Cardiology Anatomy Flashcards
1
Q
Details of Pec Major
A
- Largest, most superficial muscle.
- Fan shaped with both clavicular and sternocostal head.
- Inserts in the distal end of the humerus.
- Sternalhead — anterior portion of sternum, first 6 costal cartilages and aponerousis of the external oblique muscle.
- Costalhead — anterior medial portion of the clavicle.
- Role is to adduct and medially rotate the upper limb, draw the scapular anteriorinferiorly and the medial head is involved limb flexion.
- Innervated by lateral and medial pectoral nerves.
2
Q
Details of Pec Minor
A
- Smaller counter part of pec major lying directly below.
- Makes up the border of the axilla area.
- Originates from the 3rd to 5th ribs and inserts into the carcoid process of the scapula.
- Role is to stabilise the scapula and draw it anteriorinferiorly against the thoracic cavity.
- Innervated by the medial pectoral nerves.
3
Q
Details of Serratus Anterior
A
- Lies more laterally in the chest wall and makes up the medial border of axilla.
- Formed of different strips, originates from the costal cartilage and inserts into the medial border of the scapula.
- Role is to rotate the scapula, allow the upper limb to move 90 degrees and hold the scapula against the thoracic cage.
- Innervated by the long thoracic nerve.
4
Q
Details of subscapularis
A
- Lies underneath the clavicle.
- Provides some neurovascular protection.
- Originates from the 1st rib and costal cartilage and inserts into the inferior surface of the middle 1/3 of the clavicle.
- Anchors and depresses the clavicle.
- Innervated by the nerve to subscapularis.
5
Q
External Intercostal Muscles
A
- 11 pairs
- Inferioranteriorly
- Same as external oblique
- Lower border of rib above to superior border of the rib below.
- Expand rib cage
- Intercostal nerve (T1 to T11)
6
Q
Internal Intercostal Muscles
A
- Inferiorposteriorly
- Same as internal oblique
- Lateral border of costal groove to the superior surface of the rib below.
- Depress rib cage (Bone part) and expand rib cage (Cartilage part).
- Intercostal nerve (T1 to T11)
7
Q
Innermost Intercostal Muscles
A
- Same as internal intercostal muscle.
- Separated by neuromuscular bundles found on the costal groove.
- Medial border of costal groove to the superior surface of the rib below.
- Intercostal nerve (T1 to T11)
8
Q
Diaphragm
A
- Domed sheet of skeletal muscle that has 2 functions - contract/relaxation for breathing and also to separate the thoracic cavity from the abdo cavity.
- Peripheral attachments = vertebral column and arcuate ligaments, xiphoid process of the sternum and costal cartilages of ribs 7 - 10.
- Right crus (L1 - 3) creates sphincter around the oesophagus and left crus (L1 to L2).
- Muscle fibres from all of the diaphragm converge together to form a central tendon that attaches to the inferior surface of the fibrous pericardium.
- Right dome slightly higher than left dome.
- IVC T8 , O T10 and A T12.
- Inspiration - flattens and contracts in order to increase thoracic volume and decrease pressure.
- Expiration - relaxes and domes in order to decrease thoracic volume and increase pressure.
- Motor innervation from the phrenic nerve - C3 - C5 (Cervical plexus in the neck).
9
Q
Mediastinum
A
- Central compartment of the thoracic cavity.
- Found between the two pleura of the lungs.
- Contains most of the thoracic organs and also acts as a passage for structures from the thoracic cavity to the abdominal cavity.
- Split into superior mediastinum and inferior mediastinum at the sternal angle which is T4.
- Inferior mediastinum is split into anterior, middle and posterior mediastinum.
- Contains neural, blood vessels and pulmonary apperature.
10
Q
What is the pericardium?
A
- Found in the middle mediastinum.
- A tough fibrous sac that surrounds the heart muscle, it has limited capacity to expand if fluid fills the pericardial space causing serious pathology to the heart.
11
Q
Great Vessels
A
- Aortic arch with left common carotid and left subclavian artery and brachiocephalic artery (Right common carotid and right subclavian) found in the superior mediastinum.
12
Q
Superior Vena Cava
A
- Found in the superior mediastinum with its tributaries.
- Brachicephalic vein - drains the upper body - superintercostal vein and supreme intercostal vein - drains into the SVC.
- Azygous vein drains in the right side of the upper body - right posterior intercostal veins drains into.
- Hemiazygous drains left side of the upper body into the accessory azygous vein joining the azygous.
13
Q
Nerves through the Mediastinum
A
- Vagus Nerve —- Left vagus nerve: in between left vena cava and left subclavian nerve, passing anteriorly over the aortic arch then posteriorly under the left bronchus. Right vagus nerve passes parallel to the trachea and passes posteriorly to the SVC and right bronchus
- Phrenic Nerve —- Lateral to the great vessels then passes anteriorly into the middle mediastinum before passing anteriorly into the hilum of the lungs.
14
Q
Where does the oesophagus into the pharynx?
A
C6
15
Q
Where does the trachea bifurcate?
A
- Sternal angle behind the ascending aorta.
16
Q
What is the pleura of the lungs?
A
- Serous membrane lining the lungs and the thoracic cavity.
- It allows efficient and effortless respiration.
- 2 structures, visceral pleura and parietal pleura.
- Continuous with each other to the hilum of the lung.
- Potential space between the pleura knows as the pleural cavity.
17
Q
What is the parietal pleura?
A
- Lines the internal surface of the thoracic cavity.
- Thicker than the visceral pleura.
- Split into 4: mediastinal, cervical, costal and diaphragmatic.
18
Q
What is visceral pleura?
A
- Lines the outer surface of the lungs.
19
Q
What are the pleural recesses?
