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Jason's Cardiovascular Block > Cardio-Thoracic/Mediastinum Anatomy plus Boobs > Flashcards

Cardio-Thoracic/Mediastinum Anatomy plus Boobs Flashcards

1
Q

Where is the axillary process of the breast located?

A

supero-lateral extension

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2
Q

Why is the axillary process of the breast important

A

localized region of increase breast tissue = increased incidence of tumours

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3
Q

between which 2 ribs is the breast usually located?

A

2 & 6

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4
Q

Which layer are breast implants usually put?

A

retromammary space

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5
Q

the shape of the deep coronal layer of the breast is convex?

A

False. Concave.

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6
Q

What are the two main areas in which the breast is innervated and blood supply comes and drains?

A 
internal thoracic (laterally from sternum)
From axilla
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7
Q

Describe the lymphatics of the breast

A

mirrored with blood vessels

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8
Q

You find a swollen lymph node in the axillary region of a female patient. Just a simple rhinovirus right?

A

Could be cancer.

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9
Q

which ribs articulate with sternum?

A

upper 7 ribs

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10
Q

what does rib 11 and 12 articulate with?

A

NOTHING!

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11
Q

where does cartilage rib 8,9,10 articulate?

A

with rib 7 cartilage

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12
Q

head of the ribs has one or two heads?

A

Two!
Superior
Inferior

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13
Q

Why is the lateral tubercle of the rib convex?

A

for attachments

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14
Q

describe the medial tubercle of the rib

A

concave, made for articulating

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15
Q

what’s the costal groove for?

A

VAN
Vein
Artery
Nerve

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16
Q

What are 3 dead give-aways that you’re looking at a thoracic vertebra?

A

demifacets on superior/ inferior body
facets on the transverse processes
long vertical spinous process

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17
Q

what’s so great about radial ligaments?

A

strong as heck, break the rib long before you dislocate it

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18
Q

2 places where you can find radiating ligament:

A
  1. costotransverse joints

2. costovertebreal joints

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19
Q

what’s a flail chest?

A

one rib, two breaks, floating and gets sucked in due to negative pressure while breathing: painful.

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20
Q

Some poor dude comes into the ER with broken ribs, a few of which are broken twice in the same rib, he’s got pain whilst breathing. You suspect

A

Flail chest

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21
Q

Follow the circumferential muscles of the diaphragm from sternum to vertebra, trace the journey with anatomical landmarks and take plenty of pictures along the way!

A
  1. xyphoid process
  2. costal margins
  3. tips of rib 11/12
  4. arcuate ligaments
  5. left and right crus
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22
Q

Left crus is longer than right. T/F?

A

False.

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23
Q

What do the crus of the diaphragm do?

A

anchors the diaphragm to the vertebral bodies

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24
Q

name the two muscles that pass through the arcuate ligaments:

A
  1. Quadratud lumborum laterally

2. psoas medially

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25
Q

What’s the mickey mouse tendon?

A

Central tendon of the diaphragm

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26
Q

What level does the aorta pass through the diaphragm?

A

T12 between the crura

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27
Q

what level does the IVC pass through the diaphragm?

A

T8

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28
Q

What level does the oesophagus pass through the diaphragm??

A

T10

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29
Q

What passes through T8 in the diaphragm?

A

IVC

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30
Q

What passes through T10 in the diaphragm?

A

oesophagus

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31
Q

What passes through T12 in the diaphragm?

A

Aorta

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32
Q

how do you paralyze a hemi diaphragm?

A

cut the phrenic nerve

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33
Q

3 layers of intercostal muscles: Go.

A
  1. external
  2. internal
  3. innermost
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34
Q

describe the external ICM

A
  1. front pockets facing
  2. used for inspiration
  3. external costal membrane anteriorly
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35
Q

describe the internal ICM

A
  1. back pockets facing (postero inferiorly)
  2. for expiration (but prolly for splinting rather)
  3. internal costal membrane located posteriorly
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36
Q

Describe the inner most ICMs

A
  1. discontinuous
  2. mirrors internal ICMs
  3. lateral, parasternal, paravertebral
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37
Q

Where is the costal neuromuscular bundle located between?

A

Internal and innermost ICMs

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38
Q

how are costals innervated from?

A

Ventral ramus of intercostal nerve

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39
Q

2 arterial blood supplies for costals:

A
  1. aorta

2. internal thoracic

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40
Q

need to stab you to get to your lungs, how do I avoid the neuromuscular bundle?

A

bounce in the top of the rib. never the bottom.

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41
Q

I change in 3 directions when I breath, they are:

A
  1. vertical
  2. lateral
  3. A-P
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42
Q

pump handle movement is which direction? by which ribs?

A

A-P. upper ribs

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43
Q

lateral movement of ribs when breathing are by which ribs? what is it called?

A

lower ribs. bucket handle

44
Q

3 accessory muscles of respiration:

A
  1. abdominal muscles
  2. sternocleidomastoid
  3. scalenes
45
Q

what anchors the diaphragm’s central tendon superiorly?

A

pericardium

46
Q

what levels is the paricardial sac located?

A

Between T5 and T8

47
Q

How much fluid in the pericardial cavity?

A

1-2 ml

48
Q

Name the two layers of inner membrane of the pericardium:

A

Parietal and visceral serous membranes

49
Q

What the the layer of membrane directly surrounding the heart?

A

visceral serous memrbrane

50
Q

What the the outer most later of the pericardium called?

A

fibrous membrane

51
Q

the vessels that enter and exit the pericardium all go through one opening with a serous membrane. T/F?

A

False. Each vessels has it’s own sleeve layer of serous membrane.

