CVR 2 Flashcards
What divides the mediastinum
T4 angle of louie
What is in the anterior mediastinum
very small space, thymus gland (produce T cells). As it grows it regresses, in a child it is big.
Sits behind the sternum thus retrosternal
Middle mediastinum contains
Pericardium which sits between two lungs containing the heart.
3 Layers of the pericardium
Fibrous pericardium (tough you need a blade)
Serous pericardium (made up of parietal and visceral inner part)
Parietal - adherent to the inner surface of fibrous pericardium
Visceral Pericardium - adherent to outer layer of heart. AKA epicardium.
Pericardial cavity - potential space, thin fluid - no friction
What is the ligament between aorta and pulmonary trunk
ligamentum arteriosum which is a remnant of ductus arteriosus - which in fetal life because the lungs arent working the blood passes through this structure.
What is the apex beat
The position most lateral and inferior point at which palpating fingers feel the beat.
5th ICS MCL left of sternum
What is dextrocardia
Heart flipped other side.
Name the valves of the heart
tricuspid - right atrium and right ven
pulmonary valve - 2 semi lunar cusps
(continue)
Order of valves
PAMT P= 3rd CC A= 3 IC M=4CC T=4th IC (3344 PAMT)
How do we listen to the valves
A = 2nd ICS RIGHT of sternum
P= 2nd ICS left of sternum
(continue)
How do we listen to the valves
A = 2nd ICS RIGHT of sternum
P= 2nd ICS left of sternum
(continue)
Where does the pulmonary trunk bifurcate
behind the aorta
Where does the arch of the aorta begin
T4
Why are recurrent laryngeal nerves important and what is odd?
They look after the vocal cords and they come off the vagal branch
Right recurrent comes off vagus nerve and wraps areound right sublclavian artery
Left comes off vagus and wraps around the arch of the aorta. Compression of recurrent laryngeal nerves gives hoarseness.
Why are recurrent laryngeal nerves important and what is odd?
They look after the vocal cords and they come off the vagal branch
Right recurrent comes off vagus nerve and wraps areound right sublclavian artery
Left comes off vagus and wraps around the arch of the aorta. Compression of recurrent laryngeal nerves gives hoarseness. Mediastinal tumours L and R.
What level does the posterior mediastinum extend?
T4-T12
What is in the anterior mediastinum?
Thymus gland. Regresses after childhood.
What is in the middle mediastinum?
Pericardium, heart, roots of the great vessels.
What nerve passes between the lung and heart to reach the diaphragm?
Left and right phrenic nerves
Superficial to deep name the layers of the pericardium?
Fibrous (connective tiisue), Serious (parietal layer touching paricardial layer running over the heart).
Pericardial cavity is between the parietal layers and visceral layers for lubrication.
Name the 2 sinuses in the pericardium
Transverse pericadial sinus across pericardium between roots of great vessels b/w aorta and pulmonary trunk). Anterior to SVC.
Oblique pericardial sinuse between the right pulmondary veins and IVC and between the righ pulmonary veins and left pulmonary veins
Blood supply of pericardium
pericardiacophrenic arteries and internal thoracic arteries. Internal thoracic veins drain. Innervated by phrenic nerves.
What is at level T4
bifurcation of the trachea. Bifurcation of pulmonary trunk. Azygos termination Ligamentum arteriousum. Ductus arteriosum.
What is the ligamentum arteriosum?
remnant of ductus arteriosus.
Conveys blood in fetal life from pulmonary trunk to aorta bypassing lungs.
Where is the apex beat
5th ICS MCL left of sternum
What valve is between right ventricle and right atrium
Tricuspid
How many cusps in the pulmonary valve
3 semilunar cusps
What is between the left atrium and ventricle?
Mitral valve which is bicuspid
Describe the aortic valve?
3 semilunar cusps (anterior, right posterior, left posterior)
