Heart

Question 1

Superior Mediastinum

Answer 1

arch of the aorta with its three large branches, Right and left brachiocephalic veins, upper part of the superior vena cava, vagus (10th cranial), phrenic and the left recurrent laryngeal nerves, thymus (in children, or some possible remnants in adults), trachea, esophagus, some lymph nodes

Question 2

Inferior Mediastinum

Answer 2

anterior mediastinum: between the heart and the sternum; middle mediastinum: the heart and its pericardium; posterior mediastinum: between the heart and the vertebrae

Question 3

Best landmark for posterior chamber for inferior mediastinum.

Answer 3

dorsal vertebrae

Question 4

Some causes of mediastinal widening.

Answer 4

Anthrax inhalation, Asbestos (Found in old construction of drywall), Mesothelioma (malignant form of cancer), Trauma, Malignant lymphomas, Cardiomegaly (enlarged heart), CHF (Congestive Heart Failure), Pleural effusion (mostly in basal portion of lungs)

Question 5

The ________ pericardium is double layered, smooth, delicate mesothelium that lines and fuses with the fibrous pericardium (tough and inelastic).

Answer 5

parietal

Question 6

The _______ layer of the heart is usually called the epicardium and is continuous to the myocardium (muscle of the heart).

Answer 6

visceral

Question 7

Layers of the pericardium from superficial to deep.

Answer 7

fibrous pericardium–>parietal layer of serous pericardium–>pericardial cavity–>visceral layer of serous pericardium (epicardium)

Question 8

Cardiac muscle.

Answer 8

myocardium

Question 9

Coronary blood vessels lie just beneath the ______ layer of the serous pericardium.

Answer 9

visceral

Question 10

Pericardial fluid general characteristics.

Answer 10

pericardial fluid protects heart from external shock/jerk movements, more slippery than pleural fluid due to more lipids, accumulation of fluid in this space is considered pathological

Question 11

In embryological development, this gives rise to the pulmonary trunk.

Answer 11

bulbos cortus

Question 12

In embryological development, this gives rise to the aortic trunk.

Answer 12

trunk arteriosum

Question 13

What is Tetralogy of Fallot?

Answer 13

conus septum develops too far anteriorly giving rise to two unequally proportioned vessels characterized by a large overriding aorta and a smaller stenotic pulmonary trunk. Along with these abnormalities there is:

1. Ventricular septal defect (VSD) of the membranous portion (the septum is displaced too far anteriorly to contribute to the septum)
2. Right ventricular hypertrophy due to the abnormally deviation of blood from left to right inferior chamber.

Question 14

Risk factors for Tetralogy of Fallot.

Answer 14

Tetralogy of Fallot is perhaps an idiopathic condition. However, several factors may increase the risk of a baby being born with the disease: Nitrates in contaminated water consumed by neonate, Poor maternal nutrition during pregnancy, Mother older than 40, Maternal viral infection, i.e. rubella (measles) during pregnancy, Maternal alcoholism, Genetic predisposition (parent who had tetralogy of Fallot)

Question 15

Persistent Truncus Arteriosus

Answer 15

Congenital condition results when the truncal (truncus arteriosus) and conal (conus cordis) swellings fail to develop. A single artery, the truncus arteriosus, arises from both ventricles above the ventricular septal defect, allowing pulmonary and systemic blood to mix. Distally, the single artery may be divided into the aorta and pulmonary trunk by an incomplete septum.

Question 16

Communication from right side into the left side at a point where you can cross your fingers through (or probe). Used to clamp the vessels in heart transplant surgery.

Answer 16

transverse sinus

Question 17

Will close within hours of a baby’s first breath.

Answer 17

foramen ovale (ostium primum)

Question 18

Branches of right coronary artery (typical dominance 67-70%).

Answer 18

SA node br., Rt acute marginal br., Posterior descending interventricular br., AV nodal br.

Question 19

Branches of left coronary artery (typical dominance 7-10%).

Answer 19

Circumflex br. (Left dominance 7-10%), Anterior interventricular br. (LAD), Left marginal br.

Question 20

Coronary sinus

Answer 20

Great cardiac vv. (parallels LAD), Middle cardiac vv. (parallels post. desc. aa.), Small cardiac vv. (parallels rt. Marginal aa. - not as important), Anterior cardiac vv. (drains directly into Rt. atrium)

Question 21

Coronary arterial disease (CAD)

Answer 21

LAD (40-50%) affects anterior and apical lt. ventricle and anterior 2/3 interventricular septum (IVS); Rt. Coronary (30-40%) disturbing post. wall of lt. ventricle and post 1/3 of IVS; Lt. Circumflex (15-20%) affects lateral wall of lt. ventricle

Question 22

Coronary angiography

Answer 22

mostly done through iliac artery but can be done through aorta as well

Question 23

Indentations of endocardium that represent turbulence in the primitive ventricular system.

Answer 23

trabeculae carnae

Question 24

Path of blood flow.

Answer 24

lungs–>pulmonary veins–>left atrium–>bicuspid valve–>left ventricle–>aortic (semilunar) valve–> aorta and systemic circulation–>superior and inferior vena cava–>right atrium–>tricuspid valve–>right ventricle–>pulmonary (semilunar) valve–>pulmonary trunk and pulmonary arteries–>back to lungs for gas exchange

Question 25

Primary difference between the semilunar and bicuspid/tricuspid valves.

Answer 25

semilunar - controlled by pressure; bicuspid/tricuspid - controlled by muscle