Cardiovascular system Flashcards
1
Q
What bony landmark represents the split between the superior and inferior mediastinum?
A
T4 sternal angle
2
Q
Which bones act as the anterior border of the superior mediastinum?
A
Manubrium
1st rib
3
Q
Which bones form the posterior border of the superior mediastinum?
A
T1-4
4
Q
What heart chambers form the right border of the heart?
A
Right atrium
5
Q
What heart chambers forms the left border of the heart?
A
Left ventricle
6
Q
What heart chambers forms the anterior border of the heart?
A
Right atrium and left atrium
7
Q
What heart chambers forms the inferior border of the heart?
A
Right ventricle, right atrium and left ventricle
8
Q
What heart chambers forms the anterior surface of the heart?
A
Right ventricle
9
Q
What heart chambers forms the posterior surface (base) of the heart?
A
Left atrium
10
Q
What heart chambers forms the inferior/diaphragmatic part of the heart?
A
Left ventricle and right ventricle
11
Q
What 4 vertebrae are posterior to the heart when supine?
A
T5 - T8
12
Q
At what vertebral level does the abdominal aorta bifurcate?
A
L4
13
Q
At what vertebral level is the aortic arch?
A
T4
14
Q
At what vertebral level does the common iliac arteries bifurcate?
A
L5
15
Q
When does the common iliac arteries arise?
A
L4
16
Q
What do the external iliac arteries supply?
A
Becomes the femoral arteries and travels on to supply lower limb
17
Q
What do the internal iliac arteries supply?
A
Supply pelvis viscera at S1
18
Q
What does the superior vena cava drain?
A
Head, neck and upper limbs
19
Q
What does the inferior vena cava drain?
A
Abdomen, pelvic cavities and lower limbs
20
Q
What are the 3 main tributaries of the superior vena cava?
A
Left and right brachiocephalic veins
Azygos vein
21
Q
What are the 2 main tributaries of the inferior vena cava?
A
Left and right common iliac veins
22
Q
What are the tributaries of the left brachicephalic vein?
A
Left internal jugular vein and left subclavian vein
23
Q
What does the azygous vein system drain?
A
Drains blood from posterior intercostal veins to the superior vena cava
24
Q
Where is the azygos vein found?
A
Just to the right of the descending thoracic aorta
25
What does the azygous vein system consist of?
Azygos vein on right side of posterior mediastinum
Hemiazygos vein on the left side of the posterior mediastinum, before draining into the azygos vein at T8/9
Accessory hemiazygous - also drains left side
26
At what vertebral level does the hemiazygos vein drain into the azygos vein?
T8/9
27
What posterior chest wall arteries arise from the descending aorta?
Posterior intercostal arteries
28
From what part of the spinal nerve are the intercostal nerves made of?
Ventral ramus
29
What anterior chest wall arteries drain into the internal thoracic vein?
Anterior intercostal veins
30
What do the anterior intercostal veins drain into?
Internal thoracic vein
31
What anterior chest wall arteries arise from the internal thoracic artery?
Anterior intercostal arteries
32
From what side of the body does the thoracic duct drain?
Left side
33
From what artery does the internal thoracic artery arise from?
The internal thoracic artery arises from the subclavian artery near its origin.
34
What two vessels drain the left posterior intercostal veins?
Hemiazygos vein on the left side of the posterior mediastinum, before draining into the azygos vein at T8/9
Accessory hemiazygous - also drains left side
35
Where is the thoracic duct located?
Between azygos vein and the descending aorta on the right side of the posterior chest wall, before crossing over to left side to empty into the left subclavian vein
36
Where does the thoracic duct commence?
As the cisterna chyli at L1
37
Where does the thoracic duct drain into?
Left subclavian vein
38
Where does the right lymphatic duct drain into?
Right subclavian vein
39
What is the most inferior part of the thoracic duct called?
Cisterna chyli (also where it commences)
40
At what bony point does the subclavian artery become the axillary artery?
Lateral border of 1st rib
41
Where on the upper limb does the brachial artery branch into the radial and ulnar arteries?
Cubital fossa (around elbow joint)
42
What are the two superficial veins of the upper limb on the forearm?
Basilic vein
Cephalic vein
(both connected by media cubital vein in cubital fossa)
43
What side of the arm is the basilic vein?
Medial side
44
What side of the arm is the cephalic vein?
Lateral side
45
What are the venae comitantes?
Accompanying veins of corresponding major arteries of the limbs
46
Of what artery is the femoral artery a distal continuation of?
External iliac artery
47
Where is the great saphenous vein found and what does it drain into?
Medial side of leg, drains into femoral vein
48
Where is the small saphenous vein found and what does it drain into?
Posterior of leg, drains into popliteal vein
49
If examining a transverse image that contains a cross-section of the heart, at what vertebral level could you be at?
T5-T8
50
What are the 3 layers of the pericardium?
Visceral layer of serous pericardium
Parietal layer of serous pericardium
Fibrous pericardium
51
Where is the pericardial cavity found?
Between the visceral layer and parietal layer of the serous pericardium
52
Which layer belongs simultaneously with the heart wall and the serous pericardium?
Epicardium
53
Describe the innervation of the visceral serous pericardium
Vagus nerve via cardiac plexus
| Autonomic innervation from T1-4
54
Describe the autonomic innervation of the visceral serous pericardium
From T1-4
55
Describe the innervation of the parietal serous pericardium and the fibrous pericardium?
