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heart and mediastinum Flashcards

1
Q

Type of circulation in each side of heart

A

right- pulmonary

left- systemic

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2
Q

resistance and pressure in each side of heart

A

right- low resistance, pressure= 20mmHg

left- high/variable resistance, pressure= 130mmHg

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3
Q

Brief organisation and passage of blood in heart chambers

A

right atrium- receives deoxygenated blood from inferior and superior vena cava

blood passes through tricuspid valve into the right ventricle

leaves right ventricle via pulmonary trunk- goes to lungs

oxygenated blood passes into left atrium via pulmonary vein

passes through bicuspid valve into the left venticle

leaves via aorta

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4
Q

mediastinum definition

A

space between the lungs in the thoracic cavity where the heart is located

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5
Q

How is the heart separated from other mediastinal structures?

A

separated by a tough membrane known as the pericardium/ pericardial sac

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6
Q

Where does the heart sit?

A

Within the pericardial cavity, present in the mediastinum

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7
Q

Structure of pericardium

A

double walled sac, containing the heart and roots of the great vessels

two layers- serous layer and fibrous layer

encloses the pericardial cavity which contains pericardial fluid

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8
Q

structure of fibrous pericardium + function

A
  • most superficial dense, loose connective tissue. Continuous with outer adventitial layer of great blood vessels
  • protects the heart, anchors it to surrounding walls, prevents the overfilling with blood
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9
Q

two layers of serous pericardium + overall function

A
  • divided into two layers- parietal and visceral

lubricates the heart to prevent friction during activity

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10
Q

parietal pericardium structure + function

A

fused to and inseparable from the fibrous pericardium

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11
Q

visceral pericardium structure + function

A

extends to the beginning of the great vessels- becoming one with the parietal layer- at the aorta and pulmonary trunk and the superior and inferior cavas enter the heart

visceral layer comes into contact with the heart- forming the epicardium. made of connective tissue and functions as a protective layer

consists of a simple squamous epithelium called mesothelium, reinforced with loose, irregular or areolar connective tissue

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12
Q

Where is the pericardial fluid located?

A

between the parietal and visceral serous pericardium in the pericardial cavity

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13
Q

process of leaving blood to lungs

A

leaves right ventricle which pumps deoxygenated blood into the pulmonary trunk

bifurcates into left and right pulmonary arteries ( actually 4 in total)

vessels branch many times until they form pulmonary capillaries where gaseous exchange takes place

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14
Q

Process of blood leaving lungs and entering heart

A

pulmonary capillaries form pulmonary veins

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15
Q

surface features of the heart

A

auricles, sulci, coronary arteries

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16
Q

structure and functions of auricles

A

superficial leaf-like extension of the atria near the superior surface of the heart- one on each side

shape resembles a human ear

relatively thin walled structures that can fill with blood and empty into atria or upper chambers of the heart

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17
Q

structures and functions of sulci

A

series of fat filled grooves along the superior surfaces of the heart

major coronary blood vessels located within the sulcus

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18
Q

Structure and functions of coronary arteries

A

right and left coronary arteries- with marginal and anterior and posterior interventricular arteries present- supply heart with oxygenated blood

no functional anastomoses

both left and ride originate from the aortic valve at the aortic sinuses

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19
Q

how can the origin of the coronary arteries be viewed?

A

Dissection

coronary angiogram, where a cannula is inserted with a contrast medium

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20
Q

How is deoxygenated blood leaving the coronary arteries returned to the heart?

A

coronary sinus- a collection of veins joined together to form a large vessel that collects blood from the myocardium

venae cordis minimae- small vessels that drain directly into the right atrium

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21
Q

coronary sinus structure

A

starts at junction of the great cardiac vein and the oblique vein of the left atrium- the end of the veins is marked by the Vieussens valve

runs transversely in the left atrioventricular groove on the posterior side of the heart

valve of coronary sinus is on the posterior, inferior surface of the hear, medial to the vena cava opening

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22
Q

Major veins

A

superior and inferior vena cava, pulmonary veins

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23
Q

What forms the superior vena cava?

