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Anatomy II Test I - Jourdan > Heart and Mediastinum > Flashcards

Heart and Mediastinum Flashcards

1
Q

What makes up the superior boundary of the mediastinum?

A

Thoracic inlet

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2
Q

What is the inferior boundary of the mediastinum?

A

Diaphragm

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3
Q

What makes up the anterior boundary of the mediastinum?

A

Sternum and costal cartilages

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4
Q

What makes up the posterior boundary of the mediastinum?

A

Thoracic vertebrae

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5
Q

What makes up the lateral boundary of the mediastinum?

A

Pleura

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6
Q

What divides the mediastinum into superior and inferior parts?

A

Horizontal line from the manubriosternal joint to the T4/T5 Intervertebral joint

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7
Q

What is the inferior Mediastinum divided into?

A

Anterior, middle, and posterior

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8
Q

What are the contents of the superior mediastinum?

A 
Great vessels of the heart
Thoracic duct (left)
Part of the azygos system
R&L vagus nerves (recurrent laryngeal nerves)
Pulmonary 
Esophageal and cardiac autonomic nerve plexuses
Thymus
Parts of trachea and esophagus
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9
Q

What are the contents of the Inferior Anterior mediastinum?

A

Fat, lymph tissue, vessels, and in small children the thymus may extend into this region

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10
Q

What are the contents of the inferior middle mediastinum?

A

The heart and it’s pericardial tissues

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11
Q

What are the contents of the inferior posterior mediastinum?

A 
Thoracic aorta
esophagus
pulmonary arteries & veins
Azygos system
Thoracic Duct
Sympathetic trunk & thoracic splanchnic nerves
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12
Q

Which brachiocephalic vein is longer?

A

Left

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13
Q

Describe the thoracic sympathetic trunk

A

Bilateral; continuous with cervical and lumbar parts of sympathetic trunk
Paravertebral ganglia along its course
Lateral to the vertebral bodies

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14
Q

Describe thoracic splanchnic nerves

A

Bilateral; emerge from thoracic sympathetic trunks
Greater, lesser, least
All three are part of the abdomnopelvic splanchnic nerves and provide sympathetic innervation to viscera inferior to the diaphragm
All are PREsynaptic fibers that will synapse with prevertebral ganglia in abdomen

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15
Q

What are areas of constriction?

A

Arch of aorta, left main bronchus, and diaphragm.

These are where swallowed foreign objects are most likely to lodge and where a stricture may develop

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16
Q

What is the center of the cardiovascular system?

A

The heart

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17
Q

What does the heart connect to to transport blood between the heart and other body tissues?

A

Blood vessels

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18
Q

What are arteries?

A

Vessels that carry blood away from the heart

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19
Q

What are veins?

A

Vessels that carry blood back to the heart

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20
Q

What type of blood do arteries carry?

A

Blood high in oxygen except the pulmonary arteries

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21
Q

What type of blood do veins carry?

A

Blood in low oxygen except pulmonary veins

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22
Q

What are the great vessels?

A

The arteries and veins entering and leaving the heart

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23
Q

What does the structure of the heart ensure?

A

Ensures the unidirectional flow of blood through both the heart and the blood vessels

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24
Q

What is backflow of blood prevented by?

A

Valves within the heart

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25
Q

What does the heart act like?

A

Acts like two independent, side-by-side pumps that work independently but at the same rate

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26
Q

What does the right heart pump do?

A

Directs blood to the lungs for gas exchange

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27
Q

What does the left heart pump do?

A

Directs blood to body tissues for nutrient delivery

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28
Q

How is blood pressure developed?

A

Through alternate cycles of heart wall contraction and relaxation

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29
Q

How much blood pressure is essential to push blood through blood vessels to the body tissues for nutrient and waste exchange?

A

Minimum blood pressure

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30
Q

What is the base of the heart?

A

Left atrium primarily

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31
Q

Thinking about pulmonary circulation, the “systemic” pathway of this circuit involves which parts of the heart?

A

Left atrium and pulmonary veins: the start of the systemic circulation that has oxygenated blood that will go to the body

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32
Q

What does the pulmonary circuit consists of?

A

The chambers on the right side of the heart (right atrium and ventricle) as well as the pulmonary arteries and veins

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33
Q

What is the main function of the pulmonary circuit?

A

Convey blood to the lungs via pulmonary arteries to reduce carbon dioxide and replenish oxygen levels in the blood before returning to the heart in pulmonary veins

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34
Q

When does blood first enter the systemic circuit?

