ANATOMY - thorax p2 Flashcards
1
Q
what level does the SVC enter the RA?
A
at level 3rd rib
2
Q
where do the pulmonary aa receive blood from and where does it send it to?
A
deoxy blood from the RV –> lung
3
Q
which valve separates the pulmonary aa and the RV?
A
pulmonary valve
4
Q
at what spinal level does the pulmonary aa/trunk split into the R + L pulmonary aa
A
T5/6
5
Q
where do the pulmonary vv receive blood from and where does it send it to?
A
oxy blood from the lungs –> LA on the posterior surface
6
Q
what structure is in between the L + R pulmonary vv?
A
oblique pericardial sinus
7
Q
where does the IVC receive blood and where does it drain into?
A
blood from all structures inf to diaphragm –> inferior portion of the RA
8
Q
at what spinal level does the IVC enter the pericardium?
A
T8
9
Q
what are the 5 surfaces of the heart
A
ant - RV
post - LA
inf - LV + RV
R pulmonary - RA
L pulmonary - LV
10
Q
what are the 4 borders of the heart?
A
R - RA
inf - LV + RV
left - LV
sup - RA/LA/ great vessels
11
Q
another name for coronary sulcus
A
atrioventricular groove
12
Q
what important structure is contained within the coronary sulcus
A
RCA
13
Q
what forms pericardial sinuses?
A
because of how the pericardium folds around the great vessels
14
Q
where is the transverse pericardial sinus?
A
posterior the ascending aorta + pulmonary trunk
anterior to the SVC
superior to the LA
15
Q
what does the transverse sinus separate and what is its surgical use
A
separates the aa from the vv
used to ligate the aa of the heart during a CABG
16
Q
which 3 vv drain into the RA
A
SVC
IVC
Coronary vv
17
Q
where is the R auricle within the RA?
A
anteromedially
18
Q
role of the R auricle?
A
increases the capacity of the heart
19
Q
what divides the inferior surface of the RA into 2?
A
crista terminalis
20
Q
what 2 parts does the division of the RA by the crista terminalis make?
A
Sinus veranum (posterior to crista)
Atrium proper (anterior to crista)
21
Q
where does the sinus veranum receive blood from
A
SVC + IVC
22
Q
wall smooth or rough - sinus veranum
A
smooth
23
Q
embryological origin sinus veranum
A
sinus venosus
24
Q
wall smooth or rough - atrium proper
A
rough
25
name of the oval shaped depression in the interatrial septum
fossa ovalis
26
what is the fossa ovalis a remnant of?
foramen ovale
27
how does an atrial septal defect cause HF?
L --> R shunt --> LV overload --> pulm HTN --> RVH --> RHF
28
where is the L auricle>
superior aspect of the LA
29
inferiorly, what is the LA divided into?
inflow portion + outflow portion
30
which vessels does the inflow portion of the LA receive blood from?
pulmonary vv
31
what structure is the inflow portion of the LA derived from and how does it affect its surface
derived from pulmonary vv
hence smooth surface
32
what type of mm is the outflow portion of the LA?
pectinate mm
33
what structure divides the RV into the inflow and outflow sections?
supraventricular crest
34
name of the irregular ridges on the inflow portion of the RV
trabecula carnae
35
what are the 3 types of the trabeculae carnae
ridges
bridges (cont R bundle branches)
Pillars (papillary mm)
36
what are the pillar trabeculae carnae attached to
chordae tendinae + tricuspid valves (presents prolapse)
37
another name for the outflow portion of the RV
conus arteriosus
38
embryological origin conus arteriosis
bulbus cordis (smooth walled)
39
difference between the superior and inferior interventricular septum
sup - membranous and thinner, part of the fibrous skeleton
inf - muscular, same thicness as the LV
40
what structure lines the inflow portion of the LV
trabeculae carnae
+ 2 papillary mm (attach to mitral valve)
41
another name for outflow portion of the LV
aortic vestibule
42
embryonic origin aortic vestibule
bulbus cordis
smooth walled
43
what is tetralogy of Falot?
VSD
overriding aorta - dexoy blood into aorta
pulnary valve stenosis
RVH
(R --> L shunt)
44
what are the 4 aspects of the conductive system of the heart?
