Cardiac-Pulmonary System Flashcards
1
Q
What does the thorax include?
A
-Pulmonary system
-Cardiovascular system
2
Q
Boundaries of thoracic cage
A
Anterior: sternum (manubrium, body of sternum, xiphoid process)
Lateral: 12 pairs of ribs + costal cartilages
Posterior: thoracic vertebrae (T1-T12)
3
Q
What is the sternal angle?
A
Manubriosternal joint
4
Q
Which aperture enables communication between the thorax and upper limb, head, neck?
A
Superior thoracic aperture
5
Q
Which aperture enables communication between the thorax and abdomen?
A
Inferior thoracic aperture
6
Q
Which structure closes the inferior thoracic aperture?
A
Respiratory diaphragm
7
Q
Which structures travel through the STA?
A
Enter thorax via STA:
-Esophagus
-Trachea
-Major tributaries of super vena cava
Exit thorax via STA:
-Major branches of aorta
8
Q
Which structures travel through ITA?
A
Enter thorax via ITA:
-inferior vena cava
Exit thorax via ITA:
-esophagus
-aorta
9
Q
Which compartments make up the thoracic cavity?
A
Pulmonary cavities:
-bilateral compartments
-contain lungs and pleurae
Mediastinum:
-contains all other thoracic viscera, including heart and structures that generally conduct air, blood and food
10
Q
Boundaries of mediastinum
A
Superior: superior thoracic aperture
Anterior: sternum + costal cartilage
Posterior: bodies of T1-T12
Inferior: diaphragm
11
Q
Where does the superior mediastinum and inferior mediastinum differentiate?
A
Sternal angle at T4 and T5
12
Q
What does the superior mediastinum contain?
A
-Great vessels and branches or tributaries
-Esophagus
-Trachea
13
Q
What does the middle inferior mediastinum contain?
A
-Heart
-Pericardium
-Roots of great vessels
14
Q
What does the posterior inferior mediastinum contain?
A
-Thoracic (descending) aorta
-Esophagus
-Azygos and hemi-azygos vein and tributaries
15
Q
Function of lungs
A
-Oxygenate blood by bringing venous blood in proximity with inspired air
16
Q
Boundaries of pulmonary cavities
A
Superior: root of the neck (just superior to rib 1)
Lateral: thoracic wall
Medial: mediastinum
Inferior: diaphragm
17
Q
What is the lateral surface of the lungs called?
A
costal surface (close contact with ribs)
18
Q
What is the base of the lung called?
A
diaphragmatic surface (close contact with diaphragm)
19
Q
Main differences between left lung and right lung?
A
-Size
-Number of lobes
-Fissures
-Notches
20
Q
Lobes in right lung
A
-Superior lobe
-Middle lobe (most anterior)
-Inferior lobe
21
Q
Lobes in left lung
A
-Superior lobe
-Inferior lobe
22
Q
Fissures in right lung
A
-Oblique fissure
-Horizontal fissure
23
Q
Fissures in left lung
A
-Oblique fissure
24
Q
Notches in left lung
A
-Cardiac notch
-Lingula
25
Cardiac notch
-Accommodates apex of heart
-Superior to lingula
26
Lingula
-Thing, tongue-like process extending below cardiac notch
-Expands during respiration
27
What is the medial surface of the lung called?
Mediastinal surface
28
Hilum
-Wedge-shaped area
-Structures forming the root of the lung enter/exit the lung through the hilum
29
Structures of the root of the lung and their positioning
-Bronchi - middle (L); posterior (R)
-Pulmonary arteries - superior
-Pulmonary veins - anterior/inferior
-Nerves
-Lymphatic vessels
30
Pulmonary ligaments
-Double layer of pleura
-Anchors lung
-Accommodates respiration
31
Why are lungs isolated to their own pulmonary cavities?
