CVS 1 Flashcards
What are the sections of the mediastinum?
Superior & Inferior
Inferior is split into posterior, middle and anterior.
What is contained in the superior mediastinum?
Thymus Brachiocephalic v + SVC Vagus + Phrenic Nerves Branches of Aortic Arch Trachea + Oesophagus Thoracic Duct
What is contained in the anterior mediastinum?
Thymus (or remnants)
Lymph Nodes
Fat
What is found in the posterior mediastinum?
Oesophagus Vagus & Splanchnic Nerves Sympathetic Trunk Thoracic Duct Descending Aorta Azygos Vein
Whats in the middle mediastinum?
The pericardium and all its contents +great vessels
What vertebrae form the rear border of the heart?
T5-T8
Where is the apex of the heart located and what part of the heart forms it?
The 5th intercostal space in the mid clavicular line.
The Left Ventricle
Where is the base of the heart and what forms it?
The base is wholly posterior.
Formed from the Left Atrium
What forms the right border of the heart?
The SVC & Right Atrium
What structures make up the left border of the hearT?
The Aortic Arch and Left Ventricle
What chambers compose the anterior border of the heart?
1/4 R atrium
1/4 L Ventricle
2/4 R Ventricle
What supplies/drains the anterior intercostal arteries & Veins?
The Internal Thoracic Artery + Vein
How are the Vena Cavae arranged with reference to the Aorta?
The IVC & SVC are found to the right of the aorta
Describe the series of arteries in the upper limb:
Subclavian - arises from aortic arch
- > Becomes axillary at lateral border of rib 1
- > Becomes brachial at inferior border of teres major
- > Divides into radial/ulnar at cubital fossa
- > Both form palmar notches in palm of hand that give off digital arteries.
From where do superficial veins arise in the upper limb?
The dorsal venous arch of the back of the hand.
What two main superficial upper limb veins are there?
Cephalic vein - Travels up lateral side of limb & drins into axillary vein below clavicle.
Basilic Vein - Travels up medial side & feeds into the brachial vein as it becomes the axillary at the inferior border of teres major(Deep vein)
What connects the cephalic & basilic veins?
The median cubital vein connects the two across the cubital fossa
What is the series of arteries in the lower limb?
- > Aorta splits to ext. & int. iliac artery,
- Int. Iliac supplies pelvies
- Ext. Iliac becomes common femoral in the anterior thigh
- > Common femoral splits to superficial femoral and deep artery of thigh
- > superficial Femoral becomes popliteal artery in the popliteal fossa.
- > Popliteal splits to Anterior Tibial and Posterior Tibial in lower leg
- Anterior Tibial travels to foor dorsum and becomes dorsalis pedis between toes 1&2.
- Posterior Tibial gives off the fibular/peroneal artery in the leg then continues medially to plantar foot surface.
From where do superficial veins of the lower limb arise?
In the dorsal arch of the foot
What are the superficial veins of the lower limb?
Long Saphenous (medial) Short Saphenous (Posterior)
What happens to the long saphenous vein?
Travels up the limb medially to drain into the femoral.
The femoral then becomes the ext. iliac vein.
What happens to the short saphenous vein?
It travels up the leg posteriorly & drains into the popliteal vein.
The popliteal then becomes the femoral.
What procedure do we use superficial lower limb veins for?
A Coronary Artery Bypass Graft (CABG)
What are the 9 superficial arterial pulse points?
Temporal Artery (Temple) Facial artery (under jaw) Carotid Artery (Neck) Brachial (cubital fossa, front of elbow) Radial (Wrist) Femoral (Groin/inner thigh) Popliteal (Popliteal Fossa, rear of knee) Posterior Tibial Artery (Ankle) Dorsalis Pedis Artery (Dorsal surface of foot)
Learn cross sections from powerpoint
lots of veins/arteries & chambers to remember
What are the sections of the pericardium?
Serous pericardium split into a parietal & Visceral layer with a pericardial cavity in between.
Then an outer fibrous pericardium
What is the inner visceral pericardium also known as?
The epicardium
What makes up the epicardium (visceral pericardium)?
Endothelial Cells (simple squamous epithelium) + some fat & connective tissue.
What are the main features of the right atrium?
Openings - IVC, SVC, Coronary Sinus
Interatrial Septum with Fossa Ovalis (often in OSPE)
Musculi Pectinati
Tricuspid Valve to R Ventricle.
What are the main features of the right ventricle?
Tricuspid valve (3 cusps) + Chordae Tendinae & 3 papillary muscles.
Trabeculae Carnae
Septomarginal Trabeculum (Moderator Band)
Opening for the pulmonary trunk
Interventricular Septum
What are trabeculae carnae?
Contractile fleshy struts within the two ventricles.