A

When blood returns to the left side of the heart

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35
Q

What does the systemic circuit consists of?

A

Chambers on the left side of the heart along with all the other named blood vessels

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36
Q

What is the main function of the systemic circuit?

A

Carries blood to all the peripheral organs and tissues of the body

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37
Q

What is the largest systemic artery in the body?

A

The aorta

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38
Q

Where does gas exchange occur?

A

Capillaries

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39
Q

Where do most veins merge and drain into?

A

The superior and inferior vena cavae

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40
Q 
Thinking about position of the heart in the mediastinum, which of the following heart structures is located more posteriorly, and makes up most of what is called the "base" of the heart?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
A

C. Left atrium

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41
Q

What is the approximate size of a heart?

A

The relatively small, conical organ is approximately the size of a person’s clenched fist and weighs about 250 to 350 grams

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42
Q

What is the heart’s position in the body?

A

Left of the body midline posterior to the sternum in the middle mediastinum
Rotated such that its right side or border is located more anteriorly, while its left side or border is located more posteriorly

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43
Q

Where is the superior part of the heart relative to the ribs?

A

At the third ribs

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44
Q

Where is the apex of the heart relative to the ribs?

A

At the six ribs

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45
Q

Where is the aortic arch relative to the ribs?

A

At the manubriosternal joint

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46
Q

What is the base of the heart?

A

The posterosuperior surface of the heart, formed primarily by the left atrium

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47
Q

What borders the base of the heart?

A

The pulmonary veins that enter the left atrium

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48
Q

What is the inferior, conical end of the heart?

A

Apex

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49
Q

Where does the apex project?

A

Slightly anteroinferiorly towards the left side of the body

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50
Q 
The pericardium of the heart has three primary layers. If the pericardium of the heart is pierced by a needle, which of these primary layers would the needle first pass through?
A. Visceral pericardium
B. Pleural pericardium
C. Parietal pericardium
D. Fibrous pericardium
E. Epicardium
A

D. Fibrous pericardium

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51
Q

What is the heart contained in?

A

A fibrous, serous sac held in place within the mediastinum by connective tissue that supports the great vessels’ external walls superior to the heart and the diaphragm inferior to it

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52
Q

What does the pericardium restrict?

A

Restricts heart movements so that it doesn’t bounce and move about in the thoracic cavity, and prevents the heart from overfilling with blood

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53
Q

What is the outer portion of the pericardium?

A

A tough, dense connective tissue layer called the fibrous pericardium that is attached to both the sternum and the diaphragm

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54
Q

What is the inner portion of the pericardium?

A

A thin, double-layered serous membrane called the serous pericardium.

55
Q

What are the two layers of the inner portion of the pericardium?

A

Parietal layer and visceral layer

56
Q

What are the three distinctive layers of the heart wall?

A

External epicardium, middle myocardium and internal endocardium

57
Q

What is the outermost heart layer? What is it also known as?

A

Epicardium and is also known as the visceral layer of serous pericardium

58
Q

As we age, what is deposited in the epicardium?

A

Fat-this layer becomes thicker and more fatty

59
Q

What is the middle layer of the heart wall?

A

The myocardium that is composed chiefly of cardiac muscle tissue
Lies deep to the epicardium and superficial to the endocardium

60
Q

What is the thickest of the three heart wall layers?

A

The myocardium

61
Q

What are covered by a thin endothelium called the endocardium?

A

Internal surface of the heart and external surfaces of the heart valves

62
Q

What is between the endocardium and myocardium?

A

Subendocardial layer, which is composed of areolar connective tissue

63
Q

What are the four hollow chambers of the heart?

A

Two smaller atria and two larger ventricles

64
Q

What are atria chambers?

A

thin-walled chambers that are located superiorly.

65
Q

What are located anteriorly on each atrium?

A

A wrinkled, flaplike extension called an auricle

66
Q

What exits the heart at the basal surface?

A

Two large arteries, the pulmonary trunk and the aorta

67
Q

What does the pulmonary trunk carry blood to?

A

Carries blood from the right ventricle into the pulmonary circuit

68
Q

What does the aorta carry blood to?

A

Carries blood from the left ventricle into the systemic circuit

69
Q

What separates the atria from the ventricles externally?

A

A relatively deep coronary sulcus (or atrioventricular sulcus) that extends around the circumference of the heart

70
Q

What are located between the left and right ventricles?

