Cardiac Anatomy

Question 1

How many layers does the pericardium have?

Answer 1

3 Fibrous Parietal Visceral

Question 2

Pericardial collections may be secondary to?

Answer 2

Surgery/trauma

Inflammation (amyloidosis/viral/ uraemia/drugs)

Question 3

Fibrous pericardium limits size of sac. Compression of heart with fluid leads to what?

Answer 3

Becks Triad
Raised JVP
Low BP
Muffled heart sounds

Pulses paradoxus >10mmg on inspiration
Shock
Low cardiac output

Question 4

Posterior surface of the heart

Answer 4

LA and 4 pulmonary veins

Question 5

Lateral border of the heart

Answer 5

LV

Plus most of inferior, lateral and anterior

Question 6

Inferior border of the heart?

Answer 6

RV (one third inferior surface plus most of anterior)

Question 7

Right border consists of?

Answer 7

RA and Vena Cava

Question 8

Cardio thoracic ratio should be

Answer 8

<50%
Max transverse diameter of heart v max internal thorax diameter
Misleading if pregnant/obese or AP

Question 9

Coronary sinus and IVC and SVC drain into where?

Answer 9

RA

Question 10

RV muscle is important for what?

Answer 10

Trabeculated and so carries conduction

Question 11

Tricuspid valve lies where?

Answer 11

RA-RV 3 cusps septal/inf/ant attached to the AV ring

Question 12

Patent foramen ovale is where?

Answer 12

LA lies directly behind the RA. 15% patent demonstrated.

Question 13

Where do the 4 pulmonary veins drain?

Answer 13

Posterior wall LA

Question 14

Mitral valve lies where?

Answer 14

LA-LV 2 leaflets

Question 15

How thick is the LV wall?

Answer 15

3-4x RV wall papillary muscles important for strength.

Question 16

Cardiac action potential are generated by what and where?

Answer 16

Non contractile cardiac myocytes at SA node in superior right atrium

Question 17

SA node blood supply?

Answer 17

RCA in 65%

Question 18

AV node function is what?

Answer 18

To slow conduction of AP to ventricles. AV rings insulate the atria from the ventricles.
Abnormal pathways = reentrant tachycardia
Supplies by RCA in 80%

Question 19

Aortic sinus give rise to what?

Answer 19

2 coronary arteries

Question 20

LAD territory

Answer 20

Anterior

Question 21

Coronary veins drain where?

Answer 21

Right atrium

Question 22

Majority of venous blood drains from where to where?

Answer 22

Coronary sinus made up of great small and middle and posterior cardiac veins
Small veins drain directly into the chambers (thebesian)

Question 23

Name the nerve supply to the heart?

Answer 23

Parasympathetic - vagus recurrent laryngeal
SA and AV node supply
Reduces rate and contractility and constricts CA
Sympathetic - T1-4 lateral horns. Cardioacceleratory. Pain fibres travel with sympathetic nerves which join spinal nerves

Question 24

IJV pathway

Answer 24

Jugular foramen to subclavian vein

Question 25

Carotid sheath contains?

Answer 25

IJV, Internal carotid artery and Vagus nerve

Runs deep to SCM muscle

Question 26

Draw the venous drainage of the arm and neck

Answer 26

Picture

Question 27

Draw brachial anatomy including veins nerve and artery

Answer 27

See picture

Question 28

PICC lines use which veins?

Answer 28

Basilic or median cubital

Question 29

Complete heart block is common after which MI?

Answer 29

Inferior RCA disease

Question 30

Thoracic duct drains where?

Answer 30

Left subclavian vein

Question 31

IJV relationship to phrenic nerve?

Answer 31

Passes anterior as it crosses scalenus anterior