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1 CV > cardio anatomy > Flashcards

cardio anatomy Flashcards

1
Q

what separates the superior and inferior mediastinum?

A
  • an imaginary line that runs from the sternal angle (joint between sternal body and sternal manubrium)
  • to the T4 vertebrae
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2
Q

how many parts are there of the mediastinum?

A

4 parts

  • superior
  • inferior, which can be divided into anterior, middle, posterior
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3
Q

what are the borders of the anterior mediastinum?

A 
anterior border = sternum 
posterior border = pericardium 
roof = superior mediastinum
floor = diaphragm 
lateral border = mediastinal pleura
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4
Q

what are the borders of the superior mediastinum?

A 
superior border = the thoracic inlet
inferior bordier = inferior mediastinum
anterior border = manibrium of the sternum 
posterior border = T1-T4
lateral border = pleurae of the lungs
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5
Q

what are the borders of the middle mediastinum?

A

anterior border = anterior margin of pericardium
posterior = posterior border of pericardium
superior border = sternal angle - T4
inferior border = superior surface of diaphragm
lateral border = mediastinal pleura of lungs

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6
Q

what are the borders of the posterior mediastinum?

A 
lateral = mediastinal pleura 
anterior border = pericardium
posterior border = t5-t12
roof = sternal angle to T4 line
floor = diaphragm
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7
Q

what are the contents of the anterior mediastinum?

A

no major structures

  • thymus gland (more in children)
  • lymph nodes
  • internal thoracic vessels
  • thyroid tissue
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8
Q

what are the contents of the middle mediastinum?

A

MAIN mediastinum:

  • pericardium and heart
  • trachea and main bronchi
  • ascending aorta
  • pulmonary vessels (trunk, L&R arteries)
  • brachiocephalic vessels, forming the SVC/IVC
  • phrenic, left recurrent laryngeal nerve
  • cardia plexus (vagus & T1-T4 sympathetic )
  • tracheobronchial lymph nodes
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9
Q

what are the contents of the superior mediastinum?

A
  • Arch of the aorta (brachiocephalic artery, left common carotid artery, left subclavian artery)
  • superior vena cava ( L&R brachiocephalic veins, , some intercostal veins)
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10
Q

what are the contents of the posterior mediastinum?

A
  • Oesophagus
  • azygous, hemiazygous and accessory hemiazygous veins
  • descending/thoracic aorta (posterior intercostal, bronchial, oesophageal, superior phrenic)
  • Oesophagus plexus (L&R vagus)
  • the thoracic duct
  • thoracic sympathetic trunks
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11
Q

what is the mediastinum?

A

area between right and left pleura

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12
Q

what is the pericardium?

A
  • A fibro-serous fluid filled sac
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13
Q

what is the purpose of the pericardium?

A
  • to separate the heart and roots of the great vessels from other mediastinal structures
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14
Q

what are the layers of the pericardium?

A
  1. fibrous pericardium - outermost layer
  2. serous pericardium - has outer parietal and inner visceral layer with pericardial cavity (fluid filled potential space) between
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15
Q

what is the inner visceral layer of the serous pericardium also known as?

A

the epicardium

it is the outermost layer of the heart

visceral layers ALWAYS covers the organ

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16
Q

what is the layer under the epicardium called?

A

the myocardium - thick layer that contracts

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17
Q

what are the layers of the heart (out to in)?

A
  1. fibrous pericardium
  2. serous pericardium - parietal layer
    SPACE
  3. serous pericardium - visceral layer/ epicardium
  4. myocardium - thick, contracts
  5. endocardium - inner layer of heart, endothelial cells
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18
Q

how many surfaces does the heart have?

A

5

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19
Q

name the surfaces of the heart

A
  1. anterior/sternocostal
  2. posterior/base
  3. inferior/diaphragmatic
  4. right pulmonary
  5. left pulmonary
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20
Q

what is on the anterior surface of the heart?

A
  • mainly right ventricle
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21
Q

what is on the posterior/base surface of the heart?

A
  • left atrium

- proximal great veins

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22
Q

what is on the diaphragmatic/inferior surface of the heart?

A
  • the left ventricle

- part of right ventricle

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23
Q

what is on the left pulmonary surface of the heart?

A
  • left ventricle
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24
Q

what is on the right pulmonary surface of the heart?

A
  • right atrium
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25
Q

what 2 margins make up the apex?

A
  • obtuse margin (along left pulmonary)
  • inferior margin (along diaphragmatic)

where they meet forms the apex

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26
Q

what are the valves of the heart? (4)

A
  • mitrial (bicuspid) valve
  • aortic semilunar valve
  • pulmonary semilunar valve
  • tricuspid valve
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27
Q

what and where is the fossa ovalis?

A
  • a depression in the right atrium of the heart, at the level of the interatrial septum, the wall between right and left atrium.
  • is the remnant of a thin fibrous sheet that covered the foramen ovale during fetal development.
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28
Q

what structure holds the atrioventricular valves in place?

A
  • the chordae tendineae

- they are held by the papillary muscles

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29
Q

what are the borders of the heart?

A
  • the right border
  • the inferior border
  • the left border
  • the superior border
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30
Q

what makes up the right border?

A

the right atrium

31
Q

what makes up the left border?

A

the left ventricle (and part of left atrium)

32
Q

what makes up the superior border

A

the right atrium
the left atrium
the great vessels

33
Q

what makes up the inferior border?

