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The Heart > heart and mediastinum > Flashcards

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
Q

what forms the inferior vena cava? + FUNCTION

A

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

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26
Q

pulmonary veins function + structure

A

carries oxygenated blood from the lungs to the left atrium

four main pulmonary veins- two right and two left (two from each lung)

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27
Q

major arteries

A

aorta and pulmonary artery

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28
Q

pulmonary trunk structure and function

A

carries deoxygenated blood from the right ventricle to the lungs

branches into the right and left pulmonary arteries that each lead to one lobe

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29
Q

function of aorta

A

carries oxygenated blood from the left ventricle to the whole body

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30
Q

structure of aorta

A

ascending aorta from left ventricle

aortic arch curving round

descending thoracic aorta

the abdominal aorta

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31
Q

vessel divisions of aorta and functions

A

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
Q

structure of atria

A
  • no valves at inlets
  • rough pectinate muscles and crista terminalis of His
  • sinus venarum-
  • right atrial appendage
  • interatrial septum
  • fossa ovalis
33
Q

pectinate muscles structure, location and function

A

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
Q

Crista terminalis structure, location and function

A

represents the junction between the sinus venosus and the heart in the developing embryo

forms sinus venarum

35
Q

Sinus venarum structure, location and function

A

smooth part of right atria, separated from the rest of the atria by crista terminalis fibres

36
Q

fossa ovalis structure, location and function

A

depression in the right atrium at the level of the interatrial septum

thin fibrous sheet that covered the foramen ovale after fetal development

37
Q

structure of ventricles

A
  • valves- tricuspid, mitral, pulmonary and aortic
  • chordae tendinae
  • trabeculae carnae
  • interventricular septum
  • papillary muscle
38
Q

chordae tendinae structure, location

A

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
Q

How valves change during circulation of blood?

A
  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
Q

structure of tricuspid valve

A
  • 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
Q

structure of pulmonary valve

A

three cusps- left, right and anterior

42
Q

structure of mitral valve

A

two cusps- anterior and posterior. both cusps secured to a fibrous ring at the orifice

43
Q

structure of aortic valve

A

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
Q

papillary muscle structure, location and function

A

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
Q

trabeculae carnae structure, location and function

A

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
Q

Explain location of heart

A

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
Q

explain base of heart

A

great veins, superior and inferior vena cavae, arteries attach to the superior surface of the heart

48
Q

Apex definition

A

tip of the heart

49
Q

Cardiac notch definiton

A

depression in the medial surface of the inferior lobe of the left lung

50
Q

divisions of the mediastinum

A

anterior, superior, middle and posterior

51
Q

what is the mediastinum initially divided into + where?

A

superior and inferior mediastinum

sternal angle (sternal body and manubrium) and the T4/T5 intervertebral disc

52
Q

where does the superior mediastinum terminate?

A

extends upwards, terminate at the superior thoracic aperture

53
Q

where does the inferior mediastinum terminate?

A

extends downwards, diaphragm

54
Q

borders of the superior mediastinum

A

superior- thoracic inlet

inferior- inferior mediastinum

anterior- manubrium of sternum

posterior- vertebral bodies of T1-T4

lateral- pleurae of lungs

55
Q

what vessels are present in the superior mediastinum?

A

arch of aorta, superior vena cava

Left and right brachiocephalic veins

brachiocephalic artery, left common carotid artery and subclavian artery

56
Q

what nerves are present in superior mediastinum?

A

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
Q

other structures in superior mediastinum

A

thymus- most anterior structure, sits against posterior surface of sternum and extends into anterior mediastinum

trachea

oesophagus

thoracic duct

58
Q

middle mediastinum structures

A

heart and pericardium

tracheal bifurcation

59
Q

middle mediastinum vesels

A

ascending aorta

pulmonary trunk

superior vena cava

60
Q

middle mediastinum nerves

A

left and right phrenic to diaphragm

61
Q

middle mediastinum lymphatics

A

tracheobronchial lymph nodes

62
Q

borders of middle mediastinum

A

anterior- anterior margin of pericardium

posterior- posterior margin of pericardium

laterally- mediastinal pleura of the lungs

superiorly- superior mediastinum

inferiorly- diaphragm

63
Q

posterior mediastinum borders

A

lateral- mediastinal pleura (parietal pleura)

anterior- pericardium

posterior- T5-T12 vertebrae

roof- superior mediastinum

floor- diaphragm

64
Q

vessels in posterior mediastinum

A

thoracic aorta + its divisions such as the superior phrenic arteries

azygos, hemiazygos and accessoryhemiazygos vein

thoracic duct

65
Q

structures in posterior mediastinum

A

oesophagus , posterior to the arch of the aorta and heart - deviates to the left as it moves downwards

66
Q

nerves in posterior mediastinum

A

thoracic sympathetic trunks

67
Q

anterior mediastinum borders

A

lateral- mediastinal pleura

anterior- body of sternum and transversus thoracic muscles

posterior- pericardium

roof- superior mediastinum

floor- diaphragm

68
Q

contents of anterior mediastinum

A

no major structures

accomodates loose connective tissue, some lymph vessels, lymph nodes and branches of internal thoracic vessels

69
Q

what are coronary arteries an example of?

A

functional end arteries

70
Q

functional end artery definition

A

an artery that has ineffectual anastomoses

71
Q

why is this a problem?

A

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
Q

when does coronary artery perfusion occur? + why

A

during heart relaxation- diastole

during systole the subenchocardial coronary vessels are compressed due to high ventricular pressures

73
Q

2 consequences of coronary artery occlusion + definitions

A

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
Q

embryological condition affecting the heart + explanation

A

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
Q

lymph node location

A

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
Q

aortic aneurysm explained

A

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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