cardiovascular anatomy Flashcards
pulmonary circulation pressure
12 – 16 mmHg
corners of the heart
3rd R CC
6 R CC
2nd L CC
Left 5 interspace mid clavicular line
Lateral supraclavicular nerve
supplies skin over shoulder, which is the C4 dermatome
C3 , 4
what does the right coronary artery supply
walls of RA and RV SAN and AVN nodes post part of interventricular septum part of LA and LV His
what is an inferior infarct
obstruction of right coronary artery
what does the LCA supply
walls of LV and LA
most of interventricular septum
what is an anterior infarct
obstruction of LAD
what artery is most commonly affected by atherosclerosis
LAD
what is a lateral infarct
obstruction of the circumflex
what vessels may be used in a CABG
great saphenous vein
LIMA
left internal throracic
where will a percutaneous transluminal coronary angioplasty first be inserted
femoral artery
what artery accompanies the great cardiac vein
LAD
what artery accompanies the middle cardiac vein
post interventricular
what artery accompanies the small cardiac vein
right marginal
which veins do not drain into the coronary sinus
venae cordis minimi
where does the descending aorta start and end
angle of Louis
to aortic hiatus T12, behind the crura and median arcuate ligament
lies on the left of the vertebral bodies then moves to the midline
what are the branches of the thoracic aorta
oesophageal arteries (middle third oesophagus)
9 posterior intercostals
subcostal arteries(supply posterior abdo wall)
bronchial arteries
other small arteries
where does the middle oesophagus drain to
azygous vein
where do the internal thoracic arteries branch from
subclavian arteries
what branches from the internal thoracic
anterior intercostals
where is the oesophagus
starts at c6
25 cm long
immediately anterior to the vertebral column
pierces the diaphragm at t10
what is the function of the cricopharyngeal sphincter
stops the swallowing of air into stomach
what supplies the superior part of oesophagus
inferior thyroid arteries
brachiocephalic veins
reccurent laryngeal nerves
deep cervical nodes
what supplies the middle oesophagus
oesophageal arteries
azygous system
oesophageal plexus
tracheobronchial nodes
what supplies the inferior third of oesophagus
left gastric artery
left gastric veins and then portal vein
oesophageal plexus
left gastric and coeliac nodes
how do oesophageal varices form
liver cirrhosis
increased portal pressure
blood enters submucosal veins via porto systemic anastomosis
enters azygous
what are the 4 oesophageal constrictions
upper oesophageal sphincter
arch of aorta
left main bronchus
diaphragm (lower oesophageal sphincter)
what is the thoracic duct a continuation of
cisterna chyli
lies between the aorta and the azygous vein
what is a chylothorax
a type of pleural effusion. It results from lymph formed in the digestive system called chyle accumulating in the pleural cavity due to either disruption or obstruction of the thoracic duct eg surgery
where does the thoracic duct enter the thorax
aortic hiatus t12 with the azygous vein
what does the azygous vein drain
posterior wall of the thorax and parts of the abdomen
what ribs does the breast overlay
2-6
contains 16 ducts
what structures pass through the thoracic inlet and lie on the first rib
subclavian vein
subclavian artery
inf trunk brachial plexus
what makes up the thoracic outlet
t12
ribs 11 and 12
costal cartilage 7-10
xiphoid cartilage
what are the 4 corners of the heart
3rd right CC
6th Right CC
2 L CC
5 left is mid clavicular line
where is the thymus
jugular notch to 4th CC
what is the blood supply of the thymus
internal thoracic and inferior thyroid arteries
venous to left brachiocephalic vein
what nerve lies to the right of the trachea
right vagus
what nerve lies to the right of SVC
phrenic
structures on the left of the mediastinum are related to what
arteries and the left ventricle
what nerve lies on the arch of the aorta
left vagus
what nerve lies on the left ventricle
left phrenic
describe the mediastinal planes
thymus 1 venous plane vagus and phrenic 2arterial plane 3 trachea and oesophagus
where is the SVC origin found
behind 1st right costal cartilage
where does the azygos vein join the SVC
behind the 2nd right costal cartilage
