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Anatomy > Heart and Mediastinum > Flashcards

Heart and Mediastinum Flashcards

1
Q

What part of the mediastinum holds the heart?

A

middle

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2
Q

The superior mediastinum lies right behind the breast plate, what major vessels are in this space?

A

ascending aorta, aortic arch into right brachiocephalic trunk (splits into right common carotid and right subclavian) and left subclavian and left common carotid

superior vena cava, left and right brachiocephalic vein

ABCs - seems like eveyrhing but IVC

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3
Q

Superior mediastinum contents

Which one is most anterior?

A

thymus gland
trachea
esophagus
great vessels - BC veins, SVC, arch of aorta, carotid and subclavian artery

thymus is most anterior

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4
Q

Inferior mediastinum contents

A

*heart
thoracic aorta
esophagus
trachea

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5
Q

Contents of the anterior mediastinum

A

connective tissue and sternopericardial ligaments

(remember hard to get these off when taking off chest wall)

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6
Q

Contents of the middle mediastinum

A

Heart
Aortic Arch
Root of lung

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7
Q

Posterior Mediastinum contents

A

aorta
vena cava and azygos veins
thoracic duct
esophagus
sympathetic ganglia and splanchnic nerves

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8
Q

The visceral layer of the pericardium is also called the

A

epicardium

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9
Q

The phrenic nerve is asymmetrical because

A

the heart is offset

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10
Q

What vessels supply the pericardial sac?

A

pericardiacophrenic artery and vein

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11
Q

parent structure of the pericardiophrenic artery

A

internal thoracic artery

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12
Q

Pericarditis - causes and symptoms

A

viral and bacterial infections, systemic illness or after MI

chest pain with UE referral but relieved with sitting forward

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13
Q

What is constrictive pericarditis?

A

excessive thickening of the pericardial sac - usually only the parietal

can compress the heart and lead to heat failure

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14
Q

apex of the heart lies where from anterior view?

deep to which intercostal space?

A

inferior lateral aspect of left ventricle

deep to the 5th intercostal space

be careful of orientation on posterior view

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15
Q

describe the orientation of the interventricular septum

A

goes between ventricles and through apex on an oblique axis

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16
Q

Difference between coronary sulcus and coronary sinus (and where are they?)

A

coronary sulcus is posterior depression for the coronary sinus (vein) to run through

horizontal

vein that takes deoxy blood from the heart muscle

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17
Q

azygous vein parent structure

A

SVC?

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18
Q

Describe blood flow through the heart

A

Deoxygenated blood enters through the IVC or SVC into the right atrium, through the tricuspid valve into the right ventricle, then through the pulmonary valve into pulmonary arteries which go to the lungs, blood becomes oxygenated and returns to heart via pulmonary veins into the left atrium, then through the mitral valve into left ventricle, then through aortic valve and out through the aorta

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19
Q

A blood clot traveling from the body would first enter what structure of the body?

A

right atrium

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20
Q

T/F: the RV and LV eject the same volume of blood per beat

A

T

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21
Q

SVC drains blood from _____
IVC drains blood from ______

A

above diaphragm
below diaphragm

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22
Q

The right brachiocephalic vein is oriented ___ and the left brachiocephalic vein is oriented ___

The join together via the _____

A

vertical
horizontal

SVC

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23
Q

How many pulmonary arteries come off of the pulmonary trunk?

A

2 on the right side (superior and inferior)

1 on left side, left is longer

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24
Q

What are the parts of the aorta and what major vessels come off of it?

A

Root, ascending aorta, aortic arch, descending/thoracic artery

right brachiocephalic trunk

left subclavian
left common carotid

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25
Q

Viewing the heart posteriorly, which side is the apex on?

A

true left side along with left ventricle

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26
Q

the base of the heart consists of mainly the ___ ___ and proximal great veins

think about the pyramid diagram!

A

left atrium

Base is NOT the floor, its the back

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27
Q

The diaphragmatic surface of the heart is

A

(bottom portion of pyramid)

the heart rests on the diaphragmatic surface in anatomical position, consists of left ventricle and small portion of right ventricle

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28
Q

On an EKG, the LUB sound refers to

the DUB sound is…

A

LUB = closure of tricuspid and bicuspid valves

DUB = pulmonary and aortic valves closing

29
Q

Systolic pressure is measured between

A

LUB and DUB

ventricular contraction, so mitral and tricuspid valves close (LUB), then ventricles contract, and then the aortic and pulmonary valves open as blood is pushed through, then they close with DUB (beginning diastole)

30
Q

Diastolic pressure is measured between

A

DUB and next LUB

diastole is relaxation of ventricles, so closure of aortic and pulmonary valves (DUB) after pushing out blood, AV valves open and atrium contraction, and then closure of tricuspid and bicuspid valves (LUB)

31
Q

Where does the RCA come from and where does it lie?

A

comes from the right aortic sinus of the ascending aorta

lies between right atrium and ventricle

32
Q

branches of the right coronary artery

A

SA node branch and right marginal branch
(also posterior interventricular branch)

know where to find these!

33
Q

branches of left coronary artery

A

circumflex branch (wraps around to posterior side)

left marginal branch

anterior interventricular branch of artery or LAD (left anterior descending)

34
Q

What is the widow maker?

