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3 CVS > AP01 Topography of the Heart and Great Vessels > Flashcards

AP01 Topography of the Heart and Great Vessels Flashcards

1
Q

Where do the umbilical arteries pass from?

A

internal iliac arteries

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2
Q

what proportion of the blood from the umbilical vein passes through the liver?

A

1/2

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3
Q

how does blood from the umbilical vein pass through the liver?

A

via the portal sinus and ductus venosus

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4
Q

what happens to blood entering the right atrium in the foetus?

A

bypasses the lungs and enters the left atrium via the foramen ovale.

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5
Q

what happens to the blood from the right ventricle in the foetus?

A

some goes to the lungs, most goes to the aorta via the ductus arteriosus

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6
Q

what is PDA?

A

Patent Ductus Arteriosus

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7
Q

what proportion of the blood in the descending aorta goes to the umbilical arteries?

A

40-50%

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8
Q

what does the right recurrent laryngeal wrap around?

A

the right subclavian artery

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9
Q

what is the ligamentum arteriosum?

A

artefact of the ductus arteriosus

formed 3 weeks After birth

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10
Q

what is the function of the fibrous pericardium?

A

resists overexpansion of the heart

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11
Q

what is the pericardium attached to?

A

diaphragm
mediastinal pleura laterally
sternum anteirorly
moulds around anterior surface of great vessels posteriorly

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12
Q

what is normally used to measure pericardial pressure?

A

right atrial pressure

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13
Q

what marks the superior border of the mediastinum?

A

the sternal angle of louis / trans-thoracic plane

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14
Q

what is the clinical significance of the transverse sinus?

A

go under the aortic arch and behind the pulmonary trunk to clamp off the vessels

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15
Q

where is the oblique sinus?

A

gap behind the left atria anterior to the oesophagus

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16
Q

what would happen to heart rate if you damaged the vagus nerve?

A

inability to decrease heart rate so tachy

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17
Q

what would happen if you damaged sympathetic supply to the heart?

A

brady

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18
Q

what is the pathway of sympathetic afferents from the heart?

what is their function?

A

afferents to upper thoracic and lower cervical ganglia

feedback on blood pressure, pain sensation

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19
Q

what is the pathway of sympathetic efferents to the heart?

what is their function?

A

cardiac nerves from the lower cervical and upper thoracic ganglia

increases heart rate and force of contraction of myocardium

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20
Q

what is the pathway of parasympathetic afferents from the heart?

what is their function?

A

vagal cardiac nerves

provide feedback on blood pressure

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21
Q

what is the parasympathetic efferent pathway to the heart?

what is its’ function?

A

vagus nerve

reduces rate and force of contraction, vasoconstricts coronary arteries

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22
Q

where is the superficial cardiac plexus?

A

below the aortic arch and between the aortic arch and pulmonary trunk

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23
Q

where is the deep cardiac plexus?

A

between aortic arch and carina

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24
Q

How does parasympathetic innervation negotiate the cardiac plexus?

A

provided by the Vagus only, preganglionic fibres reach the heart and synapse with ganglia in the cardiac plexus and the walls of the atria

25
Q

How does sympathetic innervation negotiate the cardiac plexus?

A

fibres from the sympathetic trunk reach the plexus via cardiac nerves
preganglionic fibres from the upper thoracic spinal chord synapse in the lower cervical and upper thoracic ganglia

26
Q

What are the 3 main functions of sympathetic innervation of the heart?

A

increases heart rate
increases contraction force
fight / flight

27
Q

What are the 4 features of normal heart X-rays?

A

cardiothoracic ratio < 50%
upper zone of vessels smaller than lower one
lungs are clear
costophrenic angles well defined

28
Q

How can you tell a CXR is PA?

A

retracted scapulae and smaller heart appearance

29
Q

How does an angiogram work?

A

cathetier through a radial or femoral artery, which is then fed through to the start of the coronary artery, then a contrast media is used

30
Q

What drains into the right atrium?

A

superior, IVC

coronary sinus

31
Q

What are the portions of the right atrium?

A 
sinus venarum (smooth)
divided by the crista temrinalis
atrium proper (rough)
32
Q

What is the artefact of the foramen ovale?

A

fossa ovalis

33
Q

What are the portions of the right ventricle?

A

inflow - trabeculae carnae
divided by the supraventricular crest
outflow conus arteriosus

34
Q

What are the 3 features of trabeculae carnae?

A

ridges
bridges
pillars

35
Q

What feature is different about the left ventricle compared to the right?

A

outflow portion is the aortic vestiblae

36
Q

What are the muscles of the atria?

A

pectinate muscle

37
Q

What is the function of the papillary muscles?

A

the DO NOT CLOSE AV valves

the pressure in the ventricle does
they prevent the valve from prolapsing

38
Q

Where do the pulmonary arteries divide?

A

T5 -T6

39
Q

What is the only bicuspid valve?

A

Mitral

40
Q

What are AV valves supported by?

A

chordae tendinae, connected papillary muscles (1 per cup)

41
Q

What are the branches of the Left coronary artery on the anterior surface?

A

Left Anterior Descending (Diagonal branch off this)

Left Marginal Artery

42
Q

What is the posterior branch of the left coronary artery?

A

left circumflex

43
Q

What are the anterior branches of the right coronary artery?

A

sinoartrial node branch

right marginal artery

44
Q

What structure is at the meeting point between circumflex and posterior interventricular arteries?

A

Coronary Sinus (venous drainage)

45
Q

What are the tributaries of the coronary sinus?

A 
great cardiac vein
left marginal vein
left posterior ventricular vein
middle cardiac vein
small cardiac vein
46
Q

What proportion of people are right or left dominant for the posterior interventricular artery?

A

80% right
10% left
10% codominant

47
Q

Where does the sinoatrial node artery come from?

A

RCA (60%)

circumflex (40%)

48
Q

Name the 3 sulci of the heart

A 
coronary sulcus (divides atria from the ventricles)
anterior and posterior interventricular sulci
49
Q

What are the layers of pericardium?

A

fibrous pericardium
serous pericardium

separated by serous fluid

50
Q

What innervates the pericardium?

A

phrenic nerve

51
Q

What branches off the ascending aorta?

A

left and right coronary arteries

52
Q

What branches off the aortic arch?

A

brachiocephalic trunk
left common carotid
left subclavian

53
Q

What branches off the thoracic aorta?

A 
bronchial arteries
mediastinal arteries
oesophageal arteries
pericardial arteries
superior phrenic arteries
intercostal and subcostal arteries
54
Q

What are the branches and their vertebral levels of the abdominal aorta?

A 
T12 inferior phrenic arteries
T12 coeliac artery
L1 SMA
L1 middle suprarenal
L1-L2 renal
L2 Gonadal
L3 IMA
L4 median sacral artery
L1-L4 Lumbar arteries (4 pairs)
55
Q

What are the branches of the common iliac arteries?

A

external iliac

internal iliac

56
Q

What are the branches of the internal iliac arteries?

A

anterior and posterior branches

57
Q

WHat are the branches of the anterior internal iliac arteries?

A 
umbilical
obturator
inferior vesicular / vaginal
uterine
middle rectal
inferior pudendal
inferior gluteal
58
Q

What are the branches of the posterior internal iliac arteries?

A

superior gluteal

lateral sacral

3 CVS (24 decks)

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