Gross Anatomy Final Flashcards
What separates superior from inferior mediastinum? Which vertebral level?
Sternal angle - b/w T4 and T5
Which division of inferior mediastinum is the thymus found in?
Anterior mediastinum
Middle mediastinum contains?
pericardium, the heart, and the roots of the great vessels
The posterior mediastinum contains?
esophagus, vagus nerves, azygos system of veins, thoracic duct, thoracic aorta
Sternal angle is landmark for? (6 things)
- Boundary between the superior and inferior mediastinum
- Superior border of the pericardium
- Bifurcation of the trachea
- End of the ascending aorta
- Beginning and end of the arch of the aorta
- Beginning of the thoracic aorta
Pericardium divisons
- Fibrous pericardium -> prevents rapid overfilling of heart
- Parietal serous pericardium
- Parietal visceral pericardium
2+3 are continuous with each other at lines of reflection located around the pulmonary veins and the inferior vena cava
Ligamentum arteriosum connects which 2 structures
left pulmonary artery to the arch of the aorta.
Apex of heart is located at the?
Left 5th intercostal space 9cm from midline
Boundaries of superior mediastinum
Superior – superior thoracic aperture
Posterior – bodies of vertebrae T1 to T4
Anterior – manubrium of the sternum
Lateral – mediastinal pleurae (left and right)
Inferior – horizontal plane passing through the sternal angle and T4/T5 intervertebral disk.
SVC passes anterior or posterior to root of lung?
Anterior
Phrenic nerve is accompanied by which vessels?
Pericardiacophrenic artery and vein
Mediastinal tumors or aortic aneurysms can compress which nerve? cause what?
left recurrent laryngeal
paralysis of left vocal fold and hoarseness
Cardiac plexus formed by?
Located?
cardiac branches from the sympathetic trunk and the vagus nerve
lies inferior to aortic arch
Relation of phrenic and vagus nerves relative to root of the lung
Phrenic = anterior
vagus = posterior
Which cardiac vein drains does NOT drain into the coronary sinus? Where does it drain instead?
Anterior cardiac veins -> right atrium
The anterior interventricular branch of the left coronary artery is accompanied by the?
Great cardiac vein
Where does the LCA begin?
RCA?
LCA - b/w left auricle and pulmonary trunk
RCA - b/w right auricle and ascending aorta
The SA nodal branch comes of which artery?
Anterior right atrial branch of RCA
Marginal branch of RCA is accompanied by which vein?
small cardiac vein
posterior interventricular branch of the right coronary artery accompanies the
What does it supply
middle cardiac vein
LV wall and post portion of IV septum
Location of the SA node and AV node
SA node - lies at the superior end of the crista terminalis at the junction between the right atrium and the superior vena cava.
AV node - located in the interatrial septum, above the opening of the coronary sinus.
What connects papillary muscles to the valve
chordae tendinae
List papillary muscles in RV
anterior - biggest
septal - smallest
posterior
What contains part of the right bundle of the conducting system - part that stimulates anterior papillary muscles
(mentioned twice)
Septomarginal trabecula (moderator band)
-extends from IV septum to base of anterior papillary muscle
cone-shaped portion of the right ventricle inferior to the opening of the pulmonary trunk is called
conus arteriosus
Name the 3 cusps of pulmonary valve
What does the nodule do?
ant, right and left semilunar cusps
divides the free edge of the semilunar valve cusp into two halves. Each half is referred to as a LUNULE.
The nodule and lunules help to seal the valve cusps and prevent backflow of blood during diastole.
Referred pain for heart attack through which nerve?
branch of which nerve and which vertebral level?
Intercostobrachial nerve
Lateral cutaneous branch of 2nd intercostal nerve (T2)
Origins?
Posterior intercostal a.
Anterior intercostal a.
Posterior intercostal a. -> thoracic aorta
Anterior intercostal a. -> internal thoracic a.
The portion of the parietal pleura that adheres to the walls of the mediastinum is referred to as
mediastinal parietal pleura
The two brachiocephalic veins meet to form the SVC at which point?
posterior to the inferior border of the R 1st costal cartilage
The epicardium contains?
Visceral pericardium + epicardial fat
Borders of the heart
R border: formed by the R atrium
Inferior border: formed by the R ventricle and a small part of the L ventricle.
L border: formed by the L ventricle
Superior border: formed by the R & L atria and auricles.
Surfaces of the heart
Sternocostal (anterior) surface: formed mainly by the R ventricle.
Diaphragmatic (inferior) surface: formed mainly by the L ventricle and a small part of the R ventricle.
Pulmonary (Left) surface: formed mainly by the L ventricle. The pulmonary surface of the heart is in contact with the cardiac impression of the L lung.
Pericardium attaches to diaphragm using the
central tendon of the diaphragm
What does the post interventricular branch of RCA anastomose w/?
Ant interventricular branch of LCA
Opening for the LCA and RCA?
left and right aortic sinuses
TRICUSPID VALVE
Chordae tendinae attach to which cusps for the 3 papillary muscles?
Anterior papillary m: largest, attach to anterior & posterior cusps
Posterior papillary m: attach to posterior and septal cusps
Septal papillary m: smallest, attach to septal and anterior cusps
R brachiocephalic formed by which 2 veins?
internal jugular and right subclavian veins