A

anterior interventricular branch of left coronary artery

or

LAD - left anterior descending

35
Q

What is left dominant coronary artery referring to?

A

RCA typically supplies the SA and AV node branches, but rarely someone left circumflex branch of left coronary artery will supply them

36
Q

What are the three most common sites of occlusion leading to Myocardial Infarction?

A
  1. LAD - Anterior interventricular branch of LCA (40-50%)
  2. RCA (20-40%)
  3. Circumflex branch of the LCA (15-20%)
37
Q

Branches of the coronary sinus

A

left marginal vein and left posterior ventricular vein

also great, middle and small cardiac veins

38
Q

What do the papillary muscles do and where are they?

A

in the ventricles, connected to mitral and tricuspid valves via tendinous cords, preventing valves from flipping up into atrium during ventricle contraction

aka hold valve cusps in place during systole

39
Q

Sinus Venarum is in the _____ chamber of the heart and receives ____ (what vessels?)

easy - just think about what enters the RA

A

right atrium

IVC, SVC, coronary sinus

“sinus of veins”

40
Q

Coronary Sinus is in what heart chamber and receives what?

A

right atrium

receives venous return from the heart

41
Q

Atrial septum vs atrioventricular septum

A

artial - separates right and left atrium

atrioventricular septum - separates atria from ventricles and houses the bi or tri valves

42
Q

The oval fossa is in what chamber, specifically located where?

A

Right atrium, in interarterial septal wall

remnant of the foramen ovalis

43
Q

Where are the SA and AV nodes located? Which one is the pacemaker?

A

right atrium

SA (pacemaker) then AV

SA is in top corner of RA

AV is in atrial septum

44
Q

Cardiac neck pain could be caused by

A

an open foramen ovalis

(never closed during development)

45
Q

What chamber forms the largest part of the anterior surface of the heart?

A

Right ventricle

46
Q

What are the trabeculae carneae?

A

muscular ridges on right and left ventricular lumen that gives a sponge look

47
Q

Infundibulum

A

smooth outflow tract in RV leading to pulmonary valve and trunk

48
Q

Tricuspid valve prevents retrograde (backflow) during ventricle ____
while pulmonary valve prevents backflow during ____

A

contraction of ventricle

relaxation of ventricle

49
Q

What feature on the left atrium receives blood from the 4 pulmonary veins?

A

left auricle

50
Q

Which chamber of the heart heart works hardest? What is the result?

A

LV works harder than RV in adult

walls on left side are twice as thick as right

51
Q

Aortic vestibule

A

fibrous ring to which the 3 cusps of the aortic valve attaches

52
Q

Heart borders
superior
right
inferior
left

you need to look at this again lol

A

superior - two atria, L costal cartilage b/w 2nd and 3rd rib

right - R atrium, R third costal cartilage

inferior - RV, 6th costal cartilage, mid costal portion

left - L ventricle, 5th intercostal space at L midclavicular line**

53
Q

Describe the pathway of the conduction system of the heart

A

SA node impulse to→ Atria myocytes (atrial contraction) → AV node (between atria and ventricle) → Bundle of His (interventricular septum)→ Bundle branches (L and R ventricles) → Purkinje fibers → Ventricles (contraction)

54
Q

What is cardiac auscultation?

A

listening to heart to assess heart rate, rhythm and regularity

55
Q

Where is classic cardiac referred pain? (spinal levels)

A

C5 shoulder and C8 TI down the entire middle arm

lower cervical upper thoracic

56
Q

Female variation in cardiac referred pain location

A

more jaw and chin and neck pain

57
Q

The vagus nerve course is the longest course and is _______

A

asymmetrical

58
Q

what is the vagus nerves motor and sensory innervation?

A

motor - voluntary muscles of larynx and superior esophagus and other visceral innervation - tracheobronchial tree, heart and alimentary canal

sensory - pharynx larynx and same areas above

59
Q

Left recurrent laryngeal nerve is a branch of ____ and when compressed can cause hoarseness

A

left vagus nerve

60
Q

Phrenic nerve innervates each half of diaphragm and does sensory to what 3 things?

A

diaphragm, central tendon and pericardium

61
Q

What area does the diaphragm refer pain to?

A

R half goes to R shoulder
L goes to left shoulder

62
Q

The phrenic nerve is “pinned” to what structure? Then what structures does it follow?

A

anterior scalene

right reavels along with SVC and IVC
left travels over pericardium

63
Q

Which nerve is more anterior, phrenic or vagus?

A

phrenic

64
Q

Cardiac muscle innervation is via

A

sympathetic NS
parasympathetic NS
and visceral afferents from the cardiac plexus

65
Q

Describe Para and Sym NS effect on HR, force of contraction and coronary arteries (contract/dilate)

A

Para = decrease HR and force of contraction, constrict coronary arteries

Sym = increase HR and contraction force, dilate coronary arteries

66
Q

visceral nerves from the cardiac plexus use _______ and _____ nerve to send cardiac pain

A

sympathetic and vagus

67
Q

T/F: there is a superficial and deep cardiac plexus

A

T

68
Q

The thoracic duct is a lymph channel from ___ and feeds into the ____ system

A

LE
venous

Anatomy (23 decks)

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