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Regional Anatomy 1 > Anterior and Middle Mediastinum > Flashcards

Anterior and Middle Mediastinum Flashcards

1
Q

what are the divisions of the mediastinum

A

superior and inferior
inferior further divided into anterior, middle and posterior

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2
Q

where is the division between the superior and inferior mediastinum

A

imaginary line - transverse thoracic plane

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3
Q

where does the transverse thoracic plane run between

A

sternal angle to IVD between T4/T5

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4
Q

what is this boundary of the anterior mediastinum: anterior

A

body of sternum

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5
Q

what is this boundary of the anterior mediastinum: posterior

A

fibrous pericardium

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6
Q

what is this boundary of the anterior mediastinum: superior

A

transverse thoracic plane

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7
Q

what is this boundary of the anterior mediastinum: inferior

A

diaphragm

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8
Q

what are the 4 boundaries of the anterior mediastinum

A

body of sternum
fibrous pericardium
transverse thoracic plane
diaphragm

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9
Q

what is found in the anterior mediastinum

A

loose connective tissue
fat
lymphatics

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10
Q

why is the anterior mediastinum larger in children

A

contains thymus

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11
Q

where is the thymus located

A

organ of superior mediastinum that often extends into anterior mediastinum

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12
Q

what are the boundaries of the middle mediastinum

A

bounded on all sides by pericardial sac

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13
Q

what is the middle mediastinum

A

heart, pericardium and roots of great vessels

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14
Q

give 3 structures that are adjacent to the middle mediastinum

A

great vessels
phrenic nerves - become assoc. with fibrous pericardium
lung root structures

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15
Q

the right phrenic nerve passes over what part of the heart and become associated with pericardium

A

right atrium

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16
Q

the left phrenic nerve passes over what part of the heart and become associated with pericardium

A

left atrium and ventricle

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17
Q

the fibrous pericardium is a tough connective tissue sac that blends superiorly with what

A

tunica adventitia of great vessels as they enter and leave the heart

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18
Q

inferiorly the fibrous pericardium is continuous with what

A

central tendon of diaphragm

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19
Q

what proportion of the heart is on the left of the midline

A

2/3 on left
1/3 on right

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20
Q

what are the 2 types of pericardium

A

fibrous and serous

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21
Q

what is the parietal serous pericardium

A

lines the pericardial sac

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22
Q

what is the visceral serous pericardium

A

serous pericardium reflected over roots of great vessels onto surface of heart
(shiny surface on heart)

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23
Q

what is found deep to the visceral serous pericardium

A

substantial amount of fat

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24
Q

what is most superficial in arrangement of pericardium

A

tough fibrous pericardium forming pericardial sac

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25
Q

what is another name for visceral serous pericardium

A

epicardium

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26
Q

how is friction reduced when the heart beats to prevent damage to surface of muscle of heart

A

fluid produced by serous pericardium between the 2 layers of serous pericardium

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27
Q

name of muscle layer of heart

A

myocardium

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28
Q

name of lining of chambers of heart

A

endocardium

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29
Q

what is the name of the 2 pericardial sinuses of the heart

A

transverse and oblique

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30
Q

how does the transverse pericardial sinus arise

A

the heart develops from a simple tube with an inflow and outflow end. as it develops it folds in on itself and brings 2 ends closer creating a narrow channel between inflow and outflow vessels of the heart

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31
Q

if you place your finger in the transverse pericardial sinus, the outflow vessels are ____ to finger

A

outflow - anterior

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32
Q

if you place your finger in the transverse pericardial sinus, the inflow vessels are _____ to finger

A

inflow - posterior

(OsteoArthritis Is Painful)

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33
Q

where is the oblique pericardial sinus

A

space posterior to heart - slide hand underneath heart and behind so fingers are posterior to left atrium - pulmonary veins on either side

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34
Q

base of heart

A

left aftrium (mainly)

