anatomy of the heart external features and the pericardium

Question 1

what forms what 
the apex: let ventricle:
the base:
the base of the base of heart :
the upper border:
right border:
 left border:
lower border:

Answer 1

the apex: left ventricle
the base: the left atrium and to an extend the right atrium
the base of the heart is limited inferiorly by posterior part of the coronary groove containing the coronary sinus.
the upper border: is mainly formed by the two atrium (mainly the left)
the right border: by the right atrium
left border: the left ventricle and partly by the left atrium
lower border: the right ventricle mainly but the left ventricle also places a role in that

Question 2

the base of the heart is opposite to

Answer 2

it is opposite to the 4 thoracic vertebrae: (5-8)

Question 3

explain the sternocostal surface

Answer 3

Sternocostal surface:
Is divided by the coronary groove into atrial and ventricular portions:
Atrial portion:
Lies above the coronary groove.
Formed by the right atrium and the auricle of the left atrium.
The left atrium is hidden behind the ascending aorta and pulmonary trunk.
Ventricular portion:
Lies below the coronary groove.
Divided into left 1/3 by the left ventricle and right 2/3 by the right ventricle by the anterior interventricular groove.

Question 4

the diaphragmatic surface of the heart and its relation

Answer 4

Formed by the two ventricles (mainly the left ventricle).

Related to the central tendon and partly on the left cupola of the diaphragm.

Question 5

how does the pericardium attach to the sternum

Answer 5

it attaches to the sternum via the sternopericardial ligament

Question 6

where is the transverse sinus

Answer 6

A finger placed in the transverse
sinus passes in front of the
superior vena cava and behind
the aorta and pulmonary trunk.

Question 7

what is the arterial hilum of the heart

Answer 7

the aorta and the pulmonary trunk

Question 8

oblique sinus

Answer 8

Located behind the heart.
Lies between the right and left
pulmonary veins and the inferior
vena cava.
Anterior wall: posterior wall of
the left atrium between the four
pulmonary veins
Posterior wall: related to the
esophagus.

Question 9

the nerve supply of the pericardium

Answer 9

The fibrous & parietal
pericardium are innervated by
the phrenic nerve (somatic
nerve) . So the pericardial sac
can be a source of pain as in
pericarditis.
The visceral pericardium by
autonomic nerves: the vagus
(parasympathetic) and
sympathetic nerves.

Question 10

where is pericardiacocentesis performed

Answer 10

The needle is inserted just
below the xiphisternum in
the left costoxiphoid angle.
During this procedure, care
should be taken to avoid vessels.
The needle could also be passed
through the 4th and 5th left
intercostal space close to the
sternum where the heart and
pericardium are not covered by
pleura.

Question 11

cardiac referred pain explain

Answer 11

The afferent nerve fibers ascend to the
central nervous system through the
cardiac branches of sympathetic
trunk & enter the spinal cord through the
posterior roots of the upper four
thoracic nerves.
The pain is not felt in the heart, but is
referred to the skin areas supplied by
the corresponding spinal nerves. The
skin areas supplied by the upper four
intercostal nerves and by the
intercostobrachial nerve (T2) are therefore
affected.
The intercostobrachial nerve communicates
with the medial cutaneous nerve of the arm
and is distributed to skin on the medial side
of the upper part of the arm.