A

the left ventricle

the right ventricle

34
Q

what are the sulci of the heart ?

A
  • grooves on the surface of heart

- created by the internal divisions of the 4 chambers

35
Q

describe the coronary sulcus

A
  • aka. atrioventricular groove
  • runs transversely around the heart
  • it represents the wall dividing the atria from the ventricles.
  • contains the right coronary artery.
36
Q

describe the the anterior and posterior interventricular sulci

A
  • found running vertically on their respective sides of the heart.
  • They represent the wall separating the ventricles.
37
Q

what are the 2 pericardial sinuses?

A
  1. The oblique pericardial sinus
  2. The transverse pericardial sinus

The pericardial sinuses are impressions in the pericardial sac formed between the points where great vessels enter it.

38
Q

where is the oblique pericardial sinus located?

A
  • on posterior surface
  • is a cul-de-sac
  • j shaped around veins
  • posterior to left atrium
39
Q

where is the transverse pericardial sinus located?

A
  • on superior surface
  • posterior to aorta and pulmonary trunk
  • anterior to SVC
40
Q

which are the 2 main arteries supplying blood to the heart?

A
  • the L&R coronary arteries
  • these branch to supply whole heart
  • arise from the left and right aortic sinuses within the aorta.
41
Q

what are the anterior branches of the LCA?

left coronary artery

A
  • the left anterior descending (with diagonal branches) LAD
  • the left maginal artery, LMA
  • the left circumflex artery, Cx (carries on posteriorly)
42
Q

what are the anterior branches of the RCA? describe the course

(right coronary artery)

A
  • the right marginal artery, RMA

- moves along the right and inferior border of the heart towards the apex

43
Q

what are the posterior arteries of the heart?

A
  • the left circumflex , Cx

- the posterior interventricular artery (PIv)

44
Q

what is the posterior interventricular artery (PIv) normally a branch of?

A

RMA, but can be LCA

45
Q

how is the majority of blood drained in the heart?

A
  • through the coronary sinus
46
Q

where is the coronary sinus located? where does it empty?

A
  • posterior aspect of heart

cardiac vein -> coronary sinus -> RIGHT ATRIUM

47
Q

describe the course of the RCA

A
  • goes right at pulmonary trunk
  • runs along the coronary sulcus
  • branches into RMA
  • RCA carries along posteriorly, still in coronary sulcus
  • then, in 90%, turns into PIv,
  • follows posterior interventricular groove towards the apex of the heart
48
Q

describe the course of the LCA

A
  • left at pulmonary trunk

- divides into LAD, LMA and Cx

49
Q

describe the course of the LAD

A
  • descends from LCA
  • follows the anterior interventricular groove
  • towards the apex of the heart
  • continues on the posterior surface to anastomose with the posterior interventricular branch.
50
Q

describe the course of the Cx

A
  • follows the coronary sulcus to the left border and onto the posterior surface of the heart.
51
Q

how are the coronary arteries supplied with blood?

A

when heart is relaxed, the cusps/pockets of the aortic valve/sinus fills with the back flow of blood (due to pressure drop)

52
Q

where does the RCA supply blood to in the heart?

A
  • right atrium

- part of right ventricle

53
Q

where does the RMA supply blood to in the heart?

A
  • right ventricle

- apex

54
Q

where does the PIV supply blood to in the heart?

A
  • posterior 1/3 or inter ventricular septum

- AV node

55
Q

where does the LAD supply blood to in the heart?

A
  • anterior 2/3 of inter ventricular septum
  • RV
  • LV
56
Q

where does the LMA supply blood to in the heart?

A
  • left ventricle
57
Q

where does the Cx supply blood to in the heart?

A
  • Left atrium

- left ventricle

58
Q

What percentage of people have their PIV artery branch off the RCA?

A

70% RCA only
10% LCA only
20% RCA & LCA

therefore, for RCA = 90% (picture Venn diagram)

59
Q

SA node supply - what % supplied by RCA or LCA?

A
  • 60% RCA

- 40% LCA

60
Q

posterior intraventricular artery supplies the AV node. what proportion of people have it supplied by a PIV branching from RCA or LCA?

A

70% RCA only
10% LCA only
20% RCA & LCA

same q, just worded differently

61
Q

where exactly is the apex of the heart found?

A
  • left
  • midclavicular line
  • 5th intercostal space
62
Q

why do you need to know where the apex is?

A
  • where you can hear the mitral valve
63
Q

what is valve auscultation?

A
  • the action of listening to the sounds of the heart at the location of the 4 valves
64
Q

what is the auscultation position for the aortic valve?

A
  • 2nd intercostal space

- right sternal border

65
Q

when is the aortic valve heard during auscultation?

A

during S2

66
Q

what is the auscultation position for the tricuspid valve?

A
  • 5th intercostal space

- left sternal border

67
Q

when is the tricuspid valve heard during auscultation?

A

during S1

68
Q

what is the auscultation position for the mitral valve?

A
  • 5th intercostal space

- mid-clavicular line

69
Q

when is the mitral valve heard during auscultation?

A

during S1

70
Q

what is the auscultation position for the pulmonary valve?

A

2nd intercostal space

left sternal border

71
Q

when is the pulmonary valve heard during auscultation?

A

during S2

72
Q

which are the semilunar valves?

A

pulmonary + aorta

73
Q

which are the atrioventricular valves?

A

tricuspid + mitral (bicuspid)

1 CV (2 decks)

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