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35
Q

right border of heart

A

right atrium

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36
Q

inferior border of heart

A

right ventricle

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37
Q

apex of heart

A

left ventricle

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38
Q

left border of heart

A

left ventricle and left auricle

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39
Q

superior border of heart

A

right and left atria and auricles

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40
Q

when you look anteriorly at the heart what do you mostly see

A

right side

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41
Q

what are the extensions of the atria called

A

auricles

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42
Q

what are the branches of the aorta

A

(R+L coronary arteries)
brachiocephalic trunk
left common carotid
left subclavian

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43
Q

the atrioventricular/coronary groove separates what

A

RA and RV

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44
Q

what is found in the atrioventricular/coronary groove

A

right coronary artery

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45
Q

what is found in the anterior interventricular groove

A

left anterior descending
a.k.a. anterior interventricular artery

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46
Q

describe the path of the IVC

A

pierces the diaphragm at T8 and immediately enters the inferior aspect of the right atrium

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47
Q

what vessel leaves the right ventricle

A

pulmonary trunk

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48
Q

what are you looking at mostly when you look at heart from a postero-inferior view

A

mostly left side

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49
Q

what are the 5 surfaces of the heart

A

anterior (sterno-costal)
posterior (base)
right pulmonary
left pulmonary
diaphragmatic (inferior)

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50
Q

what forms the anterior (sterno-costal) surface of the heart

A

right ventricle

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51
Q

what forms the base (posterior) surface of the heart

A

left atrium

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52
Q

what forms the right pulmonary surface of the heart

A

right atrium

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53
Q

what forms the left pulomonary surface of the heart

A

left ventricle

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54
Q

what forms the diaphragmatic surface of the heart

A

left and right ventricles

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55
Q

the ligamentum arteriosum is a remnant of what

A

ductus arteriosus - after birth will close and become a fibrous structure

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56
Q

what is the function of the ductus arteriosus

A

allows communication between the aorta and pulmonary trunk so it bypasses lungs during foetal life

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57
Q

describe the left recurrent laryngeal nerve in relation to the ligamentum arteriosum

A

left recurrent laryngeal nerve runs posterior to ligamentum arteriosum

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58
Q

what is the first branch of the RCA

A

SA nodal branch

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59
Q

where is the SA node

A

in the wall of the RA

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60
Q

where does the RCA travel

A

in right AV groove
gives off branches to supply RA and RV

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61
Q

before turning onto inferior and posterior surface of heart, what branch does the RCA give off

A

right marginal

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62
Q

where does the right marginal run

A

right marginal runs along inferior border of heart (RV)

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63
Q

RCA continues on the inferior surface of heart in the ____ groove and gives off what small branch

A

Atrioventricular groove
AV nodal branch to supply AV node in wall of RA

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64
Q

how does the RCA terminate

A

gives posterior IV artery which runs in posterior IV groove between left and right ventricle

65
Q

name the branches of the RCA

A

SA nodal
right marginal
AV nodal
posterior IV

66
Q

the LCA is shorter/longer than RCA

A

shorter

67
Q

the LCA quickly terminates as what 2 branches

A

circumflex and anterior interventricular artery (LAD)

68
Q

where does the Anterior interventricular artery (LAD) run

A

down anterior aspect of heart in the IV groove between right and left ventricle

69
Q

what is the name of the branch given off by anterior interventricular artery

A

diagonal branch

70
Q

where does the diagonal branch run

A

runs across the surface of LV

71
Q

what is the course of the left circumflex artery

A

continues onto the posterior aspect of heart running in left AV groove between LA and LV

72
Q

what branch does the circumflex artery give before passing onto posterior surface of heart

A

left marginal

73
Q

where does the left marginal artery run

A

along left border of heart

74
Q

after giving off the marginal branch, what does the circumflex do

A

continues in the AV groove and ultimately anastomoses with RCA

75
Q

what are the branches of the LCA

A

circumflex
- marginal

LAD
- diagonal

76
Q

give 2 examples of variation in coronary arteries

A
  • SA nodal branch and posterior IV artery can sometimes come from circumflex artery
  • diagonal artery not always present
77
Q

what is the AV bundle

A

part of electrical component of heart

78
Q

where is the AV bundle found

A

within IV septum

79
Q

where does the AV bundle receive blood supply from

A

LCA

80
Q

what does the RCA supply

A

right atrium
most of right ventricle
SA node (usually)
AV node
posterior 1/3 of IV septum
part of left ventricle

