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My Cardiovascular > Cardiovascular anatomy > Flashcards

Cardiovascular anatomy Flashcards

1
Q

What is the pericardium?

A

It is a membrane which covers the heart it consists of two layers.

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2
Q

What is the serous pericardium divided into?

A
  1. visceral serous pericardium (in contact with heart).

2. parietal serous pericardium ( in contact with fibrous pericardium).

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3
Q

What does the epicardium secrete?

A

Pericardial fluid lubricant - allows for movement of the heart

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4
Q

What is the epicardium also known as?

A

Visceral serous pericardium.

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5
Q

What is haemopericardium

ii. What is the name of the process to treat this?

A

When the pericardium fills with blood.

ii. Pericardiocentesis

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6
Q

What is the name of the condition when build up in pressure around the heart prevents contractions?

ii. where is the needle inserted?

A

cardiac tamponade.

ii. Via infrasternal angle and directed superopostierioly

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7
Q

What is the tranverse pericardial sinus?

why is this important?

A

Space within the pericardial cavity, posterosuperiorly

ii. Cardiac surgeons use this sinus to identify and isolate the great vessels in order to commence cardiopulmonary bypass

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8
Q

Name all the great vessels connected to the heart.

A

Veins.

  1. Superior vena cava
  2. inferior vena cava
  3. right and left pulmonary veins

arteries

  1. aorta
  2. right and left pulmonary arteries

pulmonary trunk ( divides into right and left pulmonary arteries

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9
Q

What are the heart’s surfaces?

A
  1. sternocostal surface (Anterior)
  2. posterior surface (posterior)
  3. diaphragmatic surface (inferior)
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10
Q

What are the boarders of the heart?

A

right (lateral) border
left (lateral) border
Inferior border
Superior border

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11
Q

What is the apex of the heart?

A

The base of the heart ( normally to the left side)

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12
Q

How do you find the palpation of the apex of the heart?

A

5th left intercostal space in the midclavicular line.

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13
Q

What shifts the apex beat to the left of the heart?

A

Cardiac enlargement (cardiomegaly)

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14
Q

Name the nerves related to the heart.

A
  1. Vagus nerve

2. phrenic nerve

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15
Q

What are the auricles used for ?

A

It is the extensions of both atrium allowing for extra blood to enter them

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16
Q

What is the coronary groove?

A

this groove indicates the surface marking for the tricuspid valve (boundary between right atrium and right ventricle)

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17
Q

Coronary sinus divides what surfaces?

A

Diaphragmatic on top of it and base bellow it.

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18
Q

Interatrial groove indicates what?

A

indicates boundary between the 2 atria

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19
Q

anterior interventricular groove indicates what?

A

the boundary between the 2 ventricles.

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20
Q

Name all the coronary arteries and branches.

A
  1. right coronary artery
  2. left coronary artery
  3. right marginal artery
  4. left marginal artery
  5. posterior interventricular artery
  6. circumflex artery
  7. lateral branch
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21
Q

What is the role of the coronary sinus?

A

short venous conduit which receives deoxygenated blood from most cardiac veins draining into the right atrium.

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22
Q

what are the two parts to the septum?

A
  1. interatrial septum

2. interventricular septum

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23
Q

What is a septal defect refer to?

A

hole in the septa which allows mixing of arterial and venous blood.

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24
Q

What is hypoxaemia?

A

reduction in the oxygen content of systemic arterial blood in the aorta

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25
Q

Name the 4 valves

ii. where are they located?

A
  1. Tricuspid valve-between right atrium and ventricle
  2. Pulmonary valve ( right ventricle and pulmonary trunk)
  3. Mitral valve ( left atrium and ventricle)
  4. Aortic valve (left ventricle and aorta)
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26
Q

Name the two types of valves.

ii. what type of sounds do they make

A
  1. Semilunar (dub sound 2nd) - when closed

2. leaflet ( lub sound 1st) - when closed

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27
Q

What are the roles of tendinous chords and papillary muscles ?

A

prevents prolapse of blood.

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28
Q

What is the role of the moderator band?

A

Carries fibres of right bundle branch to the papillary muscle of the anterior cusp. provides a electrical activity shortcut for the anterior papillary muscle so coordinated contraction of all papillary muscles associated with the tricuspid valve occurs.

