Cardio pre-practical lecture Flashcards

1
Q

Where does the mediastinum lie?

A

The mediastinum lies between the left and right pleurae.

  • It extends from the sternum in front to the vertebral column behind, and contains all the thoracic organs except the lungs.
  • It is divided into 2 parts: a superior part and an inferior part.
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2
Q

What are the 3 regions the inferior part of the mediastinum is divided into?

A
  • It is divided relative to the pericardium.
  • The anterior mediastinum is in front of the pericardium.
  • The middle mediastinum contains the pericardium and its contents.
  • The posterior mediastinum is behind the pericardium.
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3
Q

What are the main contents of the superior mediastinum?

A
  • Glandular plane: thymus
  • Venous plane: brachiocephalic vv., SVC
  • Visceral plane: trachea, oesophagus
  • Lymphatic plane: thoracic duct
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4
Q

What does the anterior mediastinum contain?

A
  • Thymus
  • Lymph nodes
  • Fat
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5
Q

What are the main contents of the posterior mediastinum?

A
  • Oesophagus & Vagus nerve
  • Azygos vein
  • Sympathetic trunk
  • Thoracic duct
  • Descending aorta
  • Splanchnic nerve
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6
Q

What are the 2 layers of pericardium?

A

Fibrous and Serous

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7
Q

What is the serous layer composed of?

A
  • Outer parietal layer

- Inner visceral layer = Epicardium

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8
Q

What is epicardium composed of?

A

It is composed of endothelial cells and a thin layer of fat and connective tissue.

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9
Q

What cavity is present between parietal and visceral layers?

A

Pericardial cavity filled with percardial fluid

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10
Q

What surrounds the pericardium?

A

A fibrous sac

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11
Q

Various anatomical relationships for the pericardium

A
  • Surrounds heart and bases of pulmonary artery and aorta.
  • Deep to sternum and anterior chest wall.
  • The right phrenic nerve passes to the right of the pericardium.
  • The left phrenic nerve passes over the pericardium of the left ventricle.
  • Pericardial arteries supply blood to the dorsal portion of the pericardium.
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12
Q

What are the main identification features of the right atrium?

A
  • Openings for IVC, SVC, Coronary sinus
  • Interatrial septum
  • Fossa ovalis in interatrial septum
  • Musculi pectinati
  • Tricuspid valve
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13
Q

What are the main identification features of the right ventricle?

A
  • Tricuspid valve: 3 valve cusps, chordae tendineae, papillary muscles
  • Trabeculae carneae (contractile fleshy struts)
  • Moderator band (Septomarginal trabeculum)
  • Opening for pulmonary trunk
  • Interventricular septum
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14
Q

What is the purpose of the trabeculae carneae in the right ventricle?

A

The purpose of the trabeculae carneae is most likely to prevent suction that would occur with a flat surface and thus impair the heart’s ability to pump efficiently. The papillary muscles themselves are just a specialised form of trabeculae carneae.

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15
Q

What does the Moderator band (Septomarginal trabeculum) do in the right ventricle?

A

It prevents the overballooning of the right ventricle.

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16
Q

What are the main identification features of the left atrium?

A
  • Openings for L+R superior pulmonary veins and L+R inferior pulmonary veins.
  • Bicuspid (mitral) valve
  • Smooth-walled, small chamber, lying wholly postero-superiorly against oesophagus.
  • Forms base of heart
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17
Q

What are the main identification features of the left ventricle?

A
  • Bicuspid (mitral valve), 2 valve cusps, chordae tendineae, papillary muscles x2.
  • Trabeculae carneae
  • Opening for aorta
  • Interventricular septum
  • Wall 3x as thick as right ventricular wall.
  • Forms apex of the heart
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18
Q

Surface anatomy of heart: Heart

A

Lies opposite middle 4 thoracic vertebrae (T5-8) in recumbent position.

