Exam 3 -Thoracic cavity: Heart and great vessels Flashcards
What are the layers of the pericardium and how are they related to the sinuses
- heart is in Middle inerior mediastinum within the pericardial cavity
- Visceral Pericardium
- serous membrane (epicardium)
- Arterial mesocardium
- venous mesocardium
- Parietal Pericardium
- serous membrane
- fused to fibrous pericardium
- fused with centrla tendon of diaphragm
- pericardiacophrenic ligament
- fused with sternum
- superior and inferior sternopericardial ligaments
- fused with centrla tendon of diaphragm
- Transverse sinus
- space between arterial and venous mesocardium
- oblique sinus
- space between right and left pulmonary veins
What is the blood and nerve supply to the pericardium?
- Blood supply
- Pericardial arteries
- pericardiacophrenic arteries
- musculophrenic arteries
- Nerve
- Cn X
- Phrenic Nerve
- Sympathetic trunk
What are major landmarks associated with cardiac projections ?
- Apec is down and to left
- base of heart is superior to apex
- upside down triangle
- base projection
- horzontal plane across sternum
- level of csotal cartilage 3
- ends 2 cm to left of left parasternal line
- Apex projection
- 5th intercostal space
- 8 cm (interclavicular line) to left of median line of sternum
- pericardium extends up to sternal angle
What are the three layers of the heart?
- External
- epicardium
- visceral layer of serous pericardium + subserous layer of connective tissue
- epicardium
- Middle
- myocardium
- thickest
- cardiac muscle tissue
- myocardium
- inner
- Endocardium
- endothelium
- Endocardium
What is the cardiac skeleton and how does it relate to the four major valves ?
- 4 interlocking fibrous rings
- Annuli fibrosi
- interconnected with membranous portion of interbentricular septum
- Functions of the annuli fibrosi
- rigid attachment for cardiac muscle fibers
- support valves
what are the surfaces and borders that identify the external heart?
Base:
- Posterior aspect of heart
- mostly left atrium + small part of right atrium
Apex:
- located at intercostal space 5 medial to nipple
- formed from left ventricle
Diaphragmatic
- rests on diaphragm
- Mostly left ventricle and a small part of right
Sternocostal Surface
- Faces anteriorly
- mostly right ventricle
left margin (border)
- Left side of heart
- formed mostly of left ventricle and elft auricle
Inferior margin (border)
- Intersection of diaphragmatic and sternocostal surfaces
- formed mostly from right ventricle
Superior border
- left and right atria and auricles
What are two major arteries that supply the heart itself ?
- Blood supply
- Coronary arteries are the direct and only branches off the ascending aorta
- RIght and left Coronaries
What is the venous draingage of the heart?
- Coronary Sinus
- Located in posterior coronary sulcus
- opens int right atrium
- direct continuation of great cardiac vein
- tributaties
- great cardiac vein
- middle cardiac vein
- small cardiac vein
What is the origin and what does the right coronary artery supply?
- RIght Coronary Artery
- Passes between pulmonary trunk and right auricle
- to coronary sulcus
- follows coronary sulcus to diaphragmatic surface
- anastomoses with left coronary artery
- Right C. A supplies
- right atrium
- right ventricle
- posterior half of interventricular septum
- Right cornary artery branches
- artery to SA node
- Artery to AV node
- Right marginal artery
- Posterior INterventricular artery
- = posteropr descending artery (PDA)
What is the origin and what does the left coronary artery supply?
- Left coronary artery
- passes between pulmonary trunk and left atrium
- Left coronary artery supplies
- left atrium
- left ventricle
- anterior half of interventricular septum
- Left coronary artery branches
- anterior interventriclar artery
- = left anterior descending (LAD)
- Circumflex artery
- Left marginal artery
- anterior interventriclar artery
What is the source of blood flow, valves, subchambers and unique structure assocated with the right atrium?
