Heart and Lungs - 2

Question 1

boundaries of middle mediastinum

Answer 1

superior - transverse thoracic plane
inferior - diaphragm
lateral - mediastinal pleura
anterior - anterio border of pericardium
posterior - posterior border of pericardium

Question 2

contents of middle mediastinum?

Answer 2

pericardium
heart
origin of heart vessels: pulmonary trunk, ascending aorta, pulmonary veins
phrenic nerve and pericardiophrenic vessels

Question 3

superior border of heart?

Answer 3

2nd left intercostal to 3rd right intercostal

Question 4

right border of heart?

Answer 4

3rd right intercostal cartilage to 6th right costal cartilage

Question 5

inferior border of heart?

Answer 5

6th right costal cartilage to left 5th intercostal space at MCL (apex)

Question 6

left border of heart?

Answer 6

left 5th intercostal space MCL to 2nd left costal cartilage

Question 7

pericardium

Answer 7

fibroserous sace surrounding heart and origins of great vessels

Question 8

fibrous pericardium?

Answer 8

tough external layer composed of dense connective

anchors heat and prevents overfilling

Question 9

attachments of fibrous pericardium?

Answer 9

anteriorly to sternum via sternopericardial ligament

posteriorly to fascia of esophagns

inferiorly to central tendon of diaphragm via pericardiacophrenic ligaments

superiorly with the adventitia (outer connective tissue layer) of the great vessels

Question 10

serous pericardium?

Answer 10

thin serosal membranes (visceral and parietal layers)

closed sac that provides smooth, frictionless surfaces for heart to move in during contraction

Question 11

parietal pericardium

Answer 11

composed of simple squamous epithelial cells and thin layer of loose connective tissue
-adherent to inner surface of fibrous pericardium

Question 12

visceral pericardium

Answer 12

composed of simple squamous epithelial cells and thin layer of loose connective tissue
-lines heart surfaces, continuous with parietal pericardium at great vessels

forms outer layer of hear is is called EPICARDIUM

Question 13

pericardial sac

Answer 13

potential space between parietal and visceral pericardium

contains only minimal amount of serous fluid

Question 14

cardiac tamponade

Answer 14

pericardial space filled with fluid (trauma or inflammation)

heart cannot fill to capacity due to surrounding fluid and inflexibility of fibrous pericardium

max capacity of sac is 300cc

Question 15

pericardiocentesis

Answer 15

procedure removing excess pericardial fluid

needle inserted through bare area of heart

left of sternum, 5th or 6th intercostal space to avoid pleural cavity

Question 16

pericardial sinuses

Answer 16

separate arterial and venous ends of embryonic tubular heart

Question 17

transverse pericardial sinus

Answer 17

anterior border - aorta and pulmonary trunk
posterior border - SVC and pulmonary veins

can pass surgical clamp around major arteries and veins and insert tubes allowing blood to be diverted to a cardiac bypass pump during coronary artery surgery

Question 18

oblique pericardial sinus

Answer 18

pocket-like cul de sac posteriorto heart

bounded by pulmonary veins and IVC

Question 19

vascular supply of pericardial sac

Answer 19

pericardiacophrenic arteries (from internal thoracic artery

pericardiacophrenic vein - internal thoracic veins

Question 20

innervation of pericardial sac?

Answer 20

phrenic nerve - sensory innervation to fibrous and parietal pericardium

visceral pericardium - cardiac plexus

Question 21

pain from pericardium?

Answer 21

reffered to shoulder/neck region

dermatomes supplied by phrenic nerves C3,4,5

Question 22

pericarditis?

Answer 22

inflammation of serious pericardial membrane

become rough and no longer slide easily over one another

Question 23

where are there pain fibers?

Answer 23

in fibrous and parietal pericardium

none in visceral pericardium

Question 24

orientation of heart?

Answer 24

left is posterior
right is anterior

apex - inferiorly and to the left
base - posteriorly

Question 25

SVC and IVC

Answer 25

superior and inferior vena cava

-return poorly oxygenated blood to right atrium

Question 26

pulmonary trunk?

Answer 26

artery that exits right ventricle

carries de-oxygenated blood from heart to lungs

divides into right and left pulmonary arteries

Question 27

pulmonary veins?

Answer 27

enter left atrium

superior and inferior veins from left and right lungs carry oxygenated blood from lungs to heart

Question 28

ascending aorta

Answer 28

exits left ventricle

transports oxygenated blood to the body (systemic circulation)

Question 29

external sulci?

Answer 29

atrioventricular sulcus - coronary sulcus

anterior and posterior interventricular sulcus

Question 30

apex of heart

Answer 30

directed inferiorly and to left

entirely left ventricle

posterior to left fifth intercostal space MCL

Question 31

base of heart

Answer 31

formed by left atrium

directed posteriorly

Question 32

surfaces of heart

Answer 32

anterior (sternocostal) 2/3 right ventricle 1/3 left ventricle

right - right atrium

left - left ventricle and auricular appendage

diaphragmatic - 2/3 left V and 1/3 right V

Question 33

borders of heart

Answer 33

right - right atrium
inferior - 2/3 right ventricle 1/3 left ventricle
left - left ventricle and auricular appendage

Question 34

fibrous skeleton

Answer 34

provide structural support for heart valves; maintain patency and preventing distention of heart contraction

attachment site for cardiac muscle and for valve leaflets

insulates against impulse conduction from atria to ventricles, prevents aberrant and spread of impulses

tunnel for passage of A/V bundle of His

Question 35

anulus fibrosis

Answer 35

fibrous ring around orifices of 4 heart valves

Question 36

fibrous trigones

Answer 36

connections between fibrous rings

• left - between aortic and mitral valve
• right - between aortic, mitral, tricuspid valves