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Stage 1 > CVS anatomy > Flashcards

CVS anatomy Flashcards

1
Q

what is the mediastinum

A

the midline partition of the thorax separating the right and left pleural cavities

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2
Q

what does the mediastinum contain

A 
heart and its great vessels 
thoracic trachea and bronchi 
thoracic oesophagus 
vagus nerves
phrenic nerves
thoracic duct
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3
Q

what is the sternal angle

A

surface landmark for the division of the mediastinum into the superior and inferior division

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4
Q

how is the mediastinum divided

A 
into superior & inferior 
the inferior has 3 further subdivsions 
-anterior 
-middle 
-posterior
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5
Q

where is the superior mediastinum and what does it contain

A

above the sternal angle

contains the great vessels of the heart and upper portions of the thoracic trachea and oesophagus

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6
Q

where is the anterior mediastinum

A

between middle mediastinum and the body of the sternum.

anterior to pericardium

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7
Q

where is the middle mediastinum and what does it contain

A

sits behind the body of the sternum.

contains the heart and fibrous sac of pericardium

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8
Q

where is the posterior mediastinum

A

occupies area posterior to the middle mediastinum and the diaphragm

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9
Q

what does the posterior mediastinum contain

A

oesophagus
azygous veins
thoracic duct
intercostal neurovascular bundles

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10
Q

in which mediastinum is the heart located

A

middle

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11
Q

what is the function of pericardium

A

enclose the heart in situ in the thoracic cavity.
facilitates free movement of the heart when it contracts while isolating its movement from that of the structures surrounding the thorax

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12
Q

what are the 2 layers of pericardium

A

fibrous & serous

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13
Q

what is the function of fibrous pericardium

A

fibrous sac, anchors the heart in place

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14
Q

what are the further subdivisions of serous pericardium

A

visceral- stuck to the heart (myocardium- the heart muscle)

parietal -

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15
Q

how are visceral & parietal pericardium separated

A

by a narrow fluid filled space

  • pericardial space
  • pericardial fluid
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16
Q

where is pericardial fluid located

A

between the two layers of serous pericardium

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17
Q

what is cardiac tamponade

A

where increasing volume of pericardial fluid during bleeding following trauma will interfere with the ability of the heart to contract

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18
Q

which side of the heart is anterior

A

right

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19
Q

which side of the heart is posterior

A

left

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20
Q

what does the right atrium form

A

the entire right surface and border of the heart

1/4 of the anterior surface

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21
Q

what does the right ventricle occupy and form

A

occupies most of the anterior surface

forms 2/3 of the inferior border

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22
Q

what does the the left ventricle form

A

nearly all the left border and makes up large part of the posterior surface
small part on the left inferior border- apex

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23
Q

what does the left atrium make up

A

entirely on the posterior aspect of the heart

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24
Q

what is the sternocostal surface of the heart and what structures are visible

A

anterior aspect
right atrium
right ventricle
left ventricle

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25
Q

what is the diaphragmatic surface

A

inferior aspect of the heart

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26
Q

what structures are visible on the posterior surface of the heart

A

right and left atria and ventricles visible

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27
Q

where is the apex seen beating

A

in the left fifth intercostal space about 10cm from the midline

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28
Q

what does the atrioventricular groove indicate

A

the septum separating the two atria from the two ventricles

runs in vertical plane

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29
Q

what does the interventricular sulcus indicate

A

the septum separating the right and and left ventricles

divided into and anterior and interior aspect

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30
Q

what are the atrial and ventricular septa

A

connective tissue separates the right and left atria and right and left ventricles through muscular continuity maintained

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31
Q

what is the fibrous skeleton of the heart composed of

A

dense fibrous tissue between the atria and ventricles (corresponds to the atrioventricular grooves)

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32
Q

what is the function of the fibrous skeleton

A

provides opening for valves
supports and anchors valves
electrically isolates atria from ventricles except for atrioventricular bundles

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33
Q

what 3 layers does the heart wall consist of

A

epicardium
myocardium
endocardium

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34
Q

what is epicardium

A

an outer serous layer of the heart

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35
Q

what is myocardium

A

layer of cardiac involuntary muscles that originates and inserts into fibrous rings surrounding the valves orifices

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36
Q

what is endocardium

A

an inner lining of the endothelium

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37
Q

where does blood flow go after entering the sup and inf vena cava

A

Right atrium then right ventricle through r av opening and distributed to through the lungs by pulmonary trunk & arteries