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19
Q

Surface anatomy of heart: Apex

A

5th left intercostal space, midclavicular line = left ventricle

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20
Q

Surface anatomy of heart: Base

A

Wholly posterior = left atrium

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21
Q

Surface anatomy of heart: Right border

A

SVC and right atrium

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22
Q

Surface anatomy of heart: Left border

A

Aortic arch and left ventricle

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23
Q

Surface anatomy of heart: Anterior surface

A
Right atrium (1/4)
Right ventricle (2/4)
Left ventricle (1/4)
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24
Q

What are the main arteries, veins & lymphatics of trunk and chest wall?

A
  • Internal thoracic artery: gives off anterior intercostal arteries.
  • Internal thoracic vein: receives anterior thoracic veins.
  • Descending aorta
  • Inferior vena cava
  • Azygos vein
  • Thoracic duct
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25
Q

What are the main arteries of upper limb?

A
  • Subclavian artery
  • Axillary artery
  • Brachial artery
  • Radial artery
  • Ulnar artery
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26
Q

Where does the subclavian artery arise from and what does it become?

A
  • It arises from the aortic arch.

- Subclavian becomes axillary at lateral border of 1st rib.

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27
Q

What does the axillary artery change into?

A

Axillary becomes brachial at inferior border of teres major m.

28
Q

What does the brachial artery change into?

A

Brachial divides into radial and ulnar in cubital fossa.

29
Q

What do the radial and ulnar arteries form?

A

Radial and ulnar arteries form palmar arches in palm of hand which give off digital aa.

30
Q

What are the superficial veins of the upper limb?

A
  • Cephalic vein
  • Basilic vein
  • Median cubital vein
31
Q

Where do the superficial veins of the upper limb arise from?

A

They arise from the dorsal venous arch on the back of the hand.

32
Q

Where does the cephalic vein travel?

A

It travels up the limb on the lateral side.

- Drains into axillary vein below clavicle.

33
Q

Where does the basilic vein travel?

A

It travels up limb on medial side.

- Becomes continuous with brachial veins (deep veins accompanying brachial a.)

34
Q

What does the median cubital vein do?

A

It connects cephalic and basilic across cubital fossa.

35
Q

What is the main artery of the lower limb?

A

The femoral artery

36
Q

What are the arteries of the lower limb?

A
  • Aorta
  • iliac
  • Common femoral
  • Deep femoral
  • Superficial femoral
  • Popliteal
  • Anterior tibial
  • Posterior tibial
  • Peroneal
  • Pedal arch
  • Dorsalis pedis
37
Q

What does the external iliac become in the lower limb?

A

Ext. iliac becomes common femoral in anterior thigh

38
Q

What does the common femoral become?

A

Common femoral gives off superficial and deep femoral aa.

39
Q

What does the superficial femoral become?

A

Superficial femoral becomes popliteal in popliteal fossa.

40
Q

What does the popliteal artery become?

A

Popliteal artery gives off anterior and posterior tibial in leg.

41
Q

What does the posterior tibial become?

A

Post. tibial gives off fibular (peroneal = old terminology) and continues medially down to plantar surface of foot (= medial & lateral plantar aa)

42
Q

What does the anterior tibial become?

A

Ant. tibial continues down anteriorly to dorsum of foot where it becomes dorsalis pedis between 1st & 2nd toes

43
Q

What are the superficial veins of the lower limb?

A
  • Femoral vein
  • Great saphenous vein
  • Popliteal vein
  • Small saphenous vein
44
Q

Where do superficial veins arise from?

A

Superficial veins arise from dorsal arch of foot.

45
Q

Where does the great (long) saphenous vein travel?

A

Long saphenous travels up the limb medially to drain into femoral

46
Q

Where does the small (short) saphenous vein travel?

A

Short saphenous travels up the limb posteriorly to drain into popliteal

47
Q

What does the popliteal vein become?

A

Popliteal becomes femoral proximally

48
Q

What does the femoral vein become?

A

Femoral becomes external iliac proximally

49
Q

How do superficial veins drain?

