Anatomy of the Heart.

Question 1

Mediastinum.

Answer 1

Space between the two pleural cavities.

Question 2

What are the contents of the Mediastinum?

Answer 2

Thymus, Lymph nodes, Trachea, Pericardial Sac, Heart, Main arteries and veins.

Question 3

What line divides the mediastinum into superior and inferior parts?

Answer 3

Transverse plane from sternal angle to T4 and T5.

Question 4

What is the pericardium made out of?

Answer 4

A fibrous and a serous layer.

Question 5

What is the fibrous pericardium.

Answer 5

A tough connective tissue layer which defines the boundaries of the middle mediastinum.

Question 6

What are the components of the serous pericardium.

Answer 6

Parietal and Visceral layer.

Question 7

What are the attachments of the pericardium?

Answer 7

The base is attached to the central tendon of the diaphragm, and to the sternum with sternopericardial ligaments.

Question 8

What is the innervation of the pericardium?

Answer 8

The phrenic nerves.

Question 9

Origin of the phrenic nerves?

Answer 9

C3, C4, C5.

Question 10

Where is the serous and the parietal layers of the visceral pericardium continuous with each other?

Answer 10

1 surrounding the arteries and one surrounding the veins.

Question 11

Two refelections of the serous pericardium.

Answer 11

Oblique pericardial sinus and transverse pericardial sinus.

Question 12

Transverse pericardial sinus.

Answer 12

When the pericardium is opened a finger can be placed here and it seperates the arteries and the veins.

Question 13

Oblique pericardial sinus.

Answer 13

A hand under the apex of the heart and moved superiorly will meet this.

Question 14

What is the signficance of the innervation of the pericardium.

Answer 14

Somatic pain from the pericardium can be reffered by SOMATIC AFFERENT FIBRES in the phrenic nerves to the supraclavicular region.

Question 15

Pericarditis.

Answer 15

Inflammation of the pericardium.

Bacterial, viral, Chronic renal failure, Post myocardial infarction.

Question 16

How to differentiate pain from pericarditis with pain from myocardial infarction.

Answer 16

Ask patient to sit forward and you can do an ECG. Pain may radiate to one or both arms like in angina.

Question 17

Pericardial effusion.

Answer 17

Excess fluid between the layers of the pericardium.

Can compress the heart resulting in BIVENTRICULAR FAILURE.

Question 18

Cardiac tamponade.

Answer 18

Caused due to Pericardial effusion where the pericardial sac is COMPRESSED due to effusion.

Question 19

Constrictive pericarditis.

Answer 19

Abnormal thickening of the pericardial sac which constricts the heart. The jugular venous pulse in the neck increases on inspiration and is called the Kussmaul’s sign.

Question 20

What are the structures froming the base of the heart?

Answer 20

Left atrium, small part of right and proximal part of the veins.

Question 21

Where does the base of the heart rest?

Answer 21

On the pericardial wall opposite T5 to T8 (T6 - T9 when standing).

Question 22

What forms the apex of the heart?

Answer 22

Left Ventrical. Inferolateral part.

Question 23

What is the position of the apex of the heart on the surface?

Answer 23

Deep to the left fifth intercostal, midclavicular line.

Question 24

What of the heart rests on the Diaphragm?

Answer 24

2/3 Left ventricle, 1/3 Right ventricle.

Question 25

The left pulmonary surface of the heart?

Answer 25

Left atrium and ventricle.

Question 26

The right pulmonary surface of the heart?

Answer 26

Right atrium.

Question 27

The right and left margins of the heart...

Answer 27

Are the same as the right and left pulmonary surfaces.

Question 28

The inferior margin of the heart.

Answer 28

Between the front of the heart and the diaphragmatic surface.

Question 29

The obtuse margin of the heart.

Answer 29

Between the front of the heart and the left pulmonary surface.

Question 30

In a chest X-ray of the patient in AP view, what do you see on the right side of the patient?

Answer 30

Right atrium and superior vena cava.

Question 31

In a chest X-ray of the patient in AP view, what do you see on the left side of the patient?

Answer 31

Left ventricle and apex.

Question 32

Where is the Coronary sulcus?

Answer 32

Goes around the heart in a circle separating the atria from the ventricles.

Question 33

What does the Coronary sulcus contain?

Answer 33

Right coronary artery, small cardiac vein, coronary sinus, circumflex branch of the left coronary artery.

Question 34

What do the Anterior and posterior interventricular sulci do?

Answer 34

Seperate the two ventricles.

Question 35

What does the anterior interventricular sulcus contain?

Answer 35

Anterior interventricular artery and the great cardiac vein.

Question 36

What does the posterior interventricular sulcus contain?

Answer 36

Posterior interventricular artery and middle cardiac vein.

Question 37

Which 3 veins deliver blood to the atria?

Answer 37

Superior and inferior vena cava and the coronary sinus.

Question 38

What is the Sulcus terminalis cordis?

Answer 38

Indicates the division of the right atrium in to two continuous segments. Right side of the opening of the superior vena cava to the inferior vena cava.

Question 39

Where does the Sulcus terminalis originate and where does it go?

Answer 39

It goes from the right side of the opening of the superior vena cava to the right side of the opening of the inferior vena cava.

Question 40

How would you identify the sulcus terminalis from within the atria?

Answer 40

You would look for the crista terminalis.

Question 41

What is the crista teminalis?

Answer 41

Its a smooth muscular ridge found in the right atria which goes from the opening of the superior vena cava to the inferior vena cava.

Question 42

Crista terminalis in the embryo?

Answer 42

Junction of the sinus venosus and the heart in the embryo.

Question 43

The Crista terminalis is the origin for what muscle?

Answer 43

The pectinate muscle.

Question 44

Sinus of vena cavae.

Answer 44

Derived from the right horn of the sinus venosus. Vena cava empty into this.

Question 45

Atrium proper.

Answer 45

Space anterior to the crista and includes the right auricle. Its walls are covered by musculi pectinati.