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29
Q

What are the three layers of the heart?

A

Endocardium

Myocardium

Epicardium

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30
Q

What do the lub and dub sounds represent?

blood flow not valves

A
  1. Lub sound - transferring of blood from atria into ventricles.
  2. Dub sound - Ventricles expel blood from the heart.
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31
Q

Why do the ventricles produce a wringing motion when they contract?

A

Because f the double helical orientation of the cardiac muscle fibres.

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32
Q

What are the names of the two spirals associated with cardiac muscle fibre?

A

Basal spiral - (outer)

Apical spiral - (inner)

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33
Q

What makes up the skeleton of the heart?

ii. What do they cover?

A
  1. Four fibrous rings made of dense collagen.
    ii. Each ring encircles a valve, two trigones and the membranous portions of the interatrial ,interventricular and atrioventricular septum.
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34
Q

What is the role of the skeleton of the heart?

A
  1. keeps the orifices of the AV and seminular valves patent and prevents them from being overly distended.
  2. Provides attachment for the myocardium.
  3. Provides attachment for the cusps of all the valves.
  4. Forms an electrical insulator by separating the myenterically conducted impulses of the atria and ventricles.
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35
Q

What is the apex beat?

A

Where the sound of the mitral valve closure are maximal.

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36
Q

Where is the apex beat located?

A

Lies posterior to the 5th intercostal space in adults. Usually a hands breadth (9cm) from the medial plane.

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37
Q

What is the difference between the base and apex of the heart?

A

Base of the heart is posterior aspect which is opposite to apex.

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38
Q

Where does the right atrium receive blood from?

A
  1. Inferior vena cava
  2. superior vena cava
  3. coronary sinus
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39
Q

What is the role of the right auricle?

A

Increases capacity of atrium.

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40
Q

What is the tranverse pericardial sinus?

ii. What is it used for?

A

A “space” within the pericardial cavity,posterosuperiorly

ii. By surgeons to isolate the great vessels for coronary bypass.

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41
Q

Where is the thoracic inlet found?

A

It is bounded by the rib 1, T1 vertebra and jugular notch

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42
Q

The sternal angle divides what?

A

the superior and inferior mediastinum.

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43
Q

What is the thymus replaced by after puberty?

A

Thymus involutes and becomes fatty forming adipose tissue.

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44
Q

Where do both vagal trunks pass through?

A

The diaphragm with the oesophagus onto the stomach.

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45
Q

The thoracic aorta is the only thoracic part of the aorta to be found where?

A

In the posterior mediastinum.

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46
Q

What is the first branch of the ascending aorta?

A

coronary arteries

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47
Q

What is the second branch of the ascending aorta?

A

Brachiocephalic trunk

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48
Q

Where does the thoracic duct drain lymph fluid?

A

The left venous angle

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49
Q

How does the lymph drain from the lungs?

A

tracheo-bronchial lymph nodes (around the bifurcation of the trachea

right lymphatic duct

thoracic duct

left venous angle

bronchopulmonary lymph nodes (surround the main bronchus at the lung root)

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50
Q

What are the role of the phrenic nerves?

A 
formed from combined anterior rami of cervical spinal nerves 3, 4 & 5
somatic motor to the diaphragm
somatic sensory to:
mediastinal parietal pleura
fibrous pericardium
diaphragmatic parietal pleura
diaphragmatic parietal peritoneum
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51
Q

What does the vagus nerves contain? e.g. cranial nerve X

A

somatic sensory nerves for the palate, laryngopharynx & larynx

somatic motor nerves for the pharynx & larynx

autonomic parasympathetic nerves for thoracic and abdominal organs

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52
Q

What is the fibrous pericadium lined with?

A

parietal serous pericardium

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53
Q

Where is the right coronary artery found in?

A

Coronary groove

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54
Q

where is the Left anterior descending artery?

A

anterior interventricular groove

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55
Q

What do the coronary branches supply?

A

epicardium and myocardium

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56
Q

What are coronary branches normally embedded in?

A

Adipose tissues

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57
Q

What is the main stem of the coronary arteries?

A

Left coronary artery

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58
Q

Where do the coronary arteries arise from?

A

aortic sinuses of the ascending aorta

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59
Q

where is the left coronary artery found?

