterior to peritoneum

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15
Q

how does the small and large intestine sit in relation to the right kidney?

A

they sit inferiorly with the large intestine being retroperitoneal and the small intestine being intraperitoneal

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16
Q

where does the duodenum sit in relation to the kidney?

A

the duodenum sits medially to the right kidney
the beginning part of the duodenum is medial to kidney
the duodenum is retroperitoneal

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17
Q

where does the small intestine sit in relation to the left kidney?

A

the small intestine sits medially and intraperitoneally to the left kidney

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18
Q

what organs sit superiorly to the left kidney?

A

the stomach and spleen and they sit intraperitoneally

the suprarenal gland and diaphragm also and they sit retroperitoneally

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19
Q

how does the pancreas sit in relation to the left kidney?

A

it sits retroperitoneally

it cuts across the anterior surface of the left kidney

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20
Q

what is the jejunum?

A

the second part of the small intestine

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21
Q

what plane does ureter sit in relation to lumbar vertebrae?

A

sits in the agitate plane with transverse processes

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22
Q

what plane does the kidney sit in?

A

the transpyloric plate

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23
Q

what are the gross external features of the kidney?

A 
the hilum
- renal pelvis, artery, vein 
sinus
- major/minor calyx 
- lobes; divided by renal columns
- outer; cortex, renal columns
- inner; medulla
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24
Q

where do the renal pyramids point towards?

A

the sinus

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25
Q

what is the apex of the pyramid?

A

the renal papilla

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26
Q

where does the papilla drain urine into?

A
  1. minor calyx
  2. major calyx
  3. renal pelvis
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27
Q

how do the renal artery and the renal vein sit with each other?

A

renal artery us posterior to the renal vein

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28
Q

where does the renal artery emerge?

A

emerges from the abdominal aorta

level: vertebrae L1 and L2

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29
Q

what does the superior mesenteric artery do?

A

provides oxygenated blood and nutrients to the intestines

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30
Q

what are the internal arteries of the kidney?

A
  • interlobular; terminal arteries
  • arcuate
  • interlobular; become the afferent arterioles when entering the glomerulus in the nephron
  • has a posterior and anterior artery branch
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31
Q

what does ht phrenic nerve innervate?

A

it innervates the diaphragm

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32
Q

what nerves innervate the kidney?

A
  • the renal plexus; supplied by sympathetic nerves in the prevertebral plexus
  • splanchnic nerve
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33
Q

how are the ureters supplied with blood superiorly, medially and inferiorly?

A

superior: renal arteries
middle; gonadal arteries/ aorta/ common iliac arteries
inferior: internal iliac arteries

34
Q

where is the uterine artery and the ductus deferens?

A

the uterine artery is wrapped around the ureter in the women

the ductus deferens in men cuts straight across the bladder surface; brings sperm from testes to prostate

35
Q

how do kidney stones work in causing pain?

A

the stone pushes on the muscular wall and when there is smooth muscle activity pain will occur for the patient

36
Q

how does the spinal cord and brain sense referred pain?

A

the spinal cord receives sensory information from:

  1. viscera; visceral afferent nerves- unconscious monitor of internal systems
  2. skin and muscle; somatic afferent nerves- conscious sensation
37
Q

what do dermatomes represent?

A

represent areas of the skin innervated by a single spinal cord segment

38
Q

where does sensory innervation of ureters reach?

A

reaches the spinal cord segments T11-L2

pain is felt in these regions

39
Q

what are the nine abdominal regions?

A
  1. right flank
  2. left flank
  3. right groin
  4. left groin
  5. right hypochondrium
  6. left hypochondrium
  7. pubic region; hindgut referred pain
  8. umbilical region; midgut referred pain
  9. epigastric region; foregut referred pain
40
Q

where is the bladder located and what are its external features?

A
  • posterior to pubic symphysis
  • inferior to peritoneum
  • immediately anterior to vagina/rectum
  • supported by pelvic floor muscles
41
Q

what is bladders shape when empty? how is this formed?

A

it has a triangular shape
this is formed superiorly by the two entry points of the uterus
apex is pointed anteriorly

42
Q

where does the female bladder get its blood supply?

A
  • right internal iliac artery supplies the internal pelvis
  • the vaginal artery
  • superior vesical artery
43
Q

where does the male bladder get its blood supply?

A
  • right internal iliac artery
  • superior vesical artery
  • inferior vesical artery; only in males
44
Q

where does all venous drainage occur?

A

through the internal iliac veins

45
Q

what are the internal features of the bladder?

A
  • trigone
  • ruage
  • ureter openings
  • internal urethral orifice and sphincter
46
Q

in the female pelvis peritoneum where does fluid accumulate in an infection?

A

in the recto-uterine pouch and vesicle-uterine pouch; pus and blood can be drained in this pouch

47
Q

in the male pelvis peritoneum where does fluid accumulate in an infection?

A

recto-vesical pouch

48
Q

how long is female urethra? how does this affect its susceptibility?

A

4cm approx.

susceptible to UTI; bladder inflammation so prescribe oral antibiotics

49
Q

how long is the male urethra and how is it divided?

A 
approx 20cm
has four segments:
1. preprostatic urethra
2. prostatic urethra
3. membranous urethra 
4. spongy (penile) urethra
50
Q

what does the internal urethral sphincter do?

A

it closes off during ejaculation so sperm and acidic urine dont mix and kill the sperm
- controlled involuntarily by visceral nervous system

51
Q

is the external urethral sphincter movements voluntarily or involuntarily controlled?

