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Blood, Heart and Lungs > Heart and Mediastinum > Flashcards

Heart and Mediastinum Flashcards

1
Q

Which part of the mediastinum contains the thymus?

A

Anterior mediastinum

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2
Q

Until what vertebrae does the posterior mediastinum continue until?

A

12th thoracic vertebrae

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3
Q

What is held in the superior mediastinum?

A

Arch of aorta, great vessels, trachea, oesophagus, thoracic duct, phrenic and vagus nerves

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4
Q

How do the phrenic and vagus n pass through the mediastinum compared to the hilum of the lungs?

A

Phrenic - anterior

Vagus - posterior to subclavian vessels

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5
Q

What is held in the anterior mediastinum?

A

Internal thoracic vessels, fat, connective tissue, maybe some thymus

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6
Q

What arteries can be used for CABG?

A

Internal thoracic arteries

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7
Q

In child x-rays, what is the sign to recognise the thymus gland?

A

‘Sail’ sign - normal - shrinks in adults

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8
Q

What is held in the posterior mediastinum?

A

Oesophagus and plexus, descending aorta, thoracic duct, sympathetic chain and azygous system

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9
Q

What is held in the middle mediastinum?

A

Heart, pericardium, origins of the great vessels and phrenic nerves

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10
Q

What is the pericardium composed of?

A

Fibrous pericardium - tough outer connective tissue

Serous pericardium - visceral and parietal layers

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11
Q

What forms the pericardial cavity and what does it contain?

A

Between the parietal and visceral layers - lubricating pericardial serous fluid

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12
Q

What can be used in surgery to clamp arterial flow of the heart?

A

Transverse pericardial sinus (separates arteries from veins)

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13
Q

How do papillary muscles help valves?

A

Papillary muscles are extensions of ventricular wall, CONTRACT - prevent blood to black flow into atria during ventricular systole (Unidirectional flow)

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14
Q

What are the main functions of the fibrous cardiac skeleton?

A 
Mechanical stability 
Electrical insulation (stop conduction from atria to ven)
Anchor point for cardiac muscle and valve cusps
AV node is only route for signal conduction
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15
Q

How many cusps do the aortic and pulmonary valves have?

A

3 cusps - semi-lunar

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16
Q

How do the cusps help the aortic and pulmonary valves?

A

Ventricular diastole - reverse flow blood catches in the pockets - closes valve
Ventricular systole - valve cusps pushed toward vessel walls and OPEN

17
Q

What are the two main defects the disturb pumping efficiency of the heart?

A

Stenosis - valve does not open fully

Insufficiency - regurg or failure of valve to close - backflow

18
Q

Which valves are most affected by heart disease and how?

A

Mitral and aortic

inc turbulence

19
Q

What happens if the mitral valve prolapses?

A

one or both leaflets are enlarged, redundant or FLOPPY

Blood regurgitates into LA, when LV contracts -> Late systolic murmur

20
Q

What happens if there is aortic stenosis?

A

often the result of degenerative calcification

Results in LV hypertrophy

21
Q

What happens if the tricuspid or pulmonary valve is affected? What are the clinical presentations?

A

Often the result of infection, rheumatic fever or infective endocarditis (inflammation of heart lining)
Splinter hemorrhages

22
Q

Where do coronary arteries arise from?

A

the coronary sinus above the cusps of aortic valve

Main inflow = dyastole

23
Q

Which coronary artery is dominant in 60% of patients?

A

RCA -> gives rise to PIVA

LCA - 40% of patients gives rise to PIVA

24
Q

What does the RCA usually supply?

A

Right atrium & ventricle
SA node
AV node
Posterior IV Septum (minority of septum)

25
Q

What does the LCA supply?

A

Left Atrium & Ventricle
AV bundle
Right & Left bundle branches
Anterior IV septum