A

Left atrioventricular groove between pulmonary trunk and left auricle

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60
Q

Where is the right coronary artery found?

A

right atrioventricular groove

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61
Q

where is the coronary sinus found?

A

atrioventricular groove posteriorly

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62
Q

What do the grooves of the heart septums show?

A

position of the heart septum which divides the left and right heart

divides the Internal chambers too

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63
Q

Which groove shows where the interatrial septum is?

A

interatrial groove

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64
Q

which groove shows where the interventricular septum is?

A

anterior interventricular groove

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65
Q

What is the difference between the semi lunar and atrioventricular valves?

A

semilunar valves’ cusps don’t have tendinous chords attached and are smaller

semilunar valves have chordae tendinae

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66
Q

Which valves are the semilunar valves?

A

Pulmonary and aortic valves

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67
Q

Which valves are the leaflet valves?

A

Mitral and tricuspid

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68
Q

How many cusps has the pulmonary valve got?

A

3 - anterior, right and left

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69
Q

How many cusps has the aortic valve got?

A

3- right, left and posterior

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70
Q

How many cusps has tricuspid got?

A

3 - anterior, posterior and septal

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71
Q

How many cusps has mitral valve got?

A

2- anterior and posterior

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72
Q

what is the general rule when auscultating cardiac valves?

A

Follow direction of normal blood flow through the valve until the edge of the sternum is located and auscultate

(slightly different for mitral)

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73
Q

Where is the anatomical position of the aortic valve?

A

2nd right intercostal sternal edge

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74
Q

Where is the anatomical position of the pulmonary valve?

A

2nd left intercostal sternal edge

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75
Q

What is the anatomical position of the tricuspid valve?

A

4th left intercostal sternal edge ( lower left edge)

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76
Q

Where is the anatomical position of the mitral valve?

A

5th left intercostal space on the midclavicular line

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77
Q

How do autonomic innervation and visceral afferent nerves reach the heart?

A

via cardiac plexus

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78
Q

What controls visceral reflex afferents?

A

barorecptors

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79
Q

How do reflex afferents mainly travel?

A

mainly via vagus nerve (CN X)

however
some do travel via glossopharyngeal nerve ( CN IX)

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80
Q

Describe the course of sympathetic signals from the CNS heart.

A
  1. Travels inferiorly within spinal cord tracts
  2. Travels both the superior, middle and inferior cervical sympathetic ganglia
  3. synapse at T1-T5 ganglia and cervical ganglia
  4. bilateral postsynaptic fibres travel via cardiopulmonary splanchnic nerves
  5. travel through cardiac plexus and end at SA and AV nodes in relation to the termination of parasympathetic fibers on the coronary arteries
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81
Q

Describe the course of parasympathetic signals to the heart?

A
  1. Presynaptic parasympathetic fibres originate in the vagus nerve
  2. Synapses onto postsynpatic neurones. Postsynaptic cell bodies are located in the atrial wall and interatrial septum near the SA and AV nodes. along the coronary arteries.
82
Q

what do action potentials originating at the precentral gyrus of frontal lobe cause?

A

Contractions of body wall skeletal muscle

83
Q

What do action potentials arriving at the postcentral gyrus of pareital love cause?

A

Body wall sensations into the consciousness

84
Q

What separates the frontal lobe and parietal lobe?

A

central sulcus

85
Q

Where do sensory APs arrive when the left side of the chest wall is touched?

A

Postcentral gyrus of right cerebral hemisphere

86
Q

What is the pathophysiology of herpes zoster (shingles)

A

Reactivation of dormant virus in posterior root ganglion

87
Q

Where is pain felt with Herpes zoster?

A
  1. Anywhere in that dermatome

2. If in T4/5 dermatome pain may be central chest pain

88
Q

Give example of musculoskeletal causes for central chest pain?

A
  1. Pectoralis major or intercostal muscle strain
  2. dislocated costocondral joint
  3. Costovertebral joint inflammation
  4. ‘Slipped’ thoracic intervertebral disc
89
Q

What are the main sourse of dull (visceral) central chest pain?

A
  1. Trachea - tracheitis
  2. aorta - ruptured aneurysm of aortic arch
  3. oesophagus - oesophagitis
  4. heart ( angina and myocardial infarction)
  5. Abdominal viscerae (Gastritis,cholesystitis, pancreatitis,hepatitis)
90
Q

What are the subdivisions of the mediastinum?

