Basic Sciences - Anatomy of Heart and Major Vessels

Question 1

Layers of the pericardium

Answer 1

Fibrous
Parietal
Visceral

Question 2

Attachments of the fibrous pericardium

Answer 2

Great vessels
Posterior aspect of sternum
Central tendon of diaphragm

Question 3

3 cusps of the tricuspid valve

Answer 3

Septal
Inferior
Anterior

Question 4

Attachments of tricuspid valve

Answer 4

Attached to fibrous atrioventricular ring

Free edges and inferior surfaces attached by chordae tendinae to papillary muscles to RV wall

Question 5

Lining of right ventricle

Answer 5

Trabeculated muscle

Question 6

Infundibulum definition

Answer 6

Smooth wall right ventricle outflow tract (RVOT)

Question 7

Leaflets of mitral valve

Answer 7

Anterior
Posterior

Question 8

Area of left ventricle which does not have prominent trabeculae

Answer 8

LVOT
(Left ventricular outflow tract)

Question 9

Conduction pathways of the heart

Answer 9

Internodal tracts exist bit conduction through atria is normally non specific but synchronous

Question 10

Most common vascular supply to sinoatrial node

Answer 10

Right coronary artery (in 65% of people)

Question 11

Most common vascular supply to atrioventricular node

Answer 11

Right coronary artery (in 80% of people)

Question 12

Path of right coronary artery

Answer 12

Arises from anterior aortic sinus
Descends in atriventricular groove
Reaches posterior interventricular groove
Right marginal artery arises from RCA

Question 13

Source of left coronary arteries

Answer 13

Arises from left posterior aortic sinus

Question 14

Branches of Left coronary artery

Answer 14

LAD (Left anterior descending artery)
Circumflex

Question 15

Branches from LAD artery

Answer 15

Diagonal branches
Septal perforating branches

Question 16

Branches of circumflex artery

Answer 16

Obtuse marginal arteries

Question 17

Areas supplied by LAD artery

Answer 17

Anterior aspects of both ventricles
Anterior 2/3rds of ventricular septum

Question 18

Posterior descending artery ‘right dominance’ definition and percentage

Answer 18

Posterior descending artery arises from RCA
85% of people

Question 19

Posterior descending artery ‘left dominance’ definition and percentage

Answer 19

Posterior descending artery arises from circumflex artery
15% of people

Question 20

Path of posterior descending artery

Answer 20

Posterior interventricular groove

Question 21

Coronary vein drainage

Answer 21

75% drain to RA via coronary sinus
Anterior cardiac veins drain anterior part of RV directly into RA

Question 22

Principle tributaries to the coronary sinus

Answer 22

Great LV cardiac veins
Small LV cardiac veins
Middle LV cardiac veins
Posterior LV cardiac veins

Question 23

Thebesian veins

Answer 23

Small veins which drain directly into the cardiac chambers

Question 24

Source of parasympathetic fibres to SA and AV nodes

Answer 24

Vagus and recurrent laryngeal nerve branches via deep and superficial cardiac plexuses

Question 25

Parasympathetic effects on heart

Answer 25

Decreased heart rate Decreases force of contraction Constricts coronary arteries Dilates systemic arteries

Question 26

Source of sympathetic fibres to SA and AV nodes

Answer 26

Lateral horns of T1-T4 spinal cord Post ganglionic fibres arise from the 3 cervical ganglia and upper thoracic sympathetic ganglia

Question 27

Sympathetic effects on heart

Answer 27

Increases heart rate Increases force of contraction Dilates coronary arteries Constricts systemic arteries

Question 28

Location of carotid sheath

Answer 28

Deep to sternocleidomastoid muscle

Question 29

Contents of carotid sheath

Answer 29

Internal / Common carotid artery Internal jugular vein Vagus nerve

Question 30

Femoral triangle

Answer 30

Question 31

Venous system of the arm

Answer 31

Question 32

Site of PICC line insertion

Answer 32

Basilic vein or Median cubital vein

Question 33

Why Cephalic vein not used for PICC line insertion

Answer 33

As cephalic vein joins axillary vein, there is a valve and an acute angle Makes insertion technically difficult

Question 34

Locations for arterial cannulation and reasoning why

Answer 34

Radial artery or Dorsalis Pedis artery (as both have collateral flow) Can us femoral artery or axillary artery (as they are large calibre end arteries)

Question 35

Which artery to avoid in arterial cannulation and why

Answer 35

Brachial artery Lacks collateral flow and is not a large calibre end artery