Cardiovascular System Flashcards
Define the term “mediastinum” and describe its subdivisions. Give an example of a structure found in each subdivision (1, 3, 5)
Mediastinum - contents of the thorax other than the lungs and their pleurae. Means “standing in the middle of the chest”
The sternomanubrial plane (at T4) divides the mediastinum into Superior and Inferior mediastinum. Inferior subdivided into: Anterior, Middle, Posterior
Anterior: Thymus
Middle: Heart, pericardium, great vessels
Posterior: Descending aorta, oesophagus, thoracic duct, azygous vein, sympathetic chain
Describe the position of the heart and major blood vessels in the mediastinum
Anterior (2)
Posterior (3)
Lateral (2)
Inferior (2)
Superior (3)
Anterior: Sternum, costal cartilage 4-7
Posterior: Oesophagus, descending aorta, vertebrae T5-8 in recumbent position
Lateral: Pleura, phrenic nerve
Inferior: Central tendon of diaphragm, inferior vena cava
Superior: Aorta, pulmonary artery, superior vena cava
Describe which atria and ventricles are at the:
Right border (1)
Left border (1)
Superior border (2, neither is atrium/ventricle)
Inferior border (2)
Anterior surface (3)
Inferior surface (2)
Posterior surface (1)
Right border: Right atrium
Left border: Left ventricle
Superior border: R+L auricles, great vessels
Inferior border: Right and left ventricle
Anterior surface: 1/3 right atrium, 2/3 right and left ventricle
Inferior surface: Right and left ventricle
Posterior surface: Left atrium
Describe the tissue layers of the heart from inside to outside (6)
Endocardium
Myocardium
Serous pericardium (Visceral)
Pericardial cavity
Serous pericardium (Parietal)
Fibrous pericardium
Describe the intrinsic (5) and extrinsic (3) innervation of the heart
Intrinsic, modified externally by cardiac plexus:
SA node
AV node
Bundle of His
Purkinje fibres
Heart wall & heart wall vessels
Extrinsic:
Phrenic nerves: Innervate fibrous pericardium and parietal serous pericardium. Carries pain sensation
Vagus nerves (parasympathetic): Innervate myocardium and visceral serous pericardium
Sympathetic nerves: T1-4 innervate myocardium and visceral serous pericardium. Cause referred pain
Describe the surface markings of the “apex beat” and heart valves, including the areas for valve auscultation.
Apex beat: 5th intercostal space, left midclavicular line
Aortic: Right 2nd intercostal
Pulmonary: Left 2nd intercostal
Tricuspid: Left 4th intercostal
Mitral: Left 5th midclavicular
Identify the heart chambers in the anatomical position and in cross section
Anatomical position:
Top right - right atrium
Top left - left atrium
Bottom right - right ventricle
Bottom left - left ventricle
Cross section:
Looks like diamond
12 o’clock - Right ventricle
3 o’clock - left ventricle
6 o’clock - left atrium
9 o’clock - right atrium
Identify the main anatomical features of the right atrium (5)
Openings for IVC, SVC, Coronary sinus
Interatrial septum
Fossa ovalis in interatrial septum
Musculi pectinate (pectinate muscles)
Tricuspid valve
Identify the main anatomical features of the right ventricle (5)
Tricuspid valve (with 3 valve cusps, chordae tendineae, 3x papillary muscles)
Trabeculae carneae (contractile fleshy struts)
Moderator band (septomarginal trabeculum) to prevent suction which might occur with a flat surface, impairing heart’s ability to pump
Opening for pulmonary trunk
Interventricular septum
Identify the main anatomical features of the left atrium (3)
Openings for R+L superior+inferior pulmonary veins
Bicuspid/mitral valve
Smooth walled, small chamber
Identify the main anatomical features of the left atrium (5)
Bicuspid (mitral) valve with 2 valve cusps, 2 papillary muscles, and a chordae tendineae
Trabeculae carneae
Opening for aorta
Interventricular septum
Wall is 3x thicker than R ventricular wall
Identify the main vessels of the chest and trunk
Arteries
Internal thoracic artery
Aorta - ascending, arch, descending
Arch gives rise to - brachiocephalic artery (right subclavian and right common carotid artery); left common carotid artery; left subclavian artery
