CVS Flashcards
1
Q
Vaugly, what does the mediastinum contain?
A
Contents of the thorax other than the lungs and their covering pleurae
2
Q
What are the sections of the mediastinum?
A
Superior
Inferior (further divided)
3
Q
What is the inferior mediastinum further divided into?
A
Anterior
Middle
Posterior
4
Q
What bone forms the anterior border of the mediastinum?
A
Manubrium
5
Q
What vertebrae form the posterior border of the superior mediastinum?
A
T1 - T4
6
Q
What plane seperates the superior from the inferior mediastinum?
A
Transverse
7
Q
What are some structures found in the superior mediastinum?
A
Arteries (aortic arch, brachiocephalic artery, left common carotid artery, left subclavian artery)
Veins (brachiocephalic vein, superior vena cava)
Nerves (vagus nerve, phrenic nerve)
Trachea
Oesophagus
8
Q
Where in the mediastinum is the thymus found?
A
Anterior
9
Q
Where in the mediastinum is the heart, pericardium and great vessels found?
A
middle
10
Q
Where in the mediastinum is the descending aorta found?
A
Posterior
11
Q
Where in the mediastinum is the oesophagus found?
A
Posterior
12
Q
Where in the mediastinum is the thoracic duct found?
A
Posterior
13
Q
Where in the mediasinum is the azygos vein found?
A
Posterior
14
Q
Where in the mediastinum is the sympathetic chain found?
A
Posterior
15
Q
What is the difference between the pericardium, and the pleura and the peritoneum?
A
Pericardium has an outermost dense fibrous connective tissue layer - the fibrous pericardium
16
Q
What is the epicardium also known as?
A
Visceral layer
17
Q
What are the 3 layers of the pericardium from superficial to deep?
A
Fibrious pericardium
Parietal pericardium
Visceral pericardium (epicardium)
18
Q
Between what 2 layers of the pericardium does the pericardial cavity lie?
A
Parietal layer and visceral layer
19
Q
What is the endocardium composed of?
A
Simple square endothelium
20
Q
What is the endocardium composed of?
A
Simple square endothelium
21
Q
What is the myocardium composed of?
A
Cardiac muscle
22
Q
What is the epicardium composed of?
A
Simple square epithelium
23
Q
What layer belongs both to the heart wall and the serous pericardium?
A
Epicardium
24
Q
Which layer of the serous pericardium is inseperably attached to the inner aspect of the fibrous pericardium?
A
Parietal
25
What protective role is furfilled by the fibrous pericardium?
prevents overfilling
26
Explain the innervation of the pericardium?
Visceral pericardium - autonomic from T-T4 and vagus nerve via the cardiac plexus
Parietal and fibrous pericardium - phrenic nerve
27
What part of the pericardium does the vagus nerve and T1-T4 nerves innervate?
Visceral pericardium
28
What part of the pericardium does the phrenic nerve innervate?
Parietal and fibrous pericardium
29
Which layer of the pericardium is innervated by pain fibres?
Fibrous and parietal pericardium
30
What role do the atria have in a heart?
Direct blood to the atrial ventricular gap
31
What organ is the left atrium anterior to?
Oesophagus
32
What is the shape of the heart?
Pyramidal
33
What chamber of the heart forms the apex?
Left ventricle
34
What chamber of the heart forms the base?
Left atrium
35
What is the fossa ovalis a remnant of?
Foramen ovale in the foetus
36
The fossa ovalis is a remnant of the foramen ovale in the foetus, what function did this have?
Shunt the blood from the right atrium to the left to pass the lungs
37
What is the function of the moderator band? (septomarginal trabecula)
Strengthen and prevent overballooning
Carries primary conductor band with right bundle of his (goes across chamber to cut conduction time)
38
Is the right ventricle wall or left thicker?
The left is thicker by 3x
39
Why is the left ventricle wall 3x thicker than the right?
It has to pump blood to the systemic circulation, not just the pulmonary
40
How many cusps make up the tricuspid valve?
3
41
How many papillary muscles are found in the right ventricle?
3
42
What valve guards entry from the left atrium into the left ventricle?
Mitral
43
How many cusps are present in the mitral valve?
2
44
How many papillary muscles are found in the left ventricle?
2
45
What is the function of the papillary muscles?
Stop valve failure
Produce tension
46
What is the function of the chordae tendineae?