To isolate them from each other if something goes wrong
32
Grooves on right lung
-Groove for esophagus (posterior/superior to inferior)
-Groove for arch of azygos vein (arched part of the groove)
-Groove for azygos vein (inferior/posterior)
-Groove for superior vena cava (anterior)
33
Which lobes do the grooves of the right lung sit in?
Superior lobe: groove for esophagus
Inferior lobe: groove for arch of azygos vein and groove for azygos vein
Middle lobe: groove for superior vena cava
34
Grooves for the left lung
-Groove for arch of aorta (superior)
-Groove for descending aorta (posterior and inferior)
35
Are the grooves on the left lung close to the notches?
No they are posterior to the notches
36
Where does the trachea bifurcate into primary bronchi?
Sternal angle
37
Which bifurcations exist from the trachea?
-Left and right side
-Primary bronchi
-Secondary bronchi
38
Where does the primary bronchi enter lung?
Hilum
39
Parietal pleura
-Lines pulmonary cavity; adheres to thoracic wall, mediastinum, diaphragm
40
Visceral pleura
-Adheres to external surface of lungs
41
How do the parietal and visceral pleura connect?
They are continuous with one another at the hilum of the lung
42
Where is the pleural cavity?
Space between the visceral and parietal pleura
43
What are the 4 parts of the parietal pleura?
-Cervical
-Costal
-Diaphragmatic
-Mediastinal
44
What are the costodiaphragmatic recesses?
-Pleural-lined spaces between the ribs (thoracic wall) and diaphragm
45
How do the costodiaphragmatic recesses acommodate respiration?
-They serve as extra space for the lungs to move into during inspiration
46
What are the boundaries of the middle mediastinum?
Superior: sternal angle
Lateral: mediastinal pleura
Inferior: diaphragm
47
Pericardium
-Double walled, fibroserous sac that covers the heart and roots of the great vessels
-Two layers: fibrous pericardium and serous pericardium
48
Layers and characteristics of the pericardium
Fibrous pericardium:
-tough, external layer
Serous pericardium:
-Parietal layer: lines internal surface of fibrous pericardium
-Visceral layer: adheres to surface of heart
49
Are the parietal and visceral layers of the serous pericardium continuous with one another? If so, where?
Yes, at the great vessels
50
What is the space between the parietal and visceral layers of serous pericardium? What does it contain?
Pericardial cavity:
-contains fluid secreted by serous pericardium that allows for frictionless movement of heart
51
What is the fibrous pericardium continuous with?
-Tunica adventitia of great vessels: external layer of a blood vessel
-Central tendon of the diaphragm
52
Function of the fibrous pericardium
-Holds heart in place
-Limits expansion of the heart
53
______ side of the heart receives venous blood
Right
54
_______ side of the heart receives arterial blood
Left
55
Arterial blood
Well-oxygenated
56
Venous blood
Poorly-oxygenated
57
What are the receiving chambers of the heart?
Atrium
58
What are the discharging chambers of the heart?
Ventricles
59
Which chambers of the heart are visible from the anterior view?
RA
RV
LV
60
Which chambers of the heart are visible from the posterior view?
LA
LV
RA
61
What do the SVC and IVC do?
-Bring poorly oxygenated blood into the heart
-Pushes blood into the right atrium
-Upper body blood (SVC) and lower body blood (IVC)
62
From left to right, what are the major vessels of the heart?
P A S
Pulmonary trunk
Aorta
Superior vena cava
63
In anatomical position, how do the SVC and IVC align?
In a sagittal plane
64
In posterior view of the heart, which major vessels can you see?
Left and right pulmonary arteries
Aorta
Pulmonary veins
SVC and IVC
65
On the medial view of the right lung, which pulmonary artery is superior? Same with the left one.
The right one.
The left one.
66
At the level of the sternal angle, which structures bifurcate?