A
  1. Superior

inferior

  1. anterior
  2. middle
  3. posterior
91
Q

where is the heart found?

A

middle mediastinum

92
Q

What are the main structures found in the right side of the mediastinum?

A

(VENOUS SIDE)

  1. Oesophagus
  2. trachea

Right Lung

  1. Right vagus nerve
  2. SVC
  3. IVC
  4. right phrenic nerve
  5. diaphragm
  6. azygous vein
  7. right sympathetic chain
  8. right abdominopelvic splanchnic nerves
93
Q

What are the main structures of the left side of the mediastinum

A

(ARTERIAL SIDE)

  1. Thoracic duct
  2. Arch of aorta
  3. recurrent laryngeal branch of left vagus nerve
  4. Ligamentum arteriosum- remant of ductus arteriosus
  5. Left lung
  6. Diaphragm
  7. oesophagus
  8. thoracic aorta
  9. left sympathetic chain

10 Left phrenic nerve

  1. Left abdominopelvic splanchnic nerves
94
Q

What are the main structures of the posterior mediastinum?

A
  1. Oesophagus
  2. trachea and the 2 main bronchi
  3. Thoracic aorta
  4. Azygous vein
  5. right and left sympathetic chains
  6. thoracic duct
  7. 2 vagus nerves
  8. both vagal trunks
95
Q

What is difference between the role of cardiopulmonary splanchnic nerves for sympathetic signals and pain visceral afferents?

A
  1. sympathetic nerves travel to chest organs

2. Pain visceral afferents travel from chest organs

96
Q

what happens to the visceral afferent’s APs once it arrives at the brain?

A
  1. Pass bilaterally to the thalamus and hypothalamus

2. Then diffuses tot areas of the cortex

97
Q

What is the difference between radiating and referred pain?

A

Radiating pain - pain felt both at the actual site of the pathology and also radiates

referred pain - sensation of pain is felt only at a site remote from the actual area of injury or disease

98
Q

Describe the physiology of referred pain?

A
  1. Afferent (sensory) fibres from soma and afferent fibres from visceral afferents enter spinal cord at the same levels
  2. brain chooses to believe that the pain signals coming from the organ are from the soma
99
Q

What are the classic examples of cardiac referred pain?

A
  1. Upper limbs (especially left)
  2. Back
  3. neck
  4. jaw
100
Q

Where does the right marginal artery come from?

A

right coronary artery

101
Q

Where does the Left anterior descending artery come from?

A

left coronary artery

102
Q

Where does the posterior interventricular artery come from?

A

70% of patients - right coronary artery

others can be circumflex or anastomesis of left and right coronary artery

103
Q

where does the lateral branch come from?

A

left coronary artery

104
Q

Where does the circumflex artery come from?

A

left coronary artery

105
Q

Where does the left marginal artery come from?

A

left coronary artery

106
Q

What are the main sites of coronary atherosclerosis?

A
  1. LAD of LCA
  2. RCA
  3. circumflex branch of LCA
  4. LCA
107
Q

Describe the process of Coronary artery bypass grafting? (CABG)

A
  1. grafts anastomosed proximally to ascending aorta

2. Grafts anastomosed to coronary artery distal to narrowing (bypassed it)

108
Q

What are the main vessels used for CABG graft?

A
  1. Radial artery
  2. great saphenous vein (superficial vein of the lower limb)
  3. internal thoracic artery
109
Q

Where does the SA nodal branch from?

A

RCA - near RCA origin in 60% of patients

110
Q

where does the AV nodal branch from?

A

RCA - near PIV origin in 80% of patients

111
Q

Which arteries supply the interventricular septum?

A

left side: LAD

right side: PIV

112
Q

what is the thoracic inlet bounded by?

A

ribs 1, T1 vertebra and jugular notch

113
Q

Where is the transverse thoracic plane found?

A

Sternal angle

T4/5 intervertebral disc

114
Q

Where is the anterior mediastinum found?

A

Sternum and fibrous pericardium

115
Q

What is found in the anterior mediastinum?

A

thymus

116
Q

What is found in the middle mediastinum?