Stop valve failure
47
What supplies the heart wall with blood?
Left and right coronary arteries and their anastomosing branches
48
How is blood drained from the heart wall?
Cardiac veins almost entirely to the coronary sinus
49
What is the coronary sinus?
Wide venous channel on the posterior surface of the heart
50
Where does the coronary sinus drain into?
Right atrium
51
Where do the coronary arteries and cardiac veins lie?
Together in both the atrioventricular sulcus adn the interventricular sulci of the heart wall
52
What does the left coronary artery branch into?
Left anterior descending artery
Circumflex artery
53
From which part of the aorta do the coronary arteries arise?
Ascending aorta
54
What pair of coronary arteries anastomose in the coronary sulcus?
Right and left coronary arteries
55
What pair of coronary arteries anastomose in the interventricular sulcus?
Left anterior descending and posterior interventricular artery
56
What does the right coronary artery branch into?
Right marginal artery
Right posterior descending artery
57
What does the circumflex artery branch into?
Left marginal artery
Circumflex artery (continues)
58
Where are the coronary arteries initially distributed?
Embedded within the epicardium, then piercing the myocardium and giving off branches that surround each cardiac muscle cell
59
What are the origins in the ascending aorta for the coronary arteries called?
Right and left aortic sinuses
60
What does the anterior interventricular artery supply blood to?
Interventricular septum and anterior walls of both ventricles
61
What does the circumflex artery supply blood to?
Left atrium and posterior walls of the left ventricle
62
What does the right marginal artery supply blood to?
Lateral right side of heart (including right atrium)
63
What does the posterior interventricular artery supply blood to?
Posterior right ventricle walls
64
Where does the great cardiac vein lie?
Alongside the left anterior descending artery in the anterior interventricular groove
65
here does the middle cardiac vein lie?
Alongside the posterior descending artery in the posterior interventricular groove
66
Where does the small cardiac vein lie?
Alongside the right marginal artery near the righ inferior margin of the heart
67
Where does the coronary sinus lie?
Alongside the circumflex artery in the coronary sulcus on the posterior surface of the heart
68
Where does the coronary sinus drain directly into?
Right atrium
69
What are venae cordis minimae?
Small veins which drain the heart wall directly into each chamber of the heart
70
What are small veins which drain the heart wall directly into each chamber of the heart called?
Venae cordis minimae
71
What vertebrae level does the beginning and termination of the aortic arch occur?
T4
72
What vertebrae level does the bifurcation of the abdominal aorta occur?
L4
73
What vertebrae level does the bifurcation of the common iliac arteries occur?
L5
74
What branches occur from the ascending aorta?
Right coronary artery
Left coronary artery
75
What branches occur from the aortic arch?
Brachiocephalic trunk
Left common carotid artery
Left subclavian artery
76
What branches from the descending thoracic aorta?
Posterior intercostal arteries (only identifiable ones on wet specimen)
Bronchial arteries
Oesophageal arteries
Pericardial arteries
77
How do the arteries, veins and nerves supplying the chest wall occur?
Segmentally for each intercostal space being supplied in the form of a neurovascular bundle running anteriorly along the space
78
Where do the vessels of the neurovascular bundle arise from, or drain to?
Larger vessels that run vertically along the anterior and posterior chest wall
79
What chest wall arteries arise from the descending thoracic aorta?
Posterior intercostal arteries
80
What chest wall arteries arise from internal thoracic (mammary) artery?
Anterior intercostal arteries
81
What artery gives origin to the internal thoracic artery?
Subclavian arteries
82
Where does the internal thoracic artery lie?
Parasternally, being accompanied by the internal thoracic veins
83
Where do the anterior intercostal veins drain to?
Internal thoracic veins
84
What do the branches of the internal thoracic arteries supply?
Anterior intercostal arteries
Fibrous pericardium
Parietal pleura
Diaphragm
85
What do the arteries that arise from the abdominal aorta supply?
Diaphragm
Adrenals
Kidneys
Gonads
Gut tube
86
At what vertebral level do the common iliac arteries arise?
L4
87
At what vertebral levels do the external iliac arteries arise?
L5
88
At what vertebral level do the internal iliac arteries arise?
L5
89
What do the iliac arteries lie in?
Iliac fossae
90
What does the external iliac arteries go onto become?