A

Superficial vv drain to deep vv.

50
Q

What are the superficial arterial pulse points of the body?

A
  • Superficial temporal and Facial = branches of external carotid
  • Common carotid = branch of aortic arch
  • Brachial = continuation of axillary
  • Radial = lateral branch of brachial
  • Femoral = continuation of ext. iliac
  • Popliteal = continuation of femoral
  • Post. tibial = branch of popliteal
  • Dorsalis pedis = continuation of ant. tibial
51
Q

Features of the right coronary artery supplying the heart

A
  • Arises from right aortic sinus of ascending aorta.
  • Runs in coronary (atrioventricular) sulcus.
  • At inferior margin of heart it gives off right marginal artery.
  • On post surface of heart RCA gives off posterior descending artery.
52
Q

Features of the left coronary artery supplying the heart

A
  • Arises from left aortic sinus of ascending aorta.
  • Runs in coronary sulcus.
  • Divides almost immediately into left anterior descending artery (in interventricular sulcus) and circumflex artery.
53
Q

What are anastomoses and where are they found in the heart for coronary supply?

A
An anastomosis  is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams.
Found:
- Ant + Post descending 
- Circumflex + RCA 
- Occur on post surface of heart
54
Q

What are the 2 major sulci containing the branches of the coronary arteries

A
  • Coronary (atrioventricular) sulcus: between atria + ventricles.
  • Interventricular sulcus: between R+L ventricles.
55
Q

What are the main veins of the heart wall and where do they lie?

A
  • Great cardiac vein lies alongside anterior interventricular artery.
  • Middle cardiac vein lies alongside post interventricular artery.
  • Small cardiac vein lies alongside right marginal artery.
  • All above drain into the coronary sinus lying alongside the circumflex artery.
  • The coronary sinus drains into the right atrium.
  • Anterior cardiac veins drain directly into right atrium.
56
Q

Does the vagus nerve increase or decrease heart rate?

A

The vagus nerve (parasympathetic) decreases heart rate.

57
Q

What nerves increase heart rate and force of contraction?

A

Sympathetic cardiac nerves

58
Q

What nerves go to the heart?

A
  • Phrenic nerve
  • Vagus nerve
  • Sympathetic fibres
59
Q

Phrenic nerve innervation

A

Phrenic nerve innervates the fibrous pericardium and parietal layer of serous pericardium. Carries pain sensation.

60
Q

Vagus nerve innervation

A

Vagus nerve innervates heart and visceral layer of serous pericardium.

61
Q

Sympathetic fibres innervation

A

Sympathetic fibres - from the cervical and upper thoracic sympathetic ganglia innervate heart and visceral layer of serous pericardium.

62
Q

How does internal innervation (conduction) arise?

A

Signals arising in the SA node stimulate the atria to contract and travel to the AV node. After a delay, the stimulus is conducted through the bundle of His (atrioventricular bundle) to l & r bundle branches and Purkinje fibres to the endocardium at the apex of the heart, then finally to the ventricular epicardium.

63
Q

Histological features of Artery

A
  • Thick smooth muscular wall

- Lumen smaller relative to wall than vein.

64
Q

Histological features of Vein

A
  • Thinner wall than artery.
  • Less smooth muscle.
  • Lumen wider relative to wall than artery.
65
Q

Histological features of Cardiac muscle

A
  • Branching striated fibres
  • Central rounded nuclei
  • Intercalated discs
66
Q

Histological features of Muscular arteries

A
  • Smaller distributing arteries
  • Thick smooth muscle in wall, few elastic fibres.
  • e.g. brachial, radial, femoral, posterior tibial, coronary.
67
Q

Histological features of Elastic arteries

A
  • = larger conducting arteries receiving blood directly from heart
  • Numerous laminae of dark-staining, wavy, elastic fibres in wall in amongst smooth muscle fibres
  • Eg. aorta, pulmonary trunk