- Recieves blood from
- superior vena cava
- inferior vena cava
- coronary sinus
- anterior cardiac veins
- LARge, thin walled chamber
- Subchambers
- main posterior cavity
- sinus venarum
- Anterior Cavity
- Auricle
- lined with pectinate muscles
- main posterior cavity
What is the source of blood flow, valves, subchambers and unique structure assocated with the right ventricle
- Recieves blood form the rigt atrium
- thicker walled than right atrium
- trabeulae carnae
- Moderator band
- (septomarginal trabecula)
- Conveys right branch of atrioventricular byndle
- Right atrioventricular valve = tricuspid valve
- CHordae tendinae
- papillary muscles
- Pulmonary valve
- formed from three semilunar cusps
- Pulmonary trunk
- divides into left and right pulmonary arteries
What is the source of blood flow, valves, subchambers and unique structure assocated with the Left Atrium?
- Recieves blood form the four pulmonary veins
- smaller and thicker walled than right atrium
- Posterior smooth portion recieves pulmonary veins
- Anterior portion = auricle
- with pectinate muscles
- Wall is 2 or 3x thicker than right ventricle
- trabeculae carnae are less coarse than those of right venricle
- No moderator band
- Two papillary muscles
- anterior and posterior
- Left atrioventricular VAlve = bicuspid or mitral valve
- Aortic Valve
- composed of three semiluna cusps
How does the conduction travel within the heart?
- remember no nervous tissue in heart
- SInoatrial node (begins)
- Pacemaker to the heart
- Loacted in right atrium
- receives direct stimulation form
- sympathic cardiac nerves
- parasympathetic nerves
- Atrioventricular Node
- locatted in interatrial septum near tricuspid valve
- Interventricular bundle
- travels down fibrous skeleton
- Reaches interventricular septum
- only conenction between myocardium of atria and ventricles
- RIght cruus (Bundle branch) passes through moderator band
or
Left crus (bundle branch)
- Purkinje fibers
- terminal ending of bundle dibers
- embedded in myocardium of centricle
What are the two branches of the ascending aorta?
Right and left cornonary arteries
Where is the aortic arch in relation to surface landmarks of the chest wall?
- Lies within superior mediastium
- arches to the left over the left pulmonary
- artery
- apex of the arch reaches the middle of the manubrium
- T
What are the three main branches of the aortic arch?
- Brachiocephalic
- left comon carotid
- left subclavian
WHere do the anterior, inferor, and posterior surfaces of the aortic arch lie
- Anterior
- left phrenic nerve
- left vagus nerve
- superficial cardiac plexus
- Inferior
- left recurrent laryngeal nerve
- ligamentum arteriosum
- pulmonary trunk
- left primary bronchus
- Posterior
- trachea
- left recurrent laryngeal nerve
What land marks mark the begining and end of descending aorta
- begins at sternal angle
- ends in fromnt of thoracic vertebra 12
What is the origin of the internal thoracic arteries and branches? (including areas and structures supplies)
- Internal thoracic arteries
- arise within root of neck
- descend ateral to sternum
- Branches
- Musculophrenic (terminal)
- to diaphragm
- intercostal spaces 7-9
- Superior epigastric (terminal)
- Pericardiacophrenic arteries
- accompanies phrenic nerve
- Supplies pericardium, mediastinal pleura, and diaphragm
- Perforating branches
- accompany anterior, cutaneous branches of intercoastal nerves
- largest in intercoastal spaces 2-4 in female
- Musculophrenic (terminal)
What is the drainage pattern of the superior and inferior vena cavae and azygos, hemiazygos, and accessory hemiazygoes veins?
- Hemiazygos veins
- forms in abdomen from leftsubcostal and left ascending lumbar vein
- receives four posterior intercostal vein
- drains into azygos
- Acessory hemiazygoes
- drains intercostal spaces 4-7 (8) on left side into azygos
- Azygos veins
- form in abdomen form right subcostal and right ascending vein
- drain all posterior intercostal veins recieves blood from bronchial and esophageal veins
- Superior vena cava
- formed
- right brachiocephalic vein
- left brachiocephalic vein
- Recieves azygos vein
- formed