81
Q

what does the LCA supply

A

left atrium
most of left ventricle
anterior 2/3 of IV septum
AV bundle
part of right ventricle

82
Q

where is the coronary sinus located

A

swollen venous structure on the posterior surface of the heart between LA and LV

83
Q

cardiac veins drain to the coronary sinus except …

A

anterior cardiac veins

84
Q

what do the anterior cardiac veins drain and where do they drain to

A

wall of right atrium
drain directly to RA

85
Q

where is the great cardiac vein found

A

first part (anterior interventricular vein) found in anterior IV groove
second part runs around left side of heart to reach coronary sinus

86
Q

the great cardiac vein runs alongside …

A

AIVA (LAD)

87
Q

describe the course of the great cardiac vein

A

travels in the anterior IV groove then curves round the left border of the heart to reach posterior surface of heart where it drains into coronary sinus

88
Q

what is the main tributary to the coronary sinus

A

great cardiac vein

89
Q

where is the middle cardiac vein located

A

in the posterior IV groove

90
Q

what does the middle cardiac vein run alongside

A

posterior IV artery

91
Q

where is the small cardiac vein found

A

on wall of RV

92
Q

what does the small cardiac vein run alongside

A

right marginal artery

93
Q

what is the course of the small cardiac vein

A

runs along wall of RV with right marginal artery then wraps around onto inferior and posterior surface to empty into coronary sinus

94
Q

the left marginal vein runs with

A

left marginal artery

95
Q

what does the posterior ventricular vein drain

A

posterior wall of LV

96
Q

what does the oblique vein of LA drain

A

wall of LA

97
Q

where does the coronary sinus open

A

RA

98
Q

what are the 2 areas of the internal wall of the RA

A

musculi pectinati
sinus venarum

99
Q

what are the musculi pectinati

A

muscular ridges in walls of atria/auricles

100
Q

what is the sinus venarum

A

smooth area that connects entrance of SVC above with entrance of IVC below

101
Q

what is the crista terminalis

A

pronounced ridge separating the sinus venarum and the muscular wall

102
Q

the fossa ovalis is a remnant of what

A

foramen ovale

103
Q

what was the purpose of the foramen ovale

A

allowed communication between the RA and LA during development

104
Q

what does the fossa ovalis look like

A

small dome shaped depression on interatrial wall

105
Q

what other landmark can be seen in RA

A

opening of coronary sinus

106
Q

blood flows from RA to RV through what valve

A

tricuspid

107
Q

where is the tricuspid valve found

A

right AV canal

108
Q

what are the structures that anchor the tricuspid valve to the muscular projections of the ventricular wall

A

chordae tendineae

109
Q

what are the muscular projections of the ventricular wall called

A

papillary muscles

110
Q

the tricuspid valve will have how many papillary muscles

A

3

111
Q

what is the structure that is only found in the RV that extends from the IV septum towards the anterior papillary muscle

A

moderator band

112
Q

what is the function of the moderator band

A

will carry part of conducting system of heart

113
Q

what is the name of the muscular ridges in the RV wall

A

trabeculae carneae

114
Q

blood flows from the RV to the lungs via the ____

A

pulmonary trunk and pulmonary arteries

through pulmonary valve (semilunar)

115
Q

describe the walls of the LA

A

smooth and featureless
does have left auricle as an extension

116
Q

what is the name of the muscular ridges in the area of the auricle in LA

A

musculi pectinati

117
Q

blood flows from LA to LV through the ____ valve

A

bicuspid

118
Q

what is another name for the bicuspid valve

A

mitral

119
Q

how many papillary muscles will be seen in the LV

A

2

120
Q

what connects the valve cusp edges to the papillary muscles

A

chordae tendineae

121
Q

why is the wall of the LV thicker than that of the RV

A

needs to produce higher pressure to pump blood around body

122
Q

what is the name of the muscular ridges in the walls of the LV

A

trabeculae carneae

123
Q

blood pumped from LV to aorta through ___

A

aortic valve (semilunar)