Femoral artery
91
What are the common iliac arteries the terminal branches of?
Descending aorta
92
What are the external iliac arteries the terminal branches of?
Common iliac arteries
93
What does the internal iliac arteries supply?
Pelvic viscera
94
What are the internal iliac arteries the terminal branch of?
Common iliac arteries
95
Arteries have branches, what do veins have?
Tributaries
96
What are the great arteries leaving the heart?
Aorta
Pulmonary trunk
97
What are the great veins entering the heart?
Superior and inferior vena cava
98
Where does the superior vena cava (SVC) drain blood from?
Hear
Neck
Upper limbs
99
Where does the inferior vena cava (IVC) drain blood from?
Abdominal and pelvic cavities
Lower limbs
100
What drains the intercostal veins to the left and right brachiocephalic veins?
Internal thoracic (mammary) vein
101
Where does the internal thoracic (mammary) vein drain from and to?
Drains the anterior intercostal veins to the left and right brachiocephalic veins
102
What are the tributaries of the superior vena cava?
Left and right brachiocephalic veins
Azygos vein
103
What are tributaries of the inferior vena cava?
Left and right common iliac veins
104
What drains blood from the posterior intercostal veins to the superior vena cava?
Azygos venous system
105
Where does the azygos venous system drain blood from and to?
Drains blood from the posterior intercostal veins to the superior vena cava
106
What does drainage of the posterior chest wall consist of?
Azygos veinous system on the right side
Hemiazygos veinous system on the left side
107
Where does the hemoazygos vein drain into?
Azygos vein by crossing from left to right at T8/T9
108
Where does the hemiazygos vein cross the median line from left to right?
T8/T9
109
Into which vein does the azygos vein drain into?
Superior vena cava
110
Which chest wall veins are drained by the azygos and hemiazygos venous systems?
Posterior intercostal veins
111
Where does the azygos vein drain into?
Right subclavian vein
112
At what bony point does the subclavian artery become the axillary artery?
Lateral border of 1st rib
113
In which area of the upper limb does the brachial artery branch into radial and ulnar artery?
Antecubital fossa
114
Of the radial and ulnar arteries, which is more superficial of the two?
Radial artery
115
What artery is the femoral artery a distal continuation of?
External iliac artery
116
Where does the poplital artery branch into the anterior and posterior tibial artery?
Poplital fossa
117
What is the complete branching of the common iliac artery?
Common iliac - external iliac (internal iliac) - superficial femoral (deep femoral) - popliteal - anterior tibial (posterior tibial) - dorsalis pedis
118
What is the complete branching of the subclavian artery?
Subclavian - axillary - brachial - radial and ulnar
119
The dorsalis pedis artery is a continuation of what artery?
Anterior tibial artery
120
Where does the dorsalis pedis artery lie?
On the dorsum of the foot
121
The posterior tibial artery enters the sole of the foot inferior to which malleolus of the ankle?
Both left and right
122
What are the main pulse points of the body?
Carotid artery
Apex beat
Brachial artery
Abdominal aorta
Radial artery
Femoral artery
Poplital artery
Posterior tibial artery
Dorsalis pedis artery
123
What are important superficial veins of the upper limbs?
Cephalic vein
Basilic vein
Median cubital veins
124
Where do deep veins of the upper limbs lie and what names do they have?
Alongisde their corresponding artery and take the same name
125
Where do the deep veins of the lower limbs lie and how are they named?
Alongside corresponding arteries and have the same names
126
Where do the superficial veins of the lower limbs drain into?
Deep veins
127
What are the superficial veins of the lower limbs?
Great saphenous vein
Small saphenous vein
128
What are some deep veins of the lower limbs?
Femoral vein
Popliteal vein
Posterior tibial vein
129
Into which deep vein does the great saphenous vein drain into?
Femoral vein
130
Into which deep vein does the small saphenous vein drain into?
Popliteal vein
131
What happens when veins become varicose?
Leaflets of the valves no longer meet properly so the valves do not work, allowing blood to flow backwards
132
What are the 2 main lymphatic ducts?
Thoracic duct
Right lymphatic duct
133
Where does the thoracic duct drain lymph from?
3/4ths of the body to the medial end of the left subclavian vein
134
Where does the right lymphatic duct drain lymph from?
