Cardiovascular Flashcards
What nerve crosses the lateral borders of the pericardium?
Phrenic nerve
What is the function of the epicardium on the surface of the heart>
To secrete pericardial fluid
What is cardiac tamponade
Where pressure around the heart builds due to the pericardial cavity filling with fluid which can prevent contraction
What is pericardiocentesis? How is the entry point for it indicated?
Where a needle is inserted via the infrasternal angle as indicated by the xiphoid process and drains fluid in the pericardial cavity
What manouvere is performed by surgeons allowing them to identify and isolate the great vessels of the heart for open heart surgery?
Transverse pericardial sinus
What groove of the heart does the right coronary artery lie in?
Coronary groove
What groove of the heart does the LAD artery lie in?
Anterior interventricular groove
What do all of the coronary veins drain into?
The coronary sinus
What are some of the features of the right atrium?
Opening for SVC and IVC
Opening for the coronary sinus
Oval fossa
Crista terminalis (smooth muscle ridge)
Describe the heart valves in terms of types of cusps
Pulmonary; semilunar with anterior right and left cusps
Aortic; semilunar with anterior right, left and posterior cusps
Tricuspid; leaflet, tendinous cords, papillary muscle, anterior, posterior and septal cusps
Mitral; leaflet, anterior and posterior cusps
Give some features of the interior left atrium
Openings for pulmonary veins
Remains of foramen ovale
Name the places to ausculate for the 4 valves?
Aortic; right 2nd intercostal sternal edge
Pulmonary; left 2nd intercostal sternal edge
Tricuspid; left 4th intercostal sternal edge
Mitral; apex beat 5th intercostal mid clavicular USUALLY
What valves make the 1st heart sound? Lub
Tricuspid and mitral closing
What valves make the second heart sound? Dub
Pulmonary and aortic closing
At what vertebral levels do the sympathetic nerves exit the spinal cord?
T1-L2/3
At what vertebral level are the cardiopulmonary splanchnic nerves exiting the spinal cord?
T1-T5
What cranial nerves are responsible for parasympathetic stimulation?
CN III occulomotor nerve
CN VII facial nerve
CN IX glossopharyngeal nerve
CN X vagus nerve
Define radiating central chest pain
Where pain is felt in the centre of patients chest and felt spreading to another location, commonly back, jaw, neck
What part of the brain is responsible for processing somatic sensations?
Postcentral gyrus of the parietal lobe (sensory strip )
What part of the brain is responsible for contractions of skeletal muscle?
Precentral gyrus of frontal lobe (Motor strip)
What structure does the right vagus nerve cross in the mediastinum? Moving posterior or anterior to root of the lung?
The trachea and oesophagus
Posterior
What structure does the left vagus nerve cross in the mediastinum? Moving posterior or anterior to root of the lung?
Aorta
Posterior
Does the phrenic nerve pass anterior or posterior to the root of the lung on the left and right side?
Anterior, also lying lateral to the pericardium
Where does the thoracic duct lie?
The duck between two gooses
Between the azygous vein and the oesophagus
Describe visceral pain
Dull, aching, poorly localised
Describe somatic pain
Sharp localised
What are the common coronary vessels to be blocked
Right coronary artery
LAD
Circumflex
Left coronary artery
What are the commonly used grafts in coronary artery. Bypass grafting? (CABG)
Saphenous vein
Mammary artery (internal thoracic)
Radial artery
What is the blood supply to the nodes and bundle branches of the heart
Posterior interventricular artery
LAD/ anterior interventricular artery
What is the function of the left thoracic duct?
Carries lymph to left venous angle
Function of azygous vein/?
Carry venous blood from intercostal veins to SVC
What is the cisterna chyli
Swollen start of thoracic duct in the abdomen
What does the L. Reccurent laryngeal hook underneath?
Arch of aorta
What does the R. /Reccurent laryngeal hook underneath?
Left subclavian artery
What type of fibres pass through anterior rami
Sensory nerve fibres
What does the phrenic nerve supply?
- mediastinal parietal pleura
- fibrous pericardium
- diaphragmatic parietal pleura
- diaphragmatic parietal peritoneum
How can pain be referred from the diaphragm to the shoulder?
As the supraclavicular nerves also exit the spinal cord at level C3,4 similar to the phrenic nerve (C3,4,5) this can cause the brain to refer the pain to the more superficial structure
Does the right or left venous angle drain the majority of the lymph from the body (3/4 including left upper, and lower parts)
Theleft venous angle as supplied by the thoracic duct
Nerve lies anterior to the hilum of trhe lung. What is it
Phrenic
Nerve lies posterior to the hilum of trhe lung. What is it
Vagus
What are the 4 most common places for coronary artery occlusion in descending order
- LAD
- Right coronary artery
- Circumflex branch of LCA
- Left coronary artery
What are the most common vessels used in CABG
Great saphenous vein
Radial artery
Internal thoracic artery
Define aortic dissection
Split of the artery 2cm above the AV valve causing blood to fill int eh vessel wall
What syndrome makes it more likely to get aortic dissections?
Marfans
Where is the azygous vein located?
On the right side passing posterior to the root of the lung
Immediately superior the lung draining into the SVC
What areas of the body drain into the left venous angle?
The upper left quadrant
Lower limbs and abdomen
What areas of the body drain into the right lymphatic duct
Upper right quadrant
Where is the right bagus nerve found in the mediastinum
On the trachea posterior to the lung root
Where would you locate the left vagus nerve within the mediastimum
Crosses the arch of aorta anterior to the root of the lung
What lymph nodes when swollen may compress the recurrent laryngeal nerve
Tracheobronchial lymph nodes