Aorta:
-Ascending aorta becomes the arch of the aorta
Pulmonary trunk:
-Bifurcates into pulmonary arteries at sternal angle
Azygos vein:
-Azygos vein becomes the arch of the azygos vein
Trachea:
-Trachea bifurcates into primary bronchi
SVC:
-Left and right brachiocephalic veins become the SVC
67
Which great vessels are associated with the right atrium?
-Superior vena cava
-Inferior vena cava
68
Which great vessels are associated with the right ventricle?
Pulmonary trunk
69
Which great vessels are associated with the left atrium?
Pulmonary veins
70
Which great vessels are associated with the left ventricle?
Aorta
71
Which chamber forms the base of the heart? What is the positioning?
Left atrium: mostly posterior
72
Which chamber forms the apex of the heart? What is the positioning?
Left ventricle: antero-lateral, left
73
What are the surfaces of the heart? Which chambers form these surfaces?
-Anterior (sternocostal) surface: right ventricle
-Inferior (diaphragmatic) surface: mainly left ventricle, but partly right ventricle
-Right pulmonary surface: right atrium
-Left pulmonary surface: left ventricle
74
Borders of the heart
Superior:
-Right atrium
-Left atrium
Inferior:
-Right ventricle
-Left ventricle
Left:
-Left ventricle
Right:
-Formed by right atrium, extends between SVC and IVC
75
The right atrium forms the:
-Right pulmonary surface
-Right border
-Superior border
76
The right ventricle forms the:
-Diaphragmatic surface
-Sternocostal surface
-Inferior border
77
The left atrium forms the:
-Base of the heart
-Superior border
78
The left ventricle forms the:
-Diaphragmatic surface
-Left pulmonary surface
-Inferior border
-Left border
79
To place an isolated heart in anatomical position, ensure:
-Apex of heart is pointing left
-SVC is on the right, aorta in middle, pulmonary trunk on left
-SVC and IVC align in sagittal plane
-Pulmonary veins are posterior
80
What are the walls of the right atrium?
-Sinus venarum
-Interatrial septum
-Pectinate muscles
81
Sinus venarum
-Smooth posterior wall of right atrium only
-Denotes interatrial septum
82
Interatrial septum
Wall between right and left atria
83
Fossa ovalis
-Remnant from fetal circulation
-Right atrium
-Oval impress on sinus venarum
-Bypass pulmonary circulation
84
Where is the fossa ovalis in relation to the IVC?
Directly superior
85
Pectinate muscles
Rough anterior wall of:
-Right atrium
-Left atrium
86
Right auricle
Outpouching of atrium
87
Openings of the right atrium
-Opening of SVC
-Opening of IVC
-Opening of coronary sinus
-Right atrioventricular orifice
88
What guards the right AV orifice?
The tricuspid (right AV) valve
89
Walls of the right ventricle
-Trabeculae carneae
-Interventricular septum
90
Trabeculae carneae
Rough muscular wall of:
-right ventricle
-left ventricle
91
Interventricular septum
-Wall between right and left ventricles
92
Components of the tricuspid valve
-Right AV orifice
-Cusps (3)
-Tendinous cords
-Papillary muscles (3)
-Septomarginal trabecula (moderator band)
93
What does the tricuspid valve inhibit?
Regurgitation of blood into right atria during right ventricular contraction
94
What does the septomarginal trabecula do?
-Contains part of the conducting system of the heart
-Coordinates contraction of papillary muscles
95
Valves in the right ventricle
-Tricuspid valve
-Pulmonary semilunar valve
96
Components of the pulmonary semilunar valve
-3 cusps
97
What does the pulmonary semilunar valve do?
-Prevents regurgitation of blood into right ventricles during right left atrial contraction
98
Left auricle
Outpouching of atrium
99
Walls of the left atrium
-Pectinate muscles
100
Openings of the left atrium
-Openings of pulmonary vein
-Left AV orifice
101
Semilunar depression
-Left atrium
-Location of fossa ovalis
102
What is the left AV orifice guarded by?
Bicuspid (mitral/left AV) valve
103
What are the components of the bicuspid valve?