A

it is voluntarily controlled

52
Q

what is urge incontinence?

A

‘overactive bladder’

  • involuntary leakage of urine
  • sensation/urgency to urinate
  • caused by spontaneous detrusor muscle overactivity during the bladder
  • can be neurogenic
  • exacerbated by caffeine, alcohol consumption
53
Q

how can stress incontinence occur from pelvis floor muscle trauma

A
  • common in females
  • weakened pelvic floor
  • triggered by increased intra-abdominal pressure; bladder pressure> urethral pressure
  • urethral hyper mobility
54
Q

how is micturition controlled?

A

controlled by the autonomic nervous system

  1. sympathetic nerves relax bladder, contract internal urethral sphincter; bladder is empty
  2. mechanoreceptors detect stretch
  3. visceral afferent fibres to CNS
  4. parasympathetic nerves contract detrusor muscle and relax internal urethral sphincter
55
Q

what is the pelvic floor?

A

a sling that contracts around the neck of the bladder

  • has the pudendal nerve; somatic nerve
  • can squeeze your pelvic floor musculature and control whether to hold urine in
56
Q

what is the levator ani muscle?

A

made up of the puborectalis, pubococcygeus and illiococcygeus

57
Q

what splanchnic nerves are sympathetic and parasympathetic?

A

sacral splanchnic nerves ( T10- L2) are sympathetic

pelvic splanchnic nerves (S2-S4) are parasympathetic

58
Q

what is the micturition reflex?

A
  • when empty sympathetic nerves tell muscle to relax and form the wrinkled appearance
  • cause contraction of the internal urethral sphincter muscle
  • as bladder fills with water, the stretch receptors and parasympathetic nerves kick into action
  • the muscle then contracts and creates pressure onto the internal urethral sphincter
  • stretch receptors send signals back to parasympathetic nerves
  • external sphincter muscles relax so urine is released but stopped if any voluntary restriction
59
Q

where are the stretch receptors located?

A

in the wall of the bladder

60
Q

what are the basic components of CVS?

A
  • the pump (specialised muscle); 2 pumps
  • closed system of tubes; carry blood to/from capillary beds

it is actually 2 circulations;

  1. pulmonary
  2. systemic
61
Q

where is the inferior mediastinum?

A

it is below the plane between the sternal angle and vertebrae T4/T5
and above the diaphragm

62
Q

where is the middle mediastinum placed?

A

the fibrous pericardium around the heart separates the inferior mediastinum into three parts

63
Q

what are the 3 parts of the inferior mediastinum?

A

the anterior, the middle and posterior

the middle is occupied by the heart

64
Q

where is the mediastinum positioned in relation to the lungs?

A

it is centrally located between the lungs and anterior to the vertebrae
posterior to the sternum

65
Q

what are the types of pericardium are there and what are they made up of?

A
  1. Fibrous pericardium; contains heart during contraction/relaxation
    - > tough protective sleeve. prevents over distension/enlargement
    - > attached to the diaphragm and sternum
  2. Serous pericardium; layers slide over each other to allow movement during heart beat so heart can contract/relax
    - > parietal is the outer layer and attached to fibrous
    - > visceral is the inner layer and attached to hearts myocardium
66
Q

what are the layers of the heart muscle?

A
  • epicardium; visceral layer of serous pericardium
  • myocardium; allows pump to function
  • endocardium; in contact with the blood as it is the internal lining
67
Q

what are the surfaces of the heart?

A
  • base/posterior
  • anterior/ sternocostal
  • diaphragmatic
  • apex
  • left/right pulmonary
68
Q

what are the external features of the heart?

A
  • the four chambers

- sulci denote the division of these chambers; coronary arteries/veins are found here

69
Q

what are the great vessels of the heart?

A

1b. right common carotid artery
1a. right subclavian artery
1. brachiocephalic trunk
braciocephalic veins
2. left common carotid artery
3. left subclavian artery

70
Q

where does the right and left coronary artery come from?

A

right- the abdominal aorta

left- branch of the aortic valve

71
Q

when a blockage occurs with the coronary circulation what can occur?

A

no blood supply

  • cardiac muscle ischaemia
  • myocardial infarction and necrosis
72
Q

where do cardiac veins drain into? where does this drain into?

A

into the coronary sinus and the coronary sinus drains into the right atrium

73
Q

what vessels does the right atrium have? where is the sinus node in the RA?

A

it has SVC, IVC and coronary sinus

the SA node is within the superior part of the crest terminalis

74
Q

what is right atrium made up of?

A

pectinate muscle

75
Q

what does the chordae tendineae do in right ventricle?

A

stops the reflux of blood to the right atrium

76
Q

what vessels does the left atrium have? what muscle is it made up of?

A
  • smooth wall and smooth muscle
  • has left and right pulmonary veins
  • it has mitral valve for blood to enter through its two cusps
77
Q

which ventricle is thicker?

A

the left as a larger force is needed to push blood through systemic circulation
so larger papillary muscle and thick myocardium

78
Q

what is the intrinsic SA node rate?

A

ntrinsic SA node rate= 100bpm

79
Q

how does parasympathetic and sympathetic nerves affect heart rate?

A
  • parasympathetic; vagus nerve will decrease heart rate and force. this constricts the coronary arteries
  • sympathetic inputs; sympathetic trunk will increase heart rate and force.
80
Q

what is the cardiac conduction system?

A
  1. SA

2. across atrial cardiac muscle wall

HDT 2.2 (10 decks)

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