A

The anterior interventricular sulcus and the posterior interventricular sulcus

71
Q

Where do the interventricular sulci extend?

A

Inferiorly from the coronary sulcus towards the heart apex

72
Q 
Which of the following heart structures is framework of dense collagen that anchors and provides support for the antrioventricular and semilunar valves of the heart?
A. Chordae tendineae
B. Papillary muscle
C. Fibrous skeleton
D. Fossa ovalis
A

C. Fibrous skeleton

73
Q

What is between the atria and the ventricles, and is formed from dense irregular connective tissue?

A

Fibrous heart skeleton

74
Q

What are the functions of fibrous heart skeleton?

A
  • Separates the atria and ventricles
  • Anchors heart valves by forming supportive rings at their attachment points
  • Provides electrical insulation between atria and ventricles
75
Q

What does insulation from the fibrous skeleton of the heart ensure?

A

Insulation ensures that muscle impulses are not spread randomly throughout the heart, and thus prevents all of the heart chambers from beating at the same time

76
Q

What does the Fibrous skeleton of the heart provide?

A

Rigid framework for the attachment of cardiac muscle tissue

77
Q

What do the four heart chambers play a role in?

A

The continuous process of blood circulation

78
Q

What do valves permit?

A

The passage of blood in one direction and prevents its backflow

79
Q

What three major vessels empty into the right atrium?

A
  • Superior vena cava drains blood from the head, upper limbs, and superior regions of the trunk
  • Inferior vena cava drains blood from the lower limbs and trunk
  • Coronary sinus drains blood from the heart wall
80
Q

What forms a wall between the right and left atria?

A

Interatrial septum

81
Q

What is remnant in the interatrial septum?

A

The foramen ovali that is called fossa ovalis in the adult

82
Q

What muscle does the right atrium have on the internal aspects of the wall?

A

The pectinate muscle

83
Q

What separates the right atrium from the right ventricle?

A

The right AV valve

84
Q

What is another name for the right atrioventricular valve?

A

Tricuspid valve - has three triangular flaps

85
Q

When does the tricuspid valve close?

A

It is forced closed when the right ventricle begins to contract, preventing blood blackflow into the right atrium

86
Q

What forms a wall between the right and left ventricles?

A

Interventricular septum

87
Q

What does the internal wall surface of each ventricle have?

A

Two (Left) or Three (right) cone-shaped, muscular projections called papillary muscles,

88
Q

What is the function of papillary muscles?

A

Anchors chordae tendineae.

89
Q

What is the function of chordae tendineae?

A

Attach to the cusp of the right AV valve and prevent everting and flipping into the atrium when contracting

90
Q

Where are trabeculae carneae?

A

Ventricles

91
Q

The ligamentum arteriosum, a fetal remnant of the ductus arteriosis, is located where?

A

Between the pulmonary trunk and aorta

92
Q

At the superior end of the pulmonary trunk, it narrows into a smooth-walled, conical region called the _______

A

Conus arteriosus

93
Q

What marks the end of the right ventricle and the entrance into the pulmonary trunk?

A

The pulmonary semilunar valve

94
Q

What does the pulmonary trunk divide shortly into?

A

Right and left pulmonary arteries

95
Q

What is located within the walls of both ventricles immediately before the connection of the ventricle to the pulmonary trunk and aorta?

A

Semilunar valves

96
Q

What are semilunar valves composed of?

A

Three thin, pocketlike semilunar cusps

97
Q

How do semilunar valves open?

A

As blood is pumped into the arterial trunks, it pushes against the cusps, forcing the valves open

98
Q

How is blood prevented from flowing back into the ventricles from the arterial trunk?

A

When ventricular contraction ceases, the blood first enters the pockets of the semilunar valves between the cusp and the chamber wall; this causes the cusps to “inflate” and meet at the artery center, effectively blocking blood backflow

99
Q

The smooth posterior wall of the left atrium contains how many openings for oxygenated blood return?

A

Four pulmonary veins

100
Q

The right atrium has pectinate muscle along its wall, does the left atrium have pectinate muscle?

A

It has some pectinate muscles along its anterior wall as well as an auricle

101
Q

What separates the left atrium from the left ventricle?

A

The left AV valve

102
Q

What is the left AV valve also called?

A

The bicuspid or mitral valve

103
Q

True or false?

The left AV valve has different chordae tendineae than those of the right AV valve?