Phrenic nerves, intercostal nerves
56
What layers of the pericardium detect pain?
Fibrous and parietal layer of serous pericardium via phrenic nerve
57
What makes up the posterior surface of the heart?
Left atrium
58
What are the functions of the auricles?
Increases the blood holding capacity of the atrium
59
What does the adult right auricle correspond to during embryogenesis?
Primordial atrium
60
What was the function of the foramen ovale?
Sped up travel of blood in the foetus
61
Where is the moderator band (septomarginal trabeculum) found?
Connects inferior interventricular septum with the anterior of the right ventricle
62
What is the function of the moderator band (septomarginal trabeculum)?
Carries part of right bundle branch of the AV bundle and acts as a shortcut across the chamber of the ventricle to facilitate conduction time and allow the coordinated contraction of the anterior papillary muscles.
63
What valve is found between the left atrium and left ventricle?
Mitral (bicuspid) valve
64
What vessels empty into the left atrium?
Superior and inferior pulmonary veins
65
In what children is VSD common in?
Children with Downs syndrome
66
Where does the coronary sinus drain into?
Right atrium directly
67
Where do the coronary arteries arise from?
Root of aorta (before arch)
68
Which pair of arteries anastomose in the posterior atrioventricular coronary sulcus?
Right coronary artery and circumflex artery
69
Which pair of arteries anastomose in the posterior interventricular sulcus?
Left anterior and right posterior interventricular descending arteries
70
What does the right coronary artery supply?
Right atrium and ventricle
AV node and bundle
SA node (in minority of cases)
71
What does the left coronary artery supply?
Both ventricles
Interventricular septum
Left atrium
SA node (in majority of cases)
72
What vein lies alongside the left anterior interventricular artery?
Great cardiac vein
73
What does the great cardiac vein lie alongside?
Left anterior inter ventricular artery
74
What vein lies alongside the posterior interventricular vein?
Middle cardiac vein
75
What vein lies alongside the right marginal branch artery?
Small cardiac vein
76
Where is the coronary sinus found?
Found alongside the circumflex artery on the posterior of the heart in the atrioventricular groove
77
What are the oblique cardiac veins and what do they drain into?
Branching small vessels exiting the coronary sinus, which drain directly into the left atrium (why arterial blood isn't 100% saturated)
78
What cardiac veins drain into the right atrium?
All veins apart from the oblique cardiac veins drain into coronary sinus, which enters right atrium
79
What is the name of the small veins which drain the heart wall directly into each chamber?
Venae cordis minimae
80
Where do the lymph vessels from the heart drain into?
Tracheobronchial and mediastinal (bronchopulmonary and paratracheal) lymph nodes
81
From what aortic valve cusps do the coronary arteries arise from?
Right and left cusps, right and left aortic sinuses are the origins of the right and left coronary arteries
82
From what aortic valve cusp is the aortic sinus?
Posterior cusp
83
Describe the components of the cardiac plexus for autonomic innervation of the heart and coronary vessels
Vagus nerve - parasympathetic
| Spinal cord segments T1-4 - sympathetic
84
Where is the cardiac plexus situated and what does it carry?
Bifurcation of the trachea (T4)
85
Where is the sinoatrial node found?
Near the opening for the SVC in the right atrium
86
Where is the atrioventricular node found?
Inferior part of the interatrial septum
87
Where is the bundle of His found?
Each side of the interventricular septum
88
How is cardiac ischaemic pain transmitted?
Carried back to levels T1-4 via afferent sympathetic fibres
Can feel referred pain in left shoulder/arm
89
In what layer of the muscular arterial wall is the external elastic lamina found?
Tunica media
90
In what layer of the muscular arterial wall is the internal elastic lamina found?
Tunica intima
91
Where are the elastic lamina found in elastic arteries?
In tunica media, many of them!
92
What types of artery are the aorta and pulmonary trunk?
Conducting elastic arteries
93
What types of artery are the radial and femoral arteries?
Distributing muscular arteries
94
What tissue predominates in the tunica media of the arterioles?
Smooth muscle
95
What tissue forms the heart and vein valves?
Tunica intima
96
What is an end artery?
Means the artery is the only supply of oxygenated blood to the portion of tissue e.g. anterior interventricular artery
97
Which coronary artery supplies the sinoatrial node in the majority of people?
Left coronary artery
98
At the 6th IC space, what does the internal thoracic artery divide into?
After passing the sixth intercostal space, the internal thoracic artery splits into the following two terminal branches:
- Musculophrenic artery - roughly follows the costal margin.
- Superior epigastric artery - continues the course of the internal thoracic artery, travelling downward into the abdominal wall.
99
In what dermatome is the nipples?
T4
100
What is the surface marking of the apex of the heart?
Posterior to left 5th IC space on the midclavicular line in adults, around 9cm from median plane
101
Describe the fibrous pericardium
Outermost dense fibrous connective tissue layer of the heart
102
Describe the tissue of the parietal and visceral serous pericardium
Composed of simple squamous epithelium
103
Whats another name for the coronary sulcus?
Atrioventricular sulcus
104
On what surface of the heart is the coronary sinus?
Posterior, drains into right atrium
105
What is the ligamentum arteriosus and where is it found?
The ligamentum arteriosum is a small ligament that is the remnant of the ductus arteriosus formed within three weeks after birth. Found between the aorta and left pulmonary artery
106
Next to what ribs is the cardiac notch on the left lung?
Ribs 4-6