52
Q

Where can surgeons and curious medical student stick their finger in the heart safely for landmarking?

A

transverse pericardial sinus

53
Q

Where is the base of the heart

A

right supero-lateral aspect

54
Q

the 5th intercostal space is above or below the 5th rib?

A

below, low, low, low, low…….

55
Q

Superior vena cava has valves?

A

Nope.

56
Q

What are the muscle-y rough textured wall of the right atria called?

A

musculi pectinati

57
Q

where is the coronary sinus?

A

near the rudimentary IVC valve

58
Q

Describe the sinus venarum in one word

A

smooth

59
Q

what’s the crista terminalis

A

where all the musculi pectinati meet and end

60
Q

in adults what is the reminent of the foramen ovalis called?

A

fossa ovalis

61
Q

what stops the tricuspid valve from bursting open into the atria when ventricular pressure > atrial pressure?

A

chordae tendinae

62
Q

What’s the papillary muscle? how many are there?

A

gives rise to the chordae tendinae

there are 3

63
Q

right atria wall is thicker than the right ventricle?

A

False

64
Q

what’s the analagous structure to musculi pectinati in the right ventricle?

A

trabeculae carnae

65
Q

smooth area right before the pulmonary trunk is called what? describe it in one word:

A

conus arteriosus/infundibulum

Smoooooooooooooooooth!

66
Q

how many papillary muscles connect to the mitral valve via it’s chordae tendinae?

A

Two

67
Q

describe the left atrium chamber in one word.

A

Yep. Smooth bro. Real smooth.

68
Q

Does the heart have a skeleton? What two things does it do?

A
  1. yes a fibrous one

2. archors and electrically isolates them

69
Q

what’s a coronet?

A

wraps around the aorta and pulmonary trunk. Two of them.

70
Q

what’s the ‘figure 8’ fibrous skeleton of the heart feature called?

A

Trigones. Two of them. Remember: once the blood passes through the valves “y’gotta let trigones be trigones…..”

71
Q

Which side of the mitral and tricuspid valve is smooth?

A

atrial side

72
Q

name three parts of the tricuspid valve

A
  1. anterior
  2. septal cusp
  3. posterior cusp
73
Q

How are the chordae tendinae attached to the cusps?

A

each chordae attaches to half of one cusp, and half to another cusp for maximal closure/seal

74
Q

2 places where semilunar valves found?

A
  1. aortic valve

2. pulmonary valve

75
Q

pulmonary valves are passive valves. T/F?

A

true

76
Q

what supports the semilunar valves?

A

fibrous skeleton: the coronets

77
Q

where is the origin of the right and left coronary arter?

A

near the right and left cusp of the aortic valves respectively

78
Q

Origin of the SA node?

A

top of the cristae terminalis

79
Q

Where is the AV node?

A

between tricuspid and coronary sinus

80
Q

what’s at the top of the cristae terminalis?

A

SA node

81
Q

What’s between the tricuspid and the coronary sinus?

A

AV node

82
Q

bundle of His is on the atrial or ventricle side of the fibrous skeleton?

A

ventricle side

83
Q

bundle of His give rise to?

A

Purkinje Fibres.

84
Q

where is the cardiac plexus situated?

A

Base of the heart. I know right? the superior aspect bro.

85
Q

what runs between the SA and AV node on the outside of the heart?

A

Right coronary artery

86
Q

The circumflex artery is on the left or right?

A

branches off the left coronary artery

87
Q

2 places of anastamosis for coronary arteries. Go.

A
  1. right coronary and left circumflex branches posteriorly

2. Anterior interventricular branch and posterior interventricular branch.

88
Q

between which vertebrae is the middle mediastinum ?

A

T5-8

89
Q

What two nerves are always with aortic arch?

A

vagus

phrenic

90
Q

What two structures follow the oesophagus

A

thoracic duct

L recurrent laryngeal nerve

91
Q

Where does the azygous vein drain into?

A

behind 2nd right intercostal cartilage

92
Q

What is the remnant of the pulmonary circulation shunt in foetus called?

A

Ligamentum arteriosum

93
Q

If someone has dysphagia, what rare anatomical variation could be causing it?

A

Retroesophageal right subclavian artery

94
Q

4 places phrenic nerve passes through

A

anterioe scalenes
between subclavian artery/vein
anterior to lung root
pieces diaphragm`

95
Q

T/F left phrenic nerve pierces diaphragm with IVC at T8.

A

False, that’s the RIGHT phrenic nerve dummy!

96
Q

What are the most lateral structures in the media stinum?

A

phrenic nerves

97
Q

motor to diaphragm
sensory to mediastinal, pericardium
What kind of nerve is it?

A

Mixed nerve (phrenic)

98
Q

Vagus nerve path

A

Along trachea
behind lung root
ant. oesophagus

99
Q

Where does the vagus pierce diaphragm?

A

with oesophagus at T10

100
Q

Which one is in front of lung root? which one is behind? Phrenic or vagus?

A

Phrenic in front

Vagus behind

101
Q

In a cadaver, how can you tell which is the oesophagus, which is trachea?

A

oesophagus is flattened

trachea is open

102
Q

What level do the bronchi branch?

A

T4-5

103
Q

What loops around the subclavian?

A

recurrent laryngeal vagus

104
Q

What on earth is the cisterna chyli?

A

Where the thoracic duct starts (L2)

105
Q

where does the thoracic duct dump the lymph into?

A

left subclavian/left internal jugular

106
Q

Four branches of descending thoracic aorta:

A
  1. intercostal
  2. bronchial
  3. Pericardial
  4. oesophageal

Jason's Cardiovascular Block (15 decks)

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