Right upper quadrant (1/4th) to the medial end of the right subclavian vein
135
Whre is the thoracic duct located?
On the vertebral bodies between the azygos vein adn the descending thoracic aorta on the right side of the posterior thoracic wall
136
What does the thoracic duct commence as?
Cisterna chyli
137
What vertebral level does the thoracic duct commence at?
L1 as the cisterna chyli
138
What vertebral level does the thoracic duct cross the medial line from right to left?
T4
139
Where does the thoacic duct drain into?
Medial end of the left subclavian vein
140
What nodes are for lymphatic drainage of the chest wall?
Parasternal nodes
Phrenic nodes
Intercostal nodes
141
Where are parasternal nodes found?
Situated along the internal thoracic artery
142
Where do the parasternal nodes recieve lymphatic drainage from?
Medial part of the breast
Intercostal spaces
Costal pleura
Diaphragm
143
Where are the phrenic nodes found?
Situated on the thoracic surface of the diaphragm
144
Where do the phrenic nodes recieve lymphatics from?
Pericardium
Diaphragm
Liver
145
What do the phrenic nodes drain into?
Parastenal nodes
146
Where are the intercostal nodes found?
At the verebral end of the intercostal spaces
147
Where does lymph from the heart drain into?
Right inferior tracheobronchial nodes
Mediastinal (bronchopulmonary and paratracheal lymph nodes)
148
How is autonomic innervation directed to the heart and coronary arteries?
Cariac/cadiopulmonary plexus
149
What spinal levels give sympathetic innervation to the heart and coronary arteries?
T1-T4
150
What gives parasympathetic innervation to the heart and coronary arteries?
Vagas nerve
151
What do motor fibres innervate within the heart wall?
Nodes (SA and AV nodes) to generate electrical impulses
152
What are the nodes that nerves innervate within the heart wall known as?
Purkinje cells
153
What are the branches of Purkinje cells called?
Purkinje fibres
154
What do parasympathetic fibres within the heart wall act on?
SA and AV node
155
What do sympathetic fibres within the heart wall act on?
SA and AV node
Cardiac muscle
156
How does sensory and pain information travel back from the heart?
Spinal cord levels T1-T4 in the sympathetic nerves
157
Where does the SA node lie within the heart?
Near the opening of the SVC in the right atrium
158
What does SA, for SA node, stand for?
Sinu-atrial node
159
Where does the AV node lie within the heart?
Inferior part of the interatrial septum
160
What does AV, for AV node, stand for?
Atrioventricular node
161
Where does the atrioventricular bundle of His lie within the heart?
Within each side of the interventricular septum
162
Why is pain from cardiac ischaemia sometimes felt in the left arm?
The pain travels back by T1-T4 spinal nerves, T1 also supplies the upper limbs
163
What is knowledge of the surface anatomy of the heart essential for?
Diagnosis of cardiac enlargement
Location of the heart valves
Auscultation of the heart sounds
164
What are the different borders of the heart?
Superior border
Inferior border
Right border
Left border
165
Where do the surface markings of the apex (apex beat) lie?
5th left intercostal space, midclavicular line
166
How does the apex beat of children compare to adults?
More superiolateral
167
What chambers form the right border of the heart?
Right atrium and right ventricle
168
What chambers form the left border of the heart?
Left atrium and left ventricle
169
What chambers form the inferior border of the heart?
Right ventricle and left ventricle
170
What chambers forms the superior border of the heart?
Right atrium and left atrium
171
What chambers form the anterior/sternocostal surface of the heart?
Right atrium
Right ventricle
Left ventricle
172
What chambers form the posterior/base surface of the heart?
Left atrium
173
What chambers form the inferior/diaphragmatic surface of the heart?
Left ventricle
Right ventricle
174
What is the anterior surface of the heart also known as?
Sternocostal
175
What is the posterior surface of the heart also known as?
Base
176
What is the inferior surface of the heart also known as?
Diaphragmatic
177
What vertebral level is the sternomanubrial joint?
T4
178
What vertebral level is the xiphisternal joint?
T8/T9
179
The heart is posterior to what bone?
Sternum
180
The heart is anterior to what 4 vertebrae?
T5-T8
181
What structure lies inferior to the heart?
Diaphragm
182
In what order do the heart valves lie behind the sternum?
P-A-M-T
183
Where do the sounds due to the hear valves roughly radiate to?