A
  1. Pericardium
  2. Heart
  3. parts of the great vessels which connect with the heart:

Inferior part of SVC

Superior part of IVC

pulmonary trunk

pulmonary arteries

pulmonary veins

ascending aorta

117
Q

What does azygous vein arch over anteriorly inorder to drain into it?

A

SVC

118
Q

What are the main branches of the arch of aorta

A
  1. Brachiocephalic trunk
  2. left common carotid
  3. Left subclavian
119
Q

What are the branches from the thoracic aorta’s anterior surface?

A
  1. bronchial arteries
  2. oesophageal arteries
  3. mediastinal arteries
  4. pericardial arteries
  5. Phrenic arteries
120
Q

What are the main contents found in the superior mediastinum?

A
  1. thymus
  2. arch of aorta and the roots of its major branches
  3. Trachea
  4. oesophagus
  5. thoracic duct and lymphatic trunks
  6. SVC and brachiocephalic veins
  7. from lateral to medial
    phrenic nerves
    vagus nerves
    recurrent laryngeal nerves
121
Q

What is the thymus?

A

A primary lymphoid organ

after puberty the thymus undergoes gradual involution and is largely replaced by fat.

122
Q

Where is the thymus found?

A

Inferior part of neck

anterior part of superior mediastinum

123
Q

What are the main branches of the ascending aorta?

A

Right and left coronary arteries

124
Q

What is the origin of the arch of aorta?

A

Continuation of ascending aorta

125
Q

What is the origin of the thoracic (descending) aorta?

A

continuation of arch of aorta

126
Q

How does the aorta pass through the diaphragm?

A

aortic hiatus

127
Q

What vertebral level is the aortic hiatus?

A

T12

128
Q

When does the thoracic aorta become the abdominal aorta?

A

Once it has passed through the diaphragm (T12)

129
Q

what is the origin of the posterior intercostal arteries?

A

thoracic aorta

130
Q

What vertebral level does the thoracic aorta start?

A

Inferior border of the bod of the T4 vertebra

131
Q

At what level does the SVC join the right atrium?

A

at the third intercostal cartilage

132
Q

What does the right lymphatic duct drain into?

A

Right venous angle

133
Q

What does the thoracic duct drain into?

A

left venous angle

134
Q

What are the main lymph nodes of the lung?

A
  1. Tracheobronchial lymph nodes

2. bronchopulmonary lymph nodes

135
Q

Where are the tracheo-bronchial lymph nodes found?

A

Around the bifurcation of the trachea

136
Q

where are the bronchopulmonary lymph nodes found?

A

Surrounding the main bronchi at the lung root

137
Q

What is the swollen start of the thoracic duct in the abdomen called?

A

Cisterna chyli

138
Q

How does the oesophagus pass through the diaphragm?

A

Via the oesophageal hiatus

139
Q

the right phrenic nerve passes the diaphragm with what blood vessel in order to supply the diaphragm from the inferior aspect?

A

IVC

140
Q

what nerve passes under the ligamentum arteriosum and back to the larynx?

A

recurrent laryngeal branch of the left vagus nerve

141
Q

How does the left phrenic nerve supply the diaphragm?

A

like the right phrenic nerve it passes through and supplies it from the inferior aspect

142
Q

Define central veins

A

Veins which are close enough to the heart that pressure within them reflects the pressure of the right atrium

143
Q

What are the central veins?

A 
internal jugular veins
subclavian veins
brachiocephalic veins
superior vena cava
right atrium
inferior vena cava
iliac veins
femoral veins
144
Q

Which central veins are the most common access points in central venous cannulation?

A

Internal jugular vein

femoral vein

145
Q

name the 3 nerves that pass through the mediastinum?

lateral to medial

A
  1. Right and left phrenic nerves
  2. Right and left vagus nerves
  3. right and left recurrent laryngeal nerves
146
Q

Explain the anatomical differences between the right and the left recurrent laryngeal nerves.

A
  1. Right recurrent laryngeal nerve hooks under the right subclavian artery
  2. Left recurrent laryngeal nerve hooks under the arch of the aorta
  3. Right recurrent laryngeal nerve does not enter the chest
  4. Left recurrent laryngeal nerve does enter the chest
147
Q

What are the phrenic nerves formed from?