Vein
Internal thoracic vein
Vena cava - inferior and superior, which lie to the right of aorta
Azygos vein
Lymphatics
Right lymphatic duct
Thoracic duct
Identify the main vessels of the upper limb from proximal to distal
Arteries:
Subclavian
Axillary
Brachial
Radial and ulnar
Digital
Veins:
Cephalic - travels up lateral side of limb
Basilic - travels up median side of limb
Median cubital - connects cephalic and basilic in cubital fossa
Identify the main vessels of the lower limb from proximal to distal
Arteries:
External iliac
Common femoral
Superficial and deep femoral
Popliteal
Anterior and posterior tibial
Fibular
Dorsalis pedis
Digital
Veins:
Femoral vein
Great (long) saphenous vein
Popliteal
Small saphenous
Superficial veins
Dorsal venous arch of foot
Locate the main arterial pulse points of the body
Superficial temporal and facial (external carotid)
Common carotid (aortic arch)
Brachial (axillary)
Radial (brachial)
Femoral (ext. iliac)
Popliteal (femoral)
Post. tibial (popliteal)
Dorsalis pedis (ant. tibial)
Describe the structures which give rise to the surface landmarks - the jugular (suprasternal) notch, sternum, sternal angle, xiphoid process, intercostal spaces, clavicles, midclavicular line, midaxillary line, mid-scapular line
Describe and demonstrate the internal thoracic arteries and veins
Describe and demonstrate the pericardium and its attachments to related structures in the thorax
Define normal heart size radiologically and demonstrate that you can, from a PA chest x-ray correctly interpret heart size
Define and demonstrate anatomically and radiologically the names and distribution of the coronary arteries - the right and left coronary arteries, right marginal, the anterior interventricular (left anterior descending) and circumflex branches, the posterior interventricular artery (posterior descending)
Define and demonstrate the main features and functions of the atria, ventricles, interatrial and interventricular septa, heart valves, chordae tendineae, papillary muscles, orifices of the coronary arteries and opening of the coronary sinus
Explain the route the blood follows through the heart and demonstrate this using radiological images
Explain the relative bulk of the ventricles
Demonstrate anatomically and radiologically the normal central position in the chest of the mediastinum and its contents
Describe and demonstrate anatomically and radiologically the position and relations of the aorta (the ascending part, the arch, the descending part)
Describe and demonstrate anatomically and radiologically the position and relations of the trachea, main bronchi and oesophagus
Define and demonstrate the territory of supply of the coronary arteries.
Describe the venous drainage of the heart wall
Describe and demonstrate the main branches of the aortic arch and define their territory of supply
Describe and demonstrate the position and relations of the superior vena cava and inferior vena cava and their main tributaries
Describe and demonstrate the position and relations of the vagus and the phrenic nerves
Describe and demonstrate the pulmonary veins and define their function
Describe the surface anatomy of the heart and the locations for heart valve auscultation
Describe the main arterial supply and venous drainage routes of the trunk and limbs
Identify the main histological features of the heart and major blood vessels in light microscopic images
Describe the main regional veins that are useful in venipuncture and cannulation
Describe the internal jugular vein pulse and briefly describe the anatomical features used to locate its position
Describe the layers of blood vessels - tunica intima, media and adventitia - and name the main cellular components of each layer.
Describe the difference in structure of the 3 types of capillary and lymphatic vessels.
Describe the histological differences between an elastic artery and a muscular artery, and give an example of each type.
Briefly explain the purpose of an “arteriovenous shunt”.
