Cardiac Anatomy Flashcards

1
Q

What is the visceral epicardium?

A

Makes contact with the heart.

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2
Q

What is the acute margin in terms of cardiac border anatomy?

A

Inferior edge, creates the angle between the sternocostal surface and the diaphragmatic surface.

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3
Q

What ribs cover the heart?

A

3rd, 4th, and 5th.

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4
Q

Where is the phrenic nerve in the thoracic inlet?

A

Just posterior to the IMA. They run on the anterior surface of the anterior scalene muscle.

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5
Q

What is the right phrenic nerve’s course after the thoracic inlet? When might it be injured in heart surgery?

A

It lies on the lateral surface of the SVC, in harm’s way during dissection for venous cannulation for CPB.
Or during RIMA dissection.

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6
Q

What does the right recurrent laryngeal nerve pass around?

A

R SC artery. Ascends in the TE groove.

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7
Q

Excessive dissection of the SC arteries (eg during shunt procedures) can damage what? Causing what pathology?

A

The subclavian loop, which carries fibers from the stellate ganglion to the eye and head. Damage here can cause Horner’s syndrome.

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8
Q

Where are the phrenic and vagus nerves in relation to the pulmonary hilum?

A

Phrenic is anterior. Vagus is posterior.

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9
Q

Describe a midline sternotomy.

A

Skin incision from the jugular notch to the xiphoid. Bovie to the presternal fascia and expose the periostium. Divide the sternum midline with a saw. Hemostasis. Sternal spreader. Divide the thymic fat pad to the brachiocephalic (innominate) vein. Open the pericardium.

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10
Q

How can you extend a sternotomy to expose the branches of the aortic arch?

A

Extend the incision onto the neck along the anterior border of the SCM.

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11
Q

How can you extend a median sternotomy to expose the proximal descending thoracic aorta?

A

Perpendicular extension of the incision through the third intercostal space.

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12
Q

What incision is used for double lung and heart-lung transplants?

A

Bilateral transverse thoracosternotomy (ie clam shell incision) through the 4th or 5th interspace.

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13
Q

What non-sternotomy and non-clam shell incision can be made to access the R heart; tricuspid, and mitral valves; and R coronary?

A

R anterolateral thoracotomy. Can be used for Blalock-Hanlon atrial septectomy, or for valvular replacement after previous sternotomy.

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14
Q

To access the distal aortic arch and descending aorta, what incision can be made?

A

Left posterolateral thoracotomy. CPB cannulation must be done through femoral.

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