A

combined anterior rami of cervical spinal nerves 3,4,5

148
Q

What is the role of the phrenic nerves?

A
  1. Somatic motor to the diaphragm
  2. Somatic sensory to;

mediastinal parietal pleura
fibrous pericardium
diaphragmatic parietal pleura
diaphragmatic parietal peritoneum

149
Q

What does the supraclavicular nerves supply?

A

Dermatomes over the shoulder tip

150
Q

What verterbral level does the supraclavicular nerves originate from?

A

C3 and C4

151
Q

What type of nerves does the vagus nerve contain?

A
  1. Somatic sensory- palate,larynx and laryngopharynx
  2. somatic motor- pharynx and larynx
  3. autonomic parasympathetic - throracic and abdominal organs
152
Q

Which branches of the vagus nerve are responsible for the supplying somatic sensory and motor stimulation?

A

recurrent laryngeal nerves

153
Q

What does the left recurrent laryngeal nerves supply?

A

muscles of the larynx

154
Q

What is used to record the peripheral pulse in the neck?

A

Bifurcation of the common carotid artery

also site for auscultating carotid bruits

155
Q

Discuss the anatomical relationships of the bifurcation of the common carotid artery.

A

Anterior to sternocleidomastoid muscle at the level of the superior border of thyroid cartilage

156
Q

What is used to record the peripheral pulse in the upper limbs?

A
  1. brachial artery (proximal)

2. radial artery (distal)

157
Q

Discuss the anatomical relationships of the radial artery.

A

lateral to the tendon of the flexor carpi radialis

158
Q

Discuss the anatomical relationships of the brachial artery.

A

medial to biceps brachii tendon in the cubital fossa

159
Q

What is used to the record the peripheral pulse in the lower limbs?

From promixal to distal

A
  1. Femoral artery
  2. Popliteal artery
  3. Posterior tibial
  4. dorsalis pedis (dorsal artery of the foot)
160
Q

Discuss the anatomical relations of the femoral artery.

A

Inferior to midpoint of inguinal ligament

161
Q

Discuss the anatomical relations of the popliteal artery.

A

found in the popliteal fossa

immediately posterior to the knee joint

162
Q

Discuss the anatomical relations of the posterior tibial artery.

A

Found between the posterior border of the medial malleous and the achilles tendon

163
Q

Discuss the anatomical relations of the dorsalis pedis artery.

A

medial to tendon of extensor hallucis longus on the dorsum of the foot

164
Q

What other important roles does the radial artery have?

A
  1. Used for monitoring arterial blood pressure

2. ABG sampling

165
Q

What other important roles does the femoral artery have?

A

used for Intravascular interventions

166
Q

What other important roles does the subclavian artery have?

A

It is where cardiac pacing wire is inserted under US guidance

167
Q

What other important roles the femoral vein have?

A
  1. Where insertion of central line occurs

2. intravascular interventions

168
Q

What over role does the internal jugular vein have?

A

where cardiac pacing wire is inserted under US guidance

169
Q

What is the origin of the anterior intercostal arteries?

A

Internal thoracic artery

170
Q

What is the origin of the posterior intercostal arteries?

A

thoracic aorta

171
Q

What does the anterior intercostal vein drain into?

A

internal thoracic vein

172
Q

What does the posterior intercostal vein drain into?

A

azygous vein

173
Q

what does the cephalic vein drain?

A

upper limbs (superficial vein)

174
Q

what are the three main germ layers in embryo development?

A
  1. Endoderm
  2. mesoderm
  3. Ectoderm
175
Q

Where does the heart originate from?

A

visceral mesoderm

176
Q

What are two main processes which occur to allow the heart to move into its final position during development?

A
  1. Lateral folding

2. Cranio-caudal folding

177
Q

What fuses together to form the primitive heart?

A

the two endocardial tubes in the embryo

178
Q

What are the 5 main features of the primitive heart?

cranial to caudal

A
  1. truncus arteriosus
  2. bulbus cordis
  3. ventricle
  4. atrium
  5. sinus venosus
179
Q

What do each of the 5 main features of the primitive heart go on to form?