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38
Q

how is blood distributed to the lungs

A

pulmonary trunks and arteries

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39
Q

how is blood returned to the heart from the lungs

A

pulmonary veins

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40
Q

after blood enters from the pulmonary veins where does it go

A

left atrium and into left ventricle through l av opening and to the body via aorta

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41
Q

what are the structures of the right atrium

A 
orifice of sup vena cava 
orifice of inf vena cava 
crista terminalis 
fossa ovalis 
tricuspid valve 
pectinate muscles 
right auricle 
coronary sinus- post
sinoatrial and av nodes
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42
Q

where is the fossa ovalis

A

right atrium above the vena cava

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43
Q

what is the function of the coronary sinus and where does it open

A

returns blood from the heart walls and opens into the right atrium

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44
Q

where are pectinate muscles

A

right atrium, they radiate out at right angles from the crista terminalis

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45
Q

what does the tricuspid (r av valve) consist of

A

three flaps, septa

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46
Q

what is attached the edges of the flaps of the bicuspid/tricuspid valves

A

chorda tendinae

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47
Q

what is crista terminalis

A

vertical ridge running between 2 vena cava. divides atrium into smooth and rough anterior wall

48
Q

what drains into the right atrium as well as the sup and if vena cava

A

middle cardiac vein

coronary sinus

49
Q

where does the right coronary artery lie

A

in the anterior atrioventricular groove

50
Q

where does the right ventricle receive blood from

A

right atrium via the tricuspid valve (r av valve)

51
Q

what does the right ventricle contain

A 
trabecula carneae 
chorda tendiane 
papillary muscles 
pulmonary valve 
pulmonary trunk 
pulmonary artery 
moderator band
52
Q

what is the difference between trabecula carneae and pectinate muscles

A

pectinate muscles are in the atria and TC are in the ventricle

53
Q

where do chorda tendineae come out from

A

between the tricuspid valve flaps and papillary muscles

54
Q

what do the papillary muscles do

A

anchor the chorda tendineae and cusps to the heart wall

55
Q

what valves guard the opening of the pulmonary artery

A

semi lunar valves

56
Q

what does the moderator band do

A

in the rv and is part of the econducting system of the heart

57
Q

where does the left atrium receive blood from

A

pulmonary veins from the lungs carrying o2 blood

58
Q

what valve is in the LA

A

bicuspid

L AV valve

59
Q

what is the function of the left ventricle

A

pump blood to the whole body

60
Q

what are the structures in the left ventricle

A

trabeculae carneae- gives roughened aspect
left av valve (biscupid/mitral)
papillary muscles
aortic valves

61
Q

where do the papillary muscles attach

A

to the cusps of the bicuspid/tricuspid valves via the chorda tendineae

62
Q

how do the papillary muscles prevent the bicuspid/tricuspid valves from everting into the atria thus preventing a backflow during ventricular systole

A

they contract early in advance of the rest ventricular muscle causing a tensing of the chorda tendineae

63
Q

what does the aortic valve do

A

prevents back flow of blood from aorta into left ventricle

64
Q

what are the branches of the aorta

A

ascending aorta
arch of aorta
descending aorta

65
Q

what are the branches of the ascending aorta

A

coronary arteries

66
Q

what are the branches of the arch of aorta

A

brachiocephalic
left subclavian
left common carotid

67
Q

what are the branches of the descending aorta

A

bronchial arteries
oesophageal
post intercostal arteries
paired pericardial

68
Q

where does the left coronary artery arise from

A

left posterior aortic sinus

69
Q

what are the two terminal branches of the left coronary artery

A

anterior interventricular branch

circumflex branch

70
Q

where does the circumflex br of the left CA travel

A

to posterior aspect of heart into atrioventricular sulcus

71
Q

where does the anterior interventricular br descend

A

in the sulcus towards the apex of the heart

72
Q

what areas does the left CA supply blood to

A

both atria and some adjacent right ventricle

73
Q

what happens if the left coronary artery is blocked

A

cardiac muscle distal blockage would no longer be supplied with blood and be irreversibly damaged (CA are end arteries)

74
Q

what does the right coronary artery supply

A

right atrium & ventricle, sinoatrial node & AV node, portion of the left atrium & ventricle

75
Q

what are the br of the right coronary artery

A

right marginal artery

posterior interventricular artery

76
Q

where does most venous blood from cardiac veins drain

A

coronary sinus

77
Q

what are the major tributaries the coronary sinus receives

A

great cardiac vein
middle cardiac vein
small cardiac vein of the RV

78
Q

what happens to the great cardiac vein as it approaches the atrioventricular sulcus