A

formed in superior mediastinum from the right and left brachiocephalic veins

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24
Q

what forms the brachiocephalic veins? + functions

A

left and right internal jugular vein and left and right subclavian vein

jugular- draining the head

subclavian- draining the upper limb

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25
what forms the inferior vena cava? + FUNCTION
left and right common iliac veins and the azygos vein and venous plexuses next to the spinal cord deoxygenated blood from abdomen, pelvis and lower limbs
26
pulmonary veins function + structure
carries oxygenated blood from the lungs to the left atrium four main pulmonary veins- two right and two left (two from each lung)
27
major arteries
aorta and pulmonary artery
28
pulmonary trunk structure and function
carries deoxygenated blood from the right ventricle to the lungs branches into the right and left pulmonary arteries that each lead to one lobe
29
function of aorta
carries oxygenated blood from the left ventricle to the whole body
30
structure of aorta
ascending aorta from left ventricle aortic arch curving round descending thoracic aorta the abdominal aorta
31
vessel divisions of aorta and functions
right to left: - brachiocephalic trunk - gives rise to the right subclavian and common carotid - right subclavian- upper limb - right common carotid- divides into internal and external carotid artery. Internal supplies brain, external face - left common carotid - left subclavian
32
structure of atria
- no valves at inlets - rough pectinate muscles and crista terminalis of His - sinus venarum- - right atrial appendage - interatrial septum - fossa ovalis
33
pectinate muscles structure, location and function
parallel ridges in the walls of the atria of the heart Behind the crista terminalis, in front of the smooth muscle fewer in left atrium
34
Crista terminalis structure, location and function
represents the junction between the sinus venosus and the heart in the developing embryo forms sinus venarum
35
Sinus venarum structure, location and function
smooth part of right atria, separated from the rest of the atria by crista terminalis fibres
36
fossa ovalis structure, location and function
depression in the right atrium at the level of the interatrial septum thin fibrous sheet that covered the foramen ovale after fetal development
37
structure of ventricles
- valves- tricuspid, mitral, pulmonary and aortic - chordae tendinae - trabeculae carnae - interventricular septum - papillary muscle
38
chordae tendinae structure, location
colloquially known as the heart strings tendon resembling fibrous cords of the connective tissue that connect the papillary muscles to the tricuspid and mitral valves
39
How valves change during circulation of blood?
1. during atrial systole, pressure in atria exceed that of ventricles, enabling blood to flow down the gradient 2. Chordae tendinae are relaxed as the AV valves are forced open 3. when ventricles pf the heart contract during systole, the blood pressure increases- pushing the AV valves close to prevent backflow- chordae tendineae prevent the eversion and prolapse by becoming tense
40
structure of tricuspid valve
- three leaflets, named anterior, posterior and septal - each leaflet attached to the anterior, posterior and septal papillary muscles of the right ventricles base of each cusp anchored to a fibrous ring that surrounds the orifice
41
structure of pulmonary valve
three cusps- left, right and anterior
42
structure of mitral valve
two cusps- anterior and posterior. both cusps secured to a fibrous ring at the orifice
43
structure of aortic valve
right, left and posterior cusp. sides of each leaflet attached to the walls of the outflow vessel- slightly dilated to form a sinus free superior edge of each leaflet is thickened to form a lunule and is widest in the midline- nodule
44
papillary muscle structure, location and function
3 muscles in right ventricle, 2 in left muscles attach to the AV valves via chordae tendineae begin to contract shortly before ventricular systole and maintain tension- prevent regurgitation through atrial cavities
45
trabeculae carnae structure, location and function
rounded, irregular columns of muscle that project from the inner surfaces of the ventricles Either are attached along the entire length of one side as ridges or are fixed at their extremities but free in the middle, such as the moderator band prevent suction that would occur with a flat surfaced membrane. Their contraction also pulls on the chordae tendineae, preventing inversion of the mitral and tricuspid valves
46
Explain location of heart