SAN
AVN
AV 'bundle of His'
Purkinje gfibres
45
conducting system from SAN to contraction
1) AP created by SAN
2) wave of excitation spreads across the atria via gap junctions to contract
3)wave reaches AVN where signal is delayed
4) signal then is conducted in bundle of His in interventricular septum
5) bundle of His and Purkinje fibres spread waves across the ventricles --> contraction
46
where is the SAN?
upper RA at the junction where the SVC enters
47
sympathetic inn of the SAN -->
incr firing rate --> incr HR
48
parasymp inn of the SAN -->
decr firing rate --> decr HR
49
where is the AVN
in the atrioventricular sinus, near the opening of the coronary sinus
50
how long is the AVN delay? what is the significance of it
120ms
to that the atria can fully eject
51
where is the Bundle of HIs?
down the membranous portion of the IV septum
52
what are the purkinje fibres?
sub-endocardial plexus of conduction cells
53
which energy form are Purkinje fibres abundant in
glycogen
54
where are the Purkinje fibres?
in the subendocardial surface of ventricle walls
55
what are the 3 layers of the heart wall?
endocardium, myocardium, epicardium
56
what cell types make up the endocardium
CT
simple swuamous ep
57
what is the name of the single sheet of cells making up the parietal layer of the pericardium?
mesothelium
58
what is the fibrous layer of the pericardium continuous with
centra tendon of the diaghragm
59
what material makes up the fibrous pericardium and what is its function (and danger)
connective tissue
prevents rapid overfilling of heart
liable to tamponade, especially the right)
60
what type of muscle is the myocardium
involuntary striated muscle
61
what does the connective tissue of the epicardium do
secretes pericardial fluid into pericardial cavity
62
what is the outer surface of the epivardium lined by
simple squamous ep = mesothelium
63
where is the subendocardial layer of the heart
in between the endocardium + pericardium
64
where is the subepicardial layer of the heart
in between myocardium + epicardium
65
what is the pericardium
fibroserous, fluid filled sac which surrounds the body of the heart and the roots of the great vessels
66
layers of the pericardium (+ how to remember)
Farty Priya Shits Viscously
Fibrous
Parietal
Serous fl/space
Visceral
67
what are the punctiosn of the pericardium (4)
fixes heart in the mediastinum + limits motion
prevents overfilling of heart
lubrication - reduces friction
protection from infection
68
innervation of the pericardium
C3-5 phrenic nn
69
what are the 2 AV valves
tricuspid
mitral
70
what are the 2 semi-lunar valves
aortic
pulmonary
71
when do the AV valves close?
start of ventricular contraction/systole --> 1st heart sound
72
where is the tricuspid valve
between the RA+RV
73
name of the 3 tricuspid valve csusps
ant, septal, post
74
where is the mitral valve?
between LA + LV
75
name of the 2 mitral valve cusps
ant + post
76
why dont the AV valves prolapse into the atria?
supported by chordae tendinae which are attached to papillary muscles
77
when do the semi-lunar valves close?
at the beginning of ventricular diastole aka 2nd heart sound
78
where is the pulmonary valve?
between RV + pulmonary trunk
79
name of the 3 pulmonary valve cusps
L, R, ant
80
where is the aortic valve?
betw LV + aorta
81
what are the 3 aortic valve cusps called
R, L, post
82
where do the R+ LCA originate from?
L + R aortic sinuses
83
how do the aortic sinuses fill with blood?
blood recoils during diastole --> fills sinuses --> coronary aa --> myocardium
84
what structure do most of the coronary vv drain into to for blood to reach the RA?
coronary sinus
85
what are the 4 main venous tributaries of the heart
great cardiac vv
small cardiac vv
middle cardiac vv
post cardiac vv
86
great cardiac vv - route back to the coronary sinus
apex of the heart --> ascending in ant interventricular groove --> cuves to L --> post surface of heart --> enlarges to become coronary sinus
87
small cardiac vv - route back to coronary sinus
anterior surface of heart in groove between RA + RV --> post to coronary sinus
88
middle cardiac vv - route back to coronary sinus
apex of heart in post interventricular groove --> coronary sinus
89
post cardiac vv - route back to coronary sinus
post surface LV --> on left to middle cardiac vv --> coronary sinus
90
inferior MI - where on ECG + which aa occluded
II, III , AVF
RCA
91
anteroapical MI - where on ECG + which aa occluded
V3+4
distal LAD
92
anteroseptal MI - where on ECG + which aa occluded
V1/2 LAD
93
anterolateral MI - where on ECG + which aa occluded
I
avL
V5/6
circumflex
94
true post MI - where on ECG + which aa occluded
tall R V1
RCA
95
RCA - which region of heart supplied + subsequent venous drainage
RA, SAN, AVN, post part IV septum
small and middle cardiac vv
96
R marginal aa - which region of heart supplied + subsequent venous drainage
RV
Apex
small and middle cardiac vv
97
post interventricular aa - which region of heart supplied + subsequent venous drainage
RV
LV
post 1/3 IVS
l post ventricular vv
98
L coronary aa - which region of heart supplied + subsequent venous drainage
LA, LV
IVS
AV bundles
great cardiac vv
99
LAD - which region of heart supplied + subsequent venous drainage
RV, LA, ant 2/3 IVS
great cardiac vv
100
L marginal aa - which region of heart supplied + subsequent venous drainage
LV
L marginal + great cardiac vv
101
Circumflex aa - which region of heart supplied + subsequent venous drainage
LA +LV
great cardiac vv
102
structures in close proximity to medial surface L lung (4)
heart
arch aorta
thoracic aorta
oesophagus
103
structures in close proximity to the medial surface of the R lung (5)
oesophagus
heart
IVC
SVC
azygous vv
104
how many lobes Left lung
2
105
how many lobes right lung
3
106
where doe sthe horizontal fissure of the lung extend between
horizontally from stenrum at level 4th rib to meet oblique fissure
107
where does the oblique fissure extend between?