A

turns sharply posteriorly and right as the coronary sinus

79
Q

what tributaries does the great cardiac vein receive from the left ventricle

A

oblique vein

posterior vein of the left ventricle

80
Q

when does the middle cardiac vein join the the coronary sinus

A

as it approaches the right atrium

81
Q

what happens if small cardiac veins of the RV do not drain into the coronary sinus

A

they drain directly into the right atrium

82
Q

which chamber of the heart does the coronary sinus drain into

A

right atrium

83
Q

where do the left brachiocephalic veins drain

A

into the superior vena cava

84
Q

what drains into the brachiocephalic veins

A

left subclavian and left int jugular veins

85
Q

what is the function of the SA node

A

pacemaker- initiates heartbeat. impulse spreads over atrial walls causing them to contract and fill the ventricle

86
Q

where is the SA node

A

sup aspect of crista terminalis and junction of sup vena cava and RA

87
Q

what is the function of the AV node

A

pick up impulses from the atrial walls and replays the impulses down the interventricular septum via the bundle of His

88
Q

where is the AV node

A

in the atrioventricular septum just above the coronary sinus

89
Q

what is the function of the left and right atrioventricular bundles

A

synchronise contraction in different parts of the heart

90
Q

what is the function of purkinje fibres

A

stimulate ventricular myocardium

91
Q

what happens if there is damage to the SA node

A

other pacemakers act but may result in lowered heart rate or disturbed heart rhythm (arrhythmia)

92
Q

what happens when there is damage to the AV bundles

A

bundle block- leads to heart failure & insufficient supply of blood to the body

93
Q

what does it mean that the heart receives dual supply for extrinsic innervation

A

parasympathetic and sympathetic innervation

94
Q

what supplies the ps innervation to the heart

A

vagus nerve (preganglionic axons)

95
Q

what do the preganglionic ps fibres from left and right X reach the heart as

A

cardiac branches

96
Q

where do the preganglionic fibres from X synapse

A

in ganglia located within the plexus or walls of the atria

97
Q

what neurovascular bundle does X travel in

A

carotid sheath

98
Q

where does the recurrent laryngeal br of X travel on the L and R

A

left- round aorta

right- round subclavian artery

99
Q

where does X exit to

A

abdomen

100
Q

what stimulation does X provide

A

lowers heart rate- (ActCh released)
reduces force of contraction
constricts the coronary arteries

101
Q

where do to the sympathetic nerves originate from

A

sympathetic chain
thoracolumbar outflow
axons in these nerves postganglionic having synapsed in ganglia apart of the sympathetic chain

102
Q

what is the stimulation of sympathetic nerves

A

raises heart rate

increases force of contraction (by releasing noradrenaline)

103
Q

the superior mediastinum also subdivides further, what are these 3 divisiond

A

anterior
intermediate
posterior

104
Q

what does the anterior part of the superior mediastinum contain (beneath sternum)

A

sternothyroid & sternohyoid
thymus gland
sup vena cava
brachiocephalic vein

105
Q

what does the intermediate part of the superior mediastinum contain

A

aortic arches & branches

vagus & phrenic nerves

106
Q

what does the posterior part of the superior mediastinum contain (in front of vertebra)

A

oesophagus
trachea
thoracic duct
left recurrent laryngeal nerve

107
Q

what does the vagus nerve supply in the thorax

A

heart
bronchi
lungs
oesophagus

108
Q

as X passes through the diaphragm what does it supply

A

stomach, part of intestines as far as transverse colon, liver, kidneys and spleen

109
Q

where does the left recurrent laryngeal nerve originate

A

in the thorax but returns to the neck

110
Q

what would happen if there was damage to the left recurrent laryngeal nerve

A

paralysis of the muscles of that move the vocal folds, except the cricothyroid muscle

111
Q

what structures does the phrenic nerve supply in the thorax

A

motor to diaphragm & sensory supply also to diaphragm and pericardium
pleura covering the mediastinum and diaphragm
peritoneum on the abdominal side of the diaphragm

112
Q

what does the phrenic nerve cross on the right to reach the structures it supplies

A

right brachiocephalic vein
sup vena cava
right side of pericardial sac to reach the caval opening of the diaphragm

113
Q

what does the phrenic nerve cross on the left to reach the structures it supplies

A

left subclavian artery

left side of the pericardium to pierce the muscular part of the diaphragm

114
Q

what joint forms at the sternal angle

A

symphysis

115
Q

what would a left vocal fold paralysis indicate

A

damage to the left recurrent laryngeal nerve in the thorax because of advanced bronchocarcinoma

Stage 1 (21 decks)

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