A
  1. Truncus arteriosus- aorta and pulmonary trunk
  2. Bulbus cordis -Trabeculated part of right ventricle and Outflow part of both ventricles
  3. Ventricle- Trabeculated part of left ventricle
  4. Atrium - both atria
  5. Sinus venosus -coronary sinus and smooth part of the right atrium
180
Q

What is the direction of blood flow in the primitive heart?

A

caudal to cranial

181
Q

What occurs around day 23 in heart development?

A

cardiac looping

182
Q

Discuss what happens during cardiac looping

A

atrium- moves dorsal and cranial

ventricle- is displaced left

bulbus cordis - moves inferiorly, ventrally to the right

183
Q

Discuss how the heart chambers form.

A
  1. Atrioventricular groove constricts the atrioventricular canal at its waist
  2. Endocardial cushions extend and form a column separating the atrium and ventricle
  3. Proliferating ventricular septum primum moves to the base of the heart.
  4. simultaneously a proliferating atrial septum primum moves to the endocardial cushions- constricts foramen primum
  5. Foramen secundum forms in the atrial septum allowing shunting of blood between the atria in both directions.
  6. septum secundum (second interatrial septum) forms over the septum primum covering most of the foramen secundum leading to the foramen ovale. This only allows shunting of blood from right to left atrium
  7. ridges from truncus arteriosus spirals down and fuse with ventricular septum allowing for blood to leave the heart.
184
Q

What do the 6 pairs of the developing aortic arches form?

A

1 and 2 are obliterated

5 is absent

Ones that matter:

  1. 3 - carotid artery
  2. 4- right subclavian vein and part of arch of aorta
  3. 6 - sprout branches which form pulmonary artery
185
Q

Are the three main veins during embryonic development?

A
  1. Vitelline vein - drain yolk sac
  2. Umbilical vein - carry oxygenated blood from placenta
  3. cardinal vein- give systemic venous system
186
Q

What does the vitelline vein develop into?

A
  1. forms part of the portal venous system which drains gut
  2. forms hepatic sinusoids and veins
  3. forms hepatic portion of IVC
187
Q

What does the umbilical vein develop into?

A

Left one is the only that remains. Becomes the definitive umbilical vein

188
Q

What do the cardinal veins develop into?

A
  1. Anterior: drain HEAD and NECK

Jugular system and Left brachiocephalic vein

SVC

  1. Posterior: drain trunk

Azygos and Hemiazygos systems (Body wall)
Gonadal and Renal veins
Iliac veins
IVC

189
Q

Explain the difference between the IVC in foetal circulation and neonatal circulation.

A

Foetal:

carries oxygenated blood from the placenta to the liver and drains into the left atrium

Neonatal:

carries deoxygenated blood from the tissues (e.g. from the liver) and drains into right atrium

190
Q

what are the three layers of the blood vessels?

(from deep to superficial)

ii. what do they consist of?

A
  1. Tunica intima- endothelium
  2. Tunica media- smooth muscle and elastic fibres
  3. Tunica externa- connective tissue
191
Q

what is an anastomses?

ii. give an example

A

where arteries connect with each other without a capillary network

ii. circle of willis (in the brain)- prevents stokes

192
Q

where is the name for alternative routes in an anastomesis?

A

collateral

193
Q

What are the main parts of the aorta?

A
  1. Ascending aorta
  2. Arch of aorta
  3. Descending (thoracic aorta)
  4. Abdominal aorta
194
Q

where does the brachial artery branch from?

A

axillary artery

195
Q

Where does the axillary artery branch from?

A

subclavian artery

196
Q

What does the brachial artery bifurcate into?

ii. where does this occur?

A

i. radial and ulna

ii. Anterior to elbow joint

197
Q

Where does superficial lymphatics drain into?

A

Deep lymphatics

198
Q

Which is bigger superficial or deep veins?

A

deep veins

199
Q

What does the LAD artery supply?

A

Apex

anterior aspect of interventricular septum

anterior aspect of right and left ventricles

200
Q

Describe the layers of a medium sized artery. Deep to superficial

A

Tunica intima

internal elastic membrane

tunica media

external elastic membrane

tunica adventitia

201
Q

What is the femoral triangle?

ii. what vasculature bundle is found here?

A

is the area on the anterior aspect of the thigh. Formed by the crossing of various muscles to form a triangular shape.

ii. Femoral artery, vein and nerve

My Cardiovascular (8 decks)

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