inferior border of the lung in a superopost direction
108
what are the 3 surfaces of the lungs
costal, mediastinal + diaphragmatic
109
what are the 3 borders of the lugns
anterior, inferior, posterior
110
what is the anterior border of the lung
convergence of the mediastinal + costal surfaces
111
name of the notch of the L lung anterior border
cardiac notch
112
contents of the root of the lung (6)
bronchus, PA, 2 PV, bronchial vessels, pulmonary plexus nn, lymhatic vessels
113
through what do structures enter and leave the lung?
via the hilum
114
bronchial tree from trachea to alveoli
trachea
-> L + R bronchus
--> hilum where divides into lobar bronchi - 1 supplies 1 lobe
--> segmental vronchi (each provides air to 1 broncho-pulmonary segment)
--> conducting bronchioles
--> terminal bronchioles
--> respiratory bronchioles which cont alveoli
115
aa/vv supply to the lungs
bronchial aa + vv
116
bronchial aa are a branch of
thoracic aorta
117
R bronchial vv drains into
azygous vv
118
L bronchial vv drains into
accessory azygous vv
119
parasymp contribution + function pulmonary plexus
CN X
stims secretions, bronchial glands
contraction of SM
VD of pulmonary vessels
120
symp contribution + function pulmonary plexus
symp trunks
relaxation of SM
VC of pulmonary vessels
121
visceral afferent contribution pulmonary plexus
pain impulses to the sensory ganglion CNX
122
LN drainage lung parenchyma
superificial/subpleural plexus ---> tracheobronchial LN (at bifurfaction) --> L + R bronchomediastinal trunks
123
LN drainage lung root
deep plexus --> tracheobronchial LN (at bifurcation)
--> L + R bronchomediastinal trunks
124
where does the trachea extend between
lower border cricoid cartilage --> sternal angle
125
what mm supports the free ends of the tracheal rings
trachealis mm
126
lining trachea
ciliated pseudostratified columnar ep + goblet cells
127
name of bifurcation of the trachea
carina
128
inn trachea
rec laryngeal nn CNX
129
aa supply trachea
tracheal branches inf thyroid aa
130
vv drainage trachea (3)
brachiocephalic, azygous + accessory hemiazygous vv
131
which bronchus is shorter, wider and descends more vertically?
right bronchus
132
what 2 structures are sup and post to L main bronchus
sup = arch aorta
post = thoracic aorta + esophagus
133
nn supply bronchi
pulmonary branches CNX
134
aa supply bronchi
branches bronchial aa
135
vv supply bronchi
bronchiole vv
136
what cartilage do the bronchioles contain
none
137
instead of goblet cells, what cells do the bronchioles have? (+ their fct)
club cells
prodc surfactant lipoprotein - prevents airways sticking during expiration
138
cell type alveoli
simple squamous epithelium
139
how many alveoli in the adult lungs
300 million
140
where are the visceral and parietal pleura continuous with eachothoer?
at the hilum of the lungs
141
which is thicker - parietal or visceral pleura
parietal
142
what are the 4 sections of the parietal pleura
cervical
costal
mediastinal
diaphragmatic
143
what does the cervical parietal pleura cover
lines extension of the pleural cavity into neck
144
what does the costal parietal pleura cover
covers inner aspects of the ribs, costal cartilages, intercostal mm
145
what dose the mediastinal parietal pleural cover
lateral mediastinal area
146
what does the diaphragmatic parietal pleura cover
sup surface of the diapgragm
147
aa supply parietal pleural
intercostal aa
148
nn supply parietal pleura
phrenic + intercostal nn
149
to what sensation is the parietal pleura sensitive to
pressure
pain
temperature
150
aa supply visceral pleura
bronchial aa
151
inn visceral pleura
autonomic mm from pulmonary plexus
152
what sensation is the visceral pleura sensitive to?
stretch only
153
what forms the pleural recesses?
where opposing surfaces of the parietal pleura touch
154
what are the 2 pleural recesses?
costodiagrapgmatic (between costal pleura + diaphragmatic pleura)
costomediastinal - behind sternum
155
clinical importance of pleural recesses?
pleural effusions can form here