124
Q

pulmonary arteries carry what kind of blood

A

deoxygenated

125
Q

what are the 2 types of heart valve

A

semi lunar and cuspid

126
Q

where are the semi lunar valves found

A

base of aorta and pulmonary trunk

127
Q

in low pressure the semilunar valves are

A

closed

128
Q

semilunar valves open in response to

A

high pressure as ventricles contract

129
Q

what causes the semilunar valves to close

A

as heart relaxes blood falls back towards ventricles and trickles between valve cusp and vessel wall filling the space and forcing the cusps closed

130
Q

this back flow of blood to the valves also ensures what

A

blood goes to coronary arteries

131
Q

how are coronary arteries filled

A

under low pressure by backflow of blood when wall of ventricle is relaxed

132
Q

where are the cuspid valves found

A

between atria and ventricles

133
Q

in high pressure, the cuspid valves are

A

closed

134
Q

the cuspid valves are open when

A

ventricles are relaxed and blood flows freely from atria to ventricles then atria contract and blood forced into ventricles

135
Q

when the ventricular pressure increases the cuspid valves will

A

close

136
Q

how is prolapse of the cuspid valves prevented

A

chordae tendineae and papillary muscles hold the leaflets in place - papillary muscles contract at same time as ventricle

137
Q

during ventricular diastole the cuspid valves are ____ and semilunar valves are ___

A

ventricular diastole - cuspid valves open, semilunar valves close

138
Q

during ventricular systole, the cuspid valves are ____ and semilunar valves are ___

A

ventricular systole - cuspid valves are closed, semilunar valves open

139
Q

semilunar valves have how many leaflets

A

3
aortic (Right left and posterior)
pulmonary (right left and anterior)

140
Q

what part of fibrous skeleton supports cuspid valves

A

rings

141
Q

what part of fibrous skeleton supports semilunar valves

A

coronets

142
Q

what are 2 functions of the fibrous skeleton of the heart

A

support
electrical insulation between atria and ventricles

143
Q

why does the transmission of electrical signals need to be delayed from atria to ventricles

A

so that atria contract together but before ventricles

144
Q

how does the heart regulate its own heart rate

A

SA node

145
Q

where is the SA node found specifically

A

within wall of RA
- located in upper part of crista terminalis adjacent to entry of SVC

146
Q

SA node is located adjacent to what vessel entrance

A

SVC

147
Q

where do signals from SA node go

A

through wall of RA and into wall of LA so atria contract at same time
also picked up by AV node

148
Q

where is the AV node located

A

lower part of interatrial septum

149
Q

what is the function of the AV node

A

transmits the signal from the SA node down to the ventricles via the AV bundle

150
Q

the AV bundle divides into what

A

right and left bundle branches which give off many distributary branches into the wall of the ventricles

151
Q

some of the fibres of the RBB will travel via the _____ ____

A

moderator band

152
Q

what is the purpose of the moderator band (septomarginal trabecula)

A

ensures that the anterior papillary muscle and anterior part of wall of RV contract at same time as rest of walls of ventricles

153
Q

what is another name for the moderator band

A

septomarginal trabeculae

154
Q

SA can function without external influence but does get autonomic innervation from …

A

cardiac plexus

155
Q

what is the parasympathetic innervation of the heart

A

vagus nerve (CN X) - postsynaptic parasympathetic cell bodies (intrinsic ganglia) are located in the atrial wall and interatrial septum near the SA and AV nodes

156
Q

parasympathetic stimulation does what to the heart

A

decrease heart rate
decrease force of contraction
constrict coronary arteries

157
Q

sympathetic stimulation does what to the heart

A

increase HR
increase force of contraction
dilate coronary vessels

158
Q

what does sympathetic stimulation of the heart come from

A

T1-T5/6 spinal levels
- cervical and superior thoracic paravertebral ganglia (sympathetic chain)

Regional Anatomy 1 (30 decks)

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