where does the svc enter the right atrium
posterior to 3rd right cc
where does the brachiocephalic trunk divide
posterior to the right sternoclavicular joint
where does the left superior intercostal vein lie
lies on arch of the aorta between vagus and phrenic
passes into the left brachiocephalic vein
drains the 2, 3, 4 IC spaces
where is the trachea
c6 - t4/5
includes trachealis muscle
where is the left recurrent laryngeal nerve
between the trachea and oesophagus
where is the thoracic duct
in between the aorta and azygos vein
crosses behind the oesophagus and t4/5 to ascend on the left
then arches over the apex of the left lung and enters the junction of the left internal jugular and left subclavian vein at the left brachiocephalic
where is the LRLN
inferior to the ligamentum arteriosum before ascending between the trachea and oesophagus to reach the larynx
where do the mediastinal nodes lie
around the carina
superior tracheobronchial or inferior tracheobronchial
drain the lungs and hila so involved in metastasis
where are the anterior mediastinal nodes
around the brachiocephalic veins
drain to thoracic duct or right lymphatic duct and communicate with the deep cervical nodes
therefore lung cancer can cause palpable neck nodes
where is the posterior mediastinum
below IV disk at t4/5
behind the pericardial sac and diaphragm
to posterior attachment of diaphragm at t12
how many posterior intercostal arteries are there and what do they supply
9
ic spaces 3-11
subcostal arteries lie inf to 12th rib and supply post abdo wall
how many bronchial arteries are there
2 on the left and one on the right
direct branch of thoracic aorta
where does the middle oesophagus drain to
azygos
because its supplied by the aorta
what passes through the right crus of the diaphragm
oesophagus
what contributes to the physiological cardiac sphincter
oblique entry into stomach
right crus of diaphragm
resting tone in smooth muscle
this prevents gastric reflux
what does the phrenic supply
diaphragm motor sensory: central tendon of the diaphragm, its parietal pleura and underlying parietal peritoneum sensory from mediastinal parietal pleura sensory from pericardium
a branch of the cervical plexus
what is the value of the supraclavicular nerve
c3, 4
supplies skin over shoulder which is the c4 dermatome
hence referred pain
what 3 vessels lead into the RA
IVC SVC coronary sinus
where are the musculi pectinati and crista terminalis found
RA, anterior wall
where is the SAN
close to the opening of SVC
where is the AVN
septum between the opening of the coronary sinus and tricuspid valve
what is the limbus fossa ovalis
the border of the fossa ovalis
where are the trabeculae carneae found
ventricles
what is the Septomarginal trabecular aka moderator band
found in the right ventricle
carries impulse to the papillary muscles
how many cusps does each papillary muscle send chordae to
2
what is the function of the cardiac skeleton
supports the valves and myocardium
electrically separates the atria and ventricles
describe the route of the vagus nerve
carries parasympathetic fibres
arises in the medulla oblongata
passes out of the skull with the internal jugular vein
passes into the carotid sheath
lies between the arterial and venous planes
leaves the thorax with the oesophagus
also innervates striated muscles of the pharynx and larynx plus sensory fibres
what nerves make the oesophageal plexus
both vagi
also contribute to the pulmonary and cardiac autonomic plexi. they synapse close the viscus
where is the right rln
below subclavian (4th arch)
what do sensory neurones develop from
neural crest cells
what do parasympathetic nerves supply
head, neck and viscera
not skin or limbs
what do sympathetic nerves hitchhike with
somatic nerves / arteries
where is the stellate ganglion
neck of the 1st rib
what is the sympathetic supply of the UL
t4-6
what is the sympathetic supply of the thoracic and abdo walls
t1-12
matches the dermatomes
what is the sympathetic supply of the LL
t12 -L2
what dermatomes is cardiac pain referred to
t1/2 -medial aspect of left arm
what supplies the pulmonary plexus
t2-4
what supplies the oesophageal plexus
t4-6
what supply do blood vessels have
sympathetic only