4 corners of the heart
184
Where is the pulmonary valve auscultated?
2nd left intercostal space, parasternally
185
Where is the aortic valve ausculated?
2nd righ intercostal space, parasternally
186
Where is the mitral valve ausculated?
5th left intercostal space, midclavicular line (apex)
187
Where is the tricuspid valve auscultated?
Over lower sternum, or just right to it
188
What are the 3 layers of a blood vessel, from superficial to deep?
Tinuca adventita
Tunica media
Tunica intima
189
What are the 3 main histological types of arteries?
Elastic arteries
Muscular arteries
Arterioles
190
How can a slide of an artery be identified?
More round
Thick wall
Narrow lumen
191
How can a slide of a vein be identified?
Irregular, thin wall
Wider lumen
192
What is the difference between the tunica intima of muscular and elastic arteries?
Muscular arteries have the presence of internal elastic lamina
193
What is the difference between the tunica media of musclar and elastic arteries?
Muscular arteries is mainly smooth muscle
Elastic arteries have concentric fenestrated sheets of elastin and only a few smooth muscle fibres
194
What is the difference between the tunica adventitia of muscular and elastic arteries?
Muscular has the presence of vaso vasorum and is a broad layer
195
What is vaso vasorum?
Network of small blood vessels that supplies the walls of blood vessels
196
What type of artery is the aorta and pulmonary trunk?
Elastic
Conducting
197
What type of artery are the radial and femoral arteries?
Muscular
Distributing
198
What type of tissue predominate in the tunica media of arterioles?
Smooth muscle
199
Are elastic arteries conducting or distributing?
Conducting
200
Are muscular arteries conducting or distributing?
Distributing
201
What layer are valves formed from?
Tunica intima of the vessel
202
```
Which of the following is not a content of the middle mediastinum?
A. Heart
B. Oesophagus
C. Phrenic nerve
D. Lung
E. Tracheobronchial lymph nodes
```
D
203
```
Which structure lies immediately posterior to the heart?
A. Phrenic nerve
B. Pleura
C. Trachea
D. Descending aorta
E. Oesophagus
```
E
204
```
Heart lies anterior to which vertebrae?
A. T1-T4
B. T2-T5
C. T3-T6
D. T4-T7
E. T5-T8
```
E
205
```
The anterior surface of the heart is formed mainly by
A. RV
B. RA + RV
C. RA + RV + LV
D. RA + RV + LA + LV
E. RV + LA + LV
```
B
206
```
The phrenic nerve supplies
A. Visceral pericardium
B. Parietal pericardium
C. Fibrous pericardium
D. Fibrous and parietal pericardium
E. Parietal and visceral pericardium
```
D
207
Which of the following is correct regarding sympathetic innervation of the heart?
A. Decreases heart rate
B. Increases heart rate and force of contraction
C. Root value: T1-T6
D. Innervates parietal layer of the pericardium
E. Relaxes the heart muscles
B
208
Which of the following is correct?
A. Coronary sulcus is a groove situated between the right atrium and right ventricle
B. Circumflex artery is branch of right coronary artery
C. Anterior descending artery is a branch of left coronary artery
D. Coronary arteries arise from the coronary sinus
E. Posterior descending artery is a branch of left coronary artery
C
209
```
Left anterior descending artery supplies which of the following area(s) of the heart?
A. RA + RV
B. RV + LV
C. RA + RV + LV
D. RV + LV + IVS
E. LV + IVS
```
D
210
```
The coronary sinus drains into
A. Left atrium
B. Right atrium
C. Superior vena cava
D. Azygos vein
E. Inferior vena cava
```
B
211
What is the function the chordae tendinae?
A. Regulates the function of the papillary muscles
B. Regulates the function of the tricuspid valves
C. Regulates the function of the mitral valves
D. Regulates the function of semilunar valves
E. Regulates the function of the pulmonary valves
B
212
Which of the following is correct?
A. Left ventricle has three papillary muscles
B. Mitral valve is situated between the right atrium and right ventricle
C. Pulmonary veins opens into the left atrium
D. Pulmonary trunk originates from the left ventricle
E. Left ventricle has a smooth internal surface
C
213
What vertebral level does hemiazygous join azygous vein?
T7
214
What matter is present in cervical and lumbar enlargements?
Grey matter