A
- Anteriorly and posteroinferiorly the pleural cavity isn’t completely filled by the lungs, creating recesses where the opposing surfaces of the parietal pleura touch.
- Costodiaphragmatic and costomediastinal.
- Clinically important as potential fluid build up leading to pleural effusion.
20
Q
What is the neurovascular supply of the pleura?
A
- Parietal: sensitive to pressure, pain and temperature. Supplied by the phrenic nerve and produces well localised pain.
- Visceral: Not sensitive to pain, temperature and or touch. Has sensory fibres that only detect stretch. Supplied by the sympathetic chain and vagus nerve (Pulmonary plexus)
21
Q
Structure of the lungs
A
- Apex (blunt end at the top of the lung)
- Base (Inferior surface on top of the diaphragm)
- Lobes (Either 2/3)
- Surfaces (Costal, mediastinal and diaphragmatic)
- Border (Anterior, inferior and posterior)
22
Q
What are the lowest extent of the lungs in the different places?
A
- Mid clavicular line = 6th rib
- Mid axillary line = 8th line
- Posteriorly = 10th rib
23
Q
Structure of the right lung
A
- 3 lobes
- 2 fissures
- Oblique fissure - runs from the inferior border posteriosuperiorly until it reaches the posterior border of the lung.
- Horizontal fissure - Runs horizontally backwards from the level of the sternum at the level of the 4th rib until reaching the oblique fissure.
24
Q
Structure of left lung
A
- 2 lobes
- 1 fissure (Oblique)
- Has the cardiac notch on the anterior border caused by the apex of heart.
25
Q
What enters the lungs through the hilum?
A
- Collection of structures, suspending the lung from the mediastinum.
- Structures including a bronchus, pulmonary artery, 2 pulmonary veins, bronchial vessels, pulmonary plexus of nerves and lymphatic vessels.
26
Q
What is the vasculature of the lungs?
A
- Deoxygenated blood by the pair of pulmonary arteries enter the lungs, once been reoxygenated It leaves the lung via 4 pulmonary veins.
- The bronchial arteries supply the lung structure itself, this leaves from the descending aorta. The bronchial veins provide drainage from the lungs. Right bronchial vein drains into azygous vein and the left drains into the homozygous veins.
27
Q
What is the nerve supply of the lungs themselves?
A
- It is mainly by the pulmonary plexus.
- Parasympathetic - from the vagus nerve.
- Sympathetic - from sympathetic trunk.
28
Q
Right atrium
A
- Receives blood from the SVC and IVC.
- Also from the coronary veins - into the coronary sinus into the right atrium.
- Makes up the right border of the heart.
- In the anterior medial portion of the atrium is the arterial appendage this increases the capacity of the right atrial.
- Blood passes from the right atrium through the tricuspid valve into the right ventricle.
- Inflow and outflow interior separated by cristae terminals.
29
Q
Intraatrial septum
A
- Muscular wall between the two atria.
- Contains an oval shaped depression that is known as the fossa ovale, a reminent of the foramen ovale from the foetal heart - closes when the baby takes its first breath.
30
Q
Left atrium
A
- Recieves oxygenated blood from the pulmonary veins and then passes blood through the mitral valve into the left ventricle.
- It makes up the posterior border of the heart, with the left articular appendage superior to it passing in front of the pulmonary trunk.
- The inflow portion is smooth where as the outflow portion is muscular including the left articular appendage.
31
Q
Right ventricle
A
- Receive blood from the right atrium and then passes it through the pulmonary valve into the pulmonary artery.
- Split into inflow and outflow portion again.
- Inflow is split into trabeculae carnae ( bridges - attached at each end with conduction bundles running along, ridges - connected in full length to the inferior surface of the ventricles and pillars - attach to chorade tendarniae to attach to valve leaflets.
- Outflow portion is smooth.
- Makes the anterior border of the heart.
32
Q
Intraventricular Septum
A
- Between the two ventricles - has a muscular part (makes up the majority and is the same thickness as the left ventricle wall) and a membranous part.
33
Q
Left ventricle
A
- Receives oxygenated blood from the left atrium via the mitral valve and then passes blood out the aortic valve into the ascending aorta.
- Has an inflow and outflow portion also.
34
Q
Atrioventricular Heart Valves
A
- Close when ventricle systole occurs, 1st heart sound.
- Tricuspid valve: between RA and RV and as 3 leaflets (anterior, septal and posterior).
- Mitral valve: between LA and LV and has 3 leaflets (Anterior and posterior).
35
Q
Semi Lunar Heart Valves
A
- Close when ventricle diastole occurs, 2nd heart sound.
- Pulmonary valve: between RV and PA and has 3 leaflets (Right, left and anterior).
- Aortic valve: between LV and AA and has 3 leaflets (Left, right and posterior).
- In terms of the coronary arteries, these start at the sinus that are filled by blood following ventricle diastole, once the sinuses are filled this can then pass into the left and right coronary arteries to supply the myocardium and also causes the valves to close.
36
Q
What does the left coronary artery divide into?
A
- Circumflex that travels to the posterior of the heart and also splits off to become the left marginal travelling anteriorly and the left anterior descending artery, travelling down the anterior of the heart - Most commonly causes MI.
37
Q
What does the right coronary artery divide into?
A
- Longer than the left coronary artery, divides into the posterior descending artery travelling around the back of the heart and also the right marginal.
38
Q
What is the thyroid gland?
A
- Found in the anterior neck, spanning from C5 to T1.
- It is found in the visceral compartment, with the trachea, pharynx and oesophagus and is bound by a pretracheal fascia.
- It has two lobes, bound by a isthmus.
- It is behind the sternohyoid and sternothyroid muscle and wraps the cricoid cartilage and the superior tracheal rings. It is inferior to the thyroid cartilage.