dorsal surface- lies near the bodies of vertebrae anterior surface- deep to the sternum and costal cartilages base of heart- third intercostal cartilage apex- lies to the left of the sternum, between the junction of the fourth and fifth ribs bottom of heart lies against diaphragm
47
explain base of heart
great veins, superior and inferior vena cavae, arteries attach to the superior surface of the heart
48
Apex definition
tip of the heart
49
Cardiac notch definiton
depression in the medial surface of the inferior lobe of the left lung
50
divisions of the mediastinum
anterior, superior, middle and posterior
51
what is the mediastinum initially divided into + where?
superior and inferior mediastinum sternal angle (sternal body and manubrium) and the T4/T5 intervertebral disc
52
where does the superior mediastinum terminate?
extends upwards, terminate at the superior thoracic aperture
53
where does the inferior mediastinum terminate?
extends downwards, diaphragm
54
borders of the superior mediastinum
superior- thoracic inlet inferior- inferior mediastinum anterior- manubrium of sternum posterior- vertebral bodies of T1-T4 lateral- pleurae of lungs
55
what vessels are present in the superior mediastinum?
arch of aorta, superior vena cava Left and right brachiocephalic veins brachiocephalic artery, left common carotid artery and subclavian artery
56
what nerves are present in superior mediastinum?
right vagus nerve- runs parallel to the trachea and passes posteriorly to the superior vena cava and right primary bronchus left vagus nerve- enters superior mediastinum between left common carotid and left subclavian arteries, descends anteriorly to the aortic arch, before travelling posterior to the left bronchus phrenic nerve- enters superior mediastinum lateral to the great vessels
57
other structures in superior mediastinum
thymus- most anterior structure, sits against posterior surface of sternum and extends into anterior mediastinum trachea oesophagus thoracic duct
58
middle mediastinum structures
heart and pericardium tracheal bifurcation
59
middle mediastinum vesels
ascending aorta pulmonary trunk superior vena cava
60
middle mediastinum nerves
left and right phrenic to diaphragm
61
middle mediastinum lymphatics
tracheobronchial lymph nodes
62
borders of middle mediastinum
anterior- anterior margin of pericardium posterior- posterior margin of pericardium laterally- mediastinal pleura of the lungs superiorly- superior mediastinum inferiorly- diaphragm
63
posterior mediastinum borders
lateral- mediastinal pleura (parietal pleura) anterior- pericardium posterior- T5-T12 vertebrae roof- superior mediastinum floor- diaphragm
64
vessels in posterior mediastinum
thoracic aorta + its divisions such as the superior phrenic arteries azygos, hemiazygos and accessoryhemiazygos vein thoracic duct
65
structures in posterior mediastinum
oesophagus , posterior to the arch of the aorta and heart - deviates to the left as it moves downwards
66
nerves in posterior mediastinum
thoracic sympathetic trunks
67
anterior mediastinum borders
lateral- mediastinal pleura anterior- body of sternum and transversus thoracic muscles posterior- pericardium roof- superior mediastinum floor- diaphragm
68
contents of anterior mediastinum
no major structures accomodates loose connective tissue, some lymph vessels, lymph nodes and branches of internal thoracic vessels
69
what are coronary arteries an example of?
functional end arteries
70
functional end artery definition
an artery that has ineffectual anastomoses
71
why is this a problem?
if there is an occlusion in the coronary artery, there is limited ways the blood can perfuse the heart so can lead to a myocardial infarction
72
when does coronary artery perfusion occur? + why
during heart relaxation- diastole during systole the subenchocardial coronary vessels are compressed due to high ventricular pressures
73
2 consequences of coronary artery occlusion + definitions
angina- chest pain or pressure due to a decreased blood flow to the heart myocardial ischaemia- restricted blood flow to the heart, can lead to death of cardiomyocytes- leading to a heart attack
74
embryological condition affecting the heart + explanation
situs inversus- major visceral organs are reversed or mirrored from their normal positions - all organs flipped, heart on the right side, everything is normal
75
lymph node location
bronchopulmonary nodes situated in the hilum of each lung lymph then travels to trachiobronchial nodes and then to paratracheal then enters the right lymphatic duct or left thoracic duct
76
aortic aneurysm explained
enlargement/dilation of the aorta, greater than 1.5 times it normal size no symptoms unless it ruptures most commonly found in abdominal aorta, sometimes thoracic weakens the wall which leads to aortic rupture

The Heart (11 decks)

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