-Cusps (2)
-Tendinous cords
-Papillary muscles
104
Valves of the left ventricle
-Bicuspid valve
-Aortic semilunar valve
105
Components of the aortic semilunar valve
3 cusps
106
Walls of the left ventricle
-Trabeculae carneae *much thicker than right ventricle for systemic circulation
107
In a superior view of the valves with the atria removed, what are the positioning of all four valves?
posterior: pulmonary semilunar valve
middle: aortic semilunar valve
left: bicuspid valve (two cusps)
right: tricuspid valve (three cusps)
108
What valves are open during diastole?
Bicuspid and tricuspid valves
109
What valves are open during systole?
Pulmonary and aortic semilunar valves
110
Diastole
Ventricular relaxation:
-semilunar valves are closed to prevent regurgitation of blood into ventricles during atrial contraction
111
Systole
Ventricular contraction:
-bicuspid and tricuspid valves are closed to prevent regurgitation of blood into atria during ventricular contraction
112
Muscles comprising the walls of and/or found within the atria:
Pectineate
113
Muscles comprising the walls of and/or found within the ventricles:
Trabeculae carneae
Papillary muscles
114
Valves associated with the right atrium:
Tricuspid
115
Valves associated with the right ventricle:
Tricuspid
Pulmonary valve
116
Valves associated with the left atrium:
Bicuspid
117
Valves associated with the left ventricle:
Bicuspid
Aortic valve
118
Direction of blood flow, starting from the upper/lower limbs
1. IVC/SVC
2. Right atrium
3. Tricuspid valve
4. Right ventricle
5. Pulmonary valve
6. Pulmonary trunk
7. Pulmonary arteries
8. Lungs
9. Pulmonary veins
10. Left atrium
11. Bicuspid valve
12. Left ventricle
13. Aortic valve
14. Aorta
15. Body
119
When blood is flowing into the atrium from the ventricle, what structure is damaged?
Bicuspid valve (left side) or tricuspid valve (right side)
120
What component of the bicuspid valve is damaged most often?
The cusps are misshaped leading to leaky valve
121
When there is adipose tissue on the heart, is the visceral layer of the serous pericardium removed or present?
Present
122
What are the two grooves on the heart? Which way do they run?
Atrioventricular: more horizontally
Interventricular: more vertically
123
What are the two main arteries of the heart? What physically divides them?
Right coronary artery and left coronary artery
The pulmonary trunk
124
What are the branches of the right coronary artery? What are their travel paths?
First branch: sino-atrial artery
-Ascends up heart, heading towards SVC
-Deep to right auricle
Second branch: right marginal artery
-Travels towards the apex of the heart along the inferior border
Third branch: posterior interventricular artery
-descends posteriorly in the interventricular groove
-anastomoses with anterior interventricular artery
125
What is the travel path of the right coronary artery?
-Travels along the atrioventricular groove, deep to the right auricle, from anterior, along the right side, to the posterior
126
What is the travel path of the left coronary artery?
-travels deep to the left auricle, along the left side of the heart, along the interventricular and atrioventricular grooves
127
What are the branches of the left coronary artery? What are their travel paths?
First branch: Circumflex branch of of the LCA
-travels in atrioventricular groove, goes posterior, deep to the coronary sinus
Second branch: left marginal artery
-technically a branch of the circumflex branch of the LCA
-travels along the interventricular groove to the apex of the heart
Third branch: anterior interventricular artery
-travels along the interventricular groove on the anterior aspect of the heart
-anastomoses with posterior interventricular artery
128
Coronary sinus
-located within atrioventricular groove on posterior aspect of heart
-receives venous blood from most veins of the heart
129
Which chamber is the coronary sinus within?
Right atrium
130
What are the four cardiac veins?
