cardiology Flashcards
what are the 4 parts of mediastinum
- anterior
- middle
- posterior
- superior
where is the anterior mediastinum
between sternum and fibrous pericardium
what is found in the anterior mediastinum
thymus
what does middle mediastinum contain
heart and parts of the great vessel
what does the posterior mediastinum contain
- azygous vein
- sympathetic chain
- thoracic duct
- vagus nerve
- trachea
- 2 main bronchi
- thoracic aorta
- oesophagus
what does the superior mediastinum contain
brachiocephalic veins
what are the layers of the heart
- fibrous pericardium
- pericardial cavity
- visceral pericardium
- myocardium
- endocardium
what is the fibrous pericardium
outer most layer
protective
what is the fibrous pericardium lined by
parietal serous pericardium
what does the pericardial cavity contain
pericardial fluid
what is another name for visceral pericardium
epicardium
what does visceral pericardium secrete
pericardial fluid
what lines visceral pericardium
simple squamous epithelium = mesothelium
what is myocardium
thick muscle layer
what does myocardium contain
intercalated disc
what is endocardium
inner endothelial lining
what are the borders of the heart
- right lateral
- left lateral
- interior
- superior
what is at the right lateral border
right atrium
what is at the left lateral border
left ventricle
what is at the inferior border
right ventricle
what is at the superior border
great vessels
what are the 3 surfaces of the heart
anterior
base
inferior
where is apex of the heart
5th intercostal space mid-clavicular line on left side of chest
look at diagram of vessels
look at diagram of vessels
where is the azygous vein
the neuromuscular bundle between the ribs
how is the neuromuscular bundle arranged
vein artery nerve VAN (superior to inferior )
what is contained in the neuromuscular bundle
intercostal veins
azygous vein
SVC
where does right lymphatic duct drain
into right venous angle
where does thoracic duct drain
left venous angle
what types of lymphatic vessels is there
deep and superficial
what are the lymph nodes in the lung
- tracheo-bronchial
- bronchopulmonary
what is the cisterna chyli
swollen start of thoracic duct below the diaphragm
what are the 4 cardiac chambers
- right atrium
- right ventricle
- left atrium
- left ventricle
what does right atrium have at the top
auricle
what is the fossa ovale
remnant of foramen ovale
where is SA node located
right atrium
where are the papillary muscles
right ventricle
what do the papillary muscles attached to
chordae tendineae
what is the infundibulum
aka conus arterioles
cone shaped outflow tract of right ventricle
which chamber has the thickest myocardium
left ventricle
what are the 4 heart valves
- tricuspid
- pulmonary
- mitral
- aorta
where is the tricuspid valve
between right atrium and right ventricle
what valve is the tricuspid valve
AV
where is the pulmonary valve
between right ventricle and pulmonary artery
what type of valve is pulmonary valve
semilunar valve
where is the mitral valve
between left atrium and left ventricle
what type of valve is the mitral valve
AV valve
where is the aortic valve
between left ventricle and the aorta
what type of valve is the aortic valve
semilunar valve
what does shutting of AV valve produce
S1 (Lub)
what does shutting of semilunar valves produce
S2 (dub)
where is the chordae tendineae found
on tricuspid and mitral valve
what does chordae tendinae connect
valve to the papillary muscles
what does contraction of papillary muscles prevent
regurgitation of blood through the valves
where do you hear the aortic valve best
second right intercostal space
where do you heart the pulmonary valve best
second left intercostal space
where do you heart the tricuspid valve best
fourth left intercostal space at left lower sternal border
where do you heart the mitral valve best
fifth left intercostal space mid clavicular line
what is the route of blood flow
- SVC
- right atrium
- tricuspid valve
- right ventricle
- pulmonary valve
- pulmonary arteries
- lungs
- pulmonary vein
- left atrium
- mitral valve
- left ventricle
- aortic valve
- aorta
- body
what are the main coronary arteries
- right coronary
- right marginal
- left coronary
- left circumflex
- left anterior descending
- left marginal
what is coronary sulcus for
venous drainage
what is the pattern of most patients blood
right dominant pattern meaning most of their heart is supplied by right coronary artery
what are the most common arteries affected by atherosclerosis
- LAD
- right coronary
- left circumflex
what leads of ECG are anteroseptal
V1-V4
what coronary artery is blocked in anteroseptal MI (V1-V4)
LAD
what leads are blocked in inferior MI
II
III
aVF
what coronary arteries are blocked in inferior MI
right coronary
what leads show anterolateral MI
V4-V6
aVL
what coronary arteries are blocked in anterolateral MI
LAD/left coronary
what leads show lateral MI
I
aVL
V5-V6
what coronary arteries are blocked in lateral MI
left circumflex
what is CABG
coronary artery bypass graft
what is CABG used for
to restore blood flow to a coronary artery obstructed by atherosclerosis
what are commonly used grafts in CABG
- great saphenous vein
- radial artery
- internal thoracic artery
what is the phrenic nerve
C3,4,5
what is the phrenic nerve to diaphragm
somatic motor
what is the phrenic nerve to fibrous pericardium
somatic sensory and sympathetic axons
how does phrenic nerve travel compared to the heart
lateral
what does the phrenic nerve travel with
IVC
what riddle is used for phrenic nerve
C3,4,5 keeps the diaphragm alive
what does the vagus nerve travel through the diaphragm with
oesophagus
what innervation is vagus nerve to mucous lining of larynx
somatic sensory
what are the branches of vagus nerve
recurrent laryngeal nerve (right and left)
where does right recurrent laryngeal nerve go
hooks under subclavian
does the right recurrent laryngeal enter the chest
no
where does left recurrent laryngeal nerve go
hooks under arch of the aorta
does left recurrent laryngeal nerve go into the chest
yes
what position does patient need to be in for JVP to be evident
at 45 degrees lying down
what is characteristic of JVP
double pulsation
what outflow does sympathetic nerves have
thoracolumbar
what are the post-synaptic nerves of sympathetic chain
cardiopulmonary splanchnic nerves
what outflow does the parasympathetic chain have
cranio-sacral outflow
what does cranio-sacral outflow travel with
III
VI
IX
X
where is somatic pain coming from
body wall
what kind of pain is somatic pain
sharp, localised pain
examples of somatic pain
- dermatome pain in shingles
- MSK pain
- pericarditis
- pleurisy
where does visceral pain come from
organ
characteristic of visceral pain
dull, poorly localised pain
examples of visceral pain
- MI
- oesophagitis
- ruptured aneurysm
- pancreatitis