A

False

104
Q

When does the left AV valve close?

A

It is forced closed when the left ventricle begins to contract; this prevents backflow

105
Q

What is the largest of the four heart chambers?

A

The left ventricle

106
Q

How much thicker is the wall of the left ventricle than the right ventricular wall?

A

three times thicker

107
Q

Why does the left ventricle have thick walls?

A

It requires thick walls in order to generate enough pressure to force the oxygenated blood from the lungs into the aorta and then through the entire systemic circuit

108
Q

Why does the right ventricle not need thick walls?

A

Because it only has to pump blood to the nearby lungs

109
Q

Where is trabeculae carneae more prominent?

A

In the left ventricle

110
Q

What helps support the left AV valve?

A

Two large papillary muscles attached to the chordae tendineae

111
Q

What marks the end of the left ventricle and the entrance into the aorta at the superior end of the ventricular cavity?

A

The aortic semilunar valve

112
Q

What is the heart innervated by?

A

The autonomic nervous system. Both sympathetic and parasympathetic components
Referred to as the cardiac or coronary plexus

113
Q

What does sympathetic innervation going to do to the heart?

A

Increase the heart rate an the force of heart contractions

114
Q

What does parasympathetic innervation do to the heart?

A

Decreases heart rate, but tends to have no effect on the force of contractions, except in special circumstances

115
Q

What do left and right coronary arteries travel in?

A

The coronary sulcus (atrioventricular groove) of the heart

116
Q

What are the only brances of the ascending aorta that go to supply the heart wall?

A

The left and right coronary arteries

117
Q

Where are the openings for the left and right coronary arteries located?

A

Immediately superior to the aortic semilunar valve

118
Q

What does the right coronary artery typically branch into? What do the branches supply?

A

The marginal artery-supplies the right border of the heart

Posterior interventricular artery-supplies both the left and right ventricles

119
Q

What does the left coronary artery typically branch into?

What does it supply?

A

The anterior interventricular artery

  • Also called the left anterior descending artery (LAD)
  • Supplies the anterior surface of both ventricles and most of the interventricular septum

Circumflex artery
-Supplies the left atrium and ventricle

120
Q

What can vary greatly among individuals?

A

Arterial pattern

121
Q

What acts as the pacemaker of the heart?

A

The sinoatrial (SA) node

122
Q

Where is the SA node located?

A

In the posterior wall of the right atrium, adjacent to the entrance of the superior vena cava

123
Q

Where is the atrioventricular (AV) node located?

A

The floor of the right atrium between the right AV valve and the coronary sinus.
(Antriaventricular septa)

124
Q

Cardiac impulse starts at the SA node and then travels where?

A

Travels to the AV node -> atrioventricular bundle (bundle of His)->purkinje fibers

125
Q 
The main tributary of the coronary sinus is the:
A. Great cardiac vein
B. Middle cardiac vein
C. Great vein of Galen
D. Small cardiac vein
A

A. Great cardiac vein

126
Q 
The right coronary artery typically branches into the:
A. Marginal artery
B. Anterior interventricular artery
C. Lateral anterior descending artery
D. Circumflex artery
A

A. Marginal artery

127
Q

What three venous structures drain directly into the right atrium?

A

Superior vena cava, inferior vena cava and coronary sinus

128
Q

What is cardiomyopathy?

A

A condition in which a ventricle has become enlarged, thickened and/or stiffened. As a result, the heart’s ability to pump is reduced.

129
Q

What are the two types of cardiomyopathy?

A

Dilated: An enlarged, weakened left ventricle struggles to pump enough blood to meet the body’s need
Hypertrophic: Left ventricle cannot fully relax between heartbeats, resulting in less blood flow

130
Q

What is coronary artery bypass?

A

When the internal mammary artery is used to supply the heart when there are sites of blockage due to cholesterol build-up

131
Q

What other vessel can be used if there are sites of blockage to the heart?

A

The saphenous vein

132
Q

What is angioplasty?

A

A procedure in which a catheter is inserted with a tiny balloon that presses the plaque blockage against the artery so that blood may flow more freely through a vessel. A stent is then inserted to keep the vessel pathway open and the blood flowing

133
Q

What can cause an heart attack?

A

A blood clot and cholesterol plaque causes an obstruction of coronary artery supplying blood to the heart muscle and heart muscle dies.

Anatomy II Test I - Jourdan (10 decks)

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