-Great cardiac vein
-Middle cardiac vein
-Small cardiac vein
-Anterior cardiac veins
131
Travel path of great cardiac vein
-Main branch off of coronary sinus
-Travels in AV groove to the anterior IT groove
-Travels with the anterior interventricular artery
132
Travel path of middle cardiac vein
-Travels in the posterior IT groove
-Travels with the posterior interventricular artery
133
Travel path of small cardiac vein
-Travels with the right coronary artery and right marginal artery in the AV groove
-Starts posterior and travels along inferior border
134
Travel path of the anterior cardiac veins
-Bring venous blood directly into right atrium
-Jumps over RCA in AV groove
135
Borders of the superior mediastinum
Superior: superior thoracic aperture
Inferior: sternal angle
Lateral: mediastinal pleura
Anterior: sternum
Posterior: T1-T4
136
Organization of contents of superior mediastinum from anterior to posterior
Veins
Arteries
Trachea
Esophagus
Lymphatic vessels
137
At which level do the right and left brachiocephalic veins converge?
Deep to rib 1 costal cartilage
138
What do the brachiocephalic veins converge to form?
SVC
139
Which tributaries of the SVC are apart of the superior thoracic aperture?
-Right and left brachiocephalic veins
-Posterior intercostal veins
-Arch of the azygos vein
140
Which tributaries of the SVC converge in the neck?
Right and left subclavian veins, and right and left internal jugular veins
141
Which parts of the aorta are in the superior mediastinum?
-Arch of the aorta
-Brachiocephalic trunk
-Left common carotid artery
-Left subclavian artery
142
What compartment of the mediastinum is the ascending aorta in?
Middle
143
Which parts of the aorta are in the neck?
Right subclavian artery and common carotid artery
144
What is the ligamentum arteriosum?
-Remnant from fetal circulation
-Bypass the lungs so prevents blood from entering pulmonary artery and deposits it in the aorta
145
Which structure is similar to the ligamentum arteriosum?
Fossa ovalis
146
Why is the superior mediastinum the only compartment that the trachea is in?
Because it bifurcates into the primary bronchi at the sternal angle
147
What is the esophagus' positioning in relation to the trachea and aorta?
-Travels posterior to trachea in the superior mediastinum
-In the posterior mediastinum, the aorta crosses over the esophagus posteriorly
148
What are the venous angles?
The angles at which the right/left subclavian vein and right/left internal jugular veins converge to form the right and left brachiocephalic veins
149
What other vessels are present at the venous angles?
-Right lymphatic duct
-Lymphatic trunk (right)
-Thoracic duct (left)
150
Boundaries of the posterior mediastinum
Superior: sternal angle
Inferior: diaphragm
Posterior: bodies of T5-T12 vertebrae
Anterior: fibrous pericardium/diaphragm
151
What is the "blue side" of the posterior mediastinum? "red side"?
Blue side: contains veins
Red side: contains arteries
152
Organization of the posterior mediastinum from anterior to posterior
-Esophagus
-Arteries
-Veins
-Lymphatic trunks
153
Which part of the aorta is located in the posterior mediastinum?
Thoracic (descending aorta)
154
Order of the parts of the aorta, from most proximal to most distal.
Ascending aorta
Arch of the aorta
Thoracic (descending aorta)
Bronchial arteries
Esophageal arteries
Posterior intercostal arteries
155
At which opening does the thoracic aorta become the abdominal aorta?
Aortic hiatus
156
What parts of the azygos vein are in the posterior mediastinum?
Azygos vein
Accessory azygos vein
Hemi-azygos vein
157
Which veins bring blood from intercostal spaces to the azygos vein?
Posterior intercostal veins
158
Which part of the azygos vein is more superior on the left side of the body?
Accessory azygos vein
159
Which part of the lymphatic vessels are in the posterior mediastinum?
Lymphatic trunks and thoracic duct
160
Where does the azygos vein exit the posterior mediastinum?
Superiorly: sternal angle (becomes the arch of the azygos)
Inferiorly: aortic hiatus