They prevent the suction that would otherwise occur between the flat wet surfaces impairing the heart function.
What are the main features of the Left Atrium?
Openings for the L & R inferior and superior pulmonary veins (4)
Opening for the mitral/bicuspid valve
Smooth walled, the pectinate muscles are confined to the atrial appendage
What are the many features of the Left Ventricle?
Bicuspid/mitral valve (2 cusps) + Chordae tendinae & 2 papillary muscles.
Trabeculae Carnae
Opening for the Aorta
Interventricular Septum
Wall is 3x as thick as the right ventricular wall.
Forms Apex of the heart
What do we call the arterial supply to the heart?
The coronary arteries
Where are the branches of the coronary arteries found?
In 2 major sulci:
Coronary (atrioventicular) sulcus between the atria & venrtricles
Interventricular sulcus between R & L ventricles.
What artery runs in the coronary (atrioventricular) sulcus?
The right coronary artery (RCA).
From where does the RCA arise?
From the Right aortic sinus of the ascending aorta.
What are the branches of the RCA?
Right Marginal Artery - At the inferior margin of the heart
Posterior Descending Artery - On the posterior surface of the heart.
What artery runs in the interventricular sulcus?
The Left Coronary Artery (LCA)
From where does the LCA arise?
Left Coronary Artery aries form the Left of aortic sinus of the descending Aorta
How does the LCA branch?
- > Left Anterior Descending Aorta (continues to run in interventricular sulcus)
- > Circumflex Artery
Where are the two anastomoses found int he coronary circulation?
On the posterior surface of the heart:
- Between the anterior & Posterior interventricular arteries
- Between the RCA & the Circumflex Artery.
What do clinicians call the anterior & posterior interventricular arteries?
The Anterior descending artery and posterior descending artery.
What do we call the veins that drain the heart?
The Cardiac Veins (because apparently calling them coronary would make med school too easy)
What cardiac vein runs along the anterior interventricular artery?
The Great Cardiac Vein
What cardiac vein runs alongisde the Posterior Interventricular Artery?
The Middle Cardiac Vein
What cardiac vein runs alongside the Right Marginal Artery?
The Small Cardiac Vein
Where do the 3 cardiac veins drain?
To the coronary sinus alongiside the circumflex artery
Where does the coronary sinus drain?
Directly into the Right Atrium
Where do the anterior cardiac veins drain to?
Directly into the right atrium without going through the coronary sinus first.
What 3 nerves innervate the heart?
Phrenic Nerve
Vagus Nerve
Sympathetic Fibres
What parts of the heart are innervated by the phrenic nerve?
The fibrous pericardium & Parietal layer of the serous pericardium.
Carries pain sensation
What sections of the heart does the vagus nerve innervate, and to what purpose?
Innervates heart itself & the visceral layer of the serous pericardium (epicardium).
Made of parasympathetic fibres it slows heart rate.
What part of the heart is innervated by sympathetic fibres, and to what purpose?
Cervical & upper thoracic sympathetic ganglia innervate the heart & epicardium (visceral serous pericardium).
Sympathetic cardiac nerves can increase Heart Rate and Force of Contraction
What sets the heart rate?
At rest the hearts inherent rate is set by the specialised pacemaker cells in the Sinoatrial (SA) Node.
HR can be altered by the ANS (parasympathetic in the vagus nerve and sympathetic in individual fibres)
How is a signal to contract (depolarisation) conducted through the heart?
- > Signals arise in SA node
- > Atria Contract
- > Signal travels to AV node
- > After a delay signal travels through bundle of his
- > Signal reaches L & R bundle branches
- > Signal spreads rapidly through endocardium in purkinje fibres.
- > Signal spreads through endocardium to epicardium
What are the histological differences between arteries & Veins?
Arteries have thicker smooth muscle walls whereas veins have thinner walls with much less smooth muscle.
Veins have a much wider lumen than arteries.
How do we recognise an image of cardiac muscle?
Branching fibres
Striations
Central Rounded Nuclei
Intercalated Discs
How do we tell apart muscular and elastic arteries histologically?
Muscular arteries have a thick smooth muscle wall with few elastic fibres
Elastic arteries have numerous laminae of dark staining wavy elastic fibres in amongst the smooth muscle.
Whats the functions of muscular and elastic arteries?
Muscular arteries are smaller distributing arteries
Elastic arteries are Large Conducting Arteries that receive blood direct from the heart.
Examples of Muscular vs elastic arteries?
Muscular:
- Brachial
- Radial
- Femoral
- Posterior Tibial
- Coronary
Elastic:
- Aorta
- Pulmonary Trunk
Need to learn arteries, veins, histology etc from powerpoint images. Especially coronary vessels.
…..bye
