Heart and mediastinum

Question 1

What are the vessels seen on the pericardial sac supplying?

Answer 1

The fibrous pericardium and the parietal layer of the serous pericardium

Question 2

The (blank) reflects onto the ascending aorta and the SVC.

Answer 2

pericardial sac

Question 3

As the heart grows into the serous pericardium to form a pericardial sac it invaginates the sac creating two layers. What are they? Which layer forms the outer layer of the heart (epicardium)? Which layer fuses with the serofibrous connective tissue of the fibrous pericardial sac. Both parietal and visceral layers are (blank) (basically one cell layer thick). The fibrous pericardium is relatively (blank) except over long periods of time.

Answer 3

Parietal and visceral layer
Visceral
Parietal
Mesothelium
non-distendable

Question 4

Left Vagus nerve courses past the aortic arch and heads posteriorly to reach the esophageal plexus giving off the (blank) on the way.

Answer 4

left recurrent branch

Question 5

The transverse sinus is located (blank) to the outflow and (blank) to the inflow. It is clinically significant because it is an easy way to identify the aorta and pulmonary trunk in heart surgery

Answer 5

posterior; anterior

Question 6

The oblique sinus is formed by the reflections of the (blank) over the pulmonary veins and sup. and inf. vena cava

Answer 6

serous pericardium

Question 7

The base of the heart is primarily which atrium?

Answer 7

Left atrium

Question 8

A right dominant heart has the PD descending from where? How about a left dominant heart?

Answer 8

Right coronary artery; circumflex artery

Question 9

The great, middle, and small cardiac veins drain into the (blank).

Answer 9

Coronary sinus

Question 10

Discuss these structures in the right atrium: 
Fossa ovalis
Muscular and smooth walls
Auricle
Crista terminalis

Answer 10

Fossa ovalis is the remnant of the primitive foramen ovale
The muscular portion of the atrium is called the pectinate muscles
Auricle can pump extra blood, like a reserve
The crista terminalis separates the rough from the smooth wall

Question 11

Discuss right ventricle:
Smooth and rough parts of the wall
Papillary muscles
Moderator band
Chordae tendineae; cusps of the tricuspid valve
Pulmonic valve

Answer 11

Smooth part = conus arteriosus
Rough part = trabeculae carneae
3 papillary muscles: anterior, posterior, and septal
Moderator band: connects the septum to the anterior papillary muscle

Question 12

In the left ventricle, how many cusps are there?

Answer 12

Two!

Question 13

The left atrium is mostly smooth. Why?

Answer 13

Receives the pulmonary veins

Question 14

What keeps the aortic and pulmonic valves from allowing back flow?

Answer 14

The cusps close in a semilunar fashion

Question 15

What prevents the mitral and tricuspid valves from prolapsing?

Answer 15

The papillary muscles pulling on the chordae tendonae.

Question 16

All four valves of the heart are located within this structure

Answer 16

Fibrous skeleton

Question 17

Are nerves going to the cardiopulmonary plexus pre or postganglionic?

Answer 17

Postganglionic, because they are above the diaphragm

Question 18

Where do efferents to the heart come from? How do afferents return to CNS?

Answer 18

The vagus, the T1-4 chain ganglia, and the cervical chain ganglia.
Afferents return on the vagus for relfexes and via the sympathetics where they transmit painful stimuli and refer to surface locations on the body.

Question 19

Where are the four valves located? A; P; T; M

Answer 19

A: Body of sternum at 3rd intercostal space
P: Body of sternum at 3rd intercostal cartilage
T: Body of sternum at level of 4th intercostal space
M: Left side of sternum at 4th intercostal cartilage

Question 20

Where do you listen for the four valves? A; P; T; M

Answer 20

A: Listen at the right 2nd intercostal space
P: Listen at the left 2nd intercostal space
T: Listen at the 5th or 6th intercostal space
M: Listen at the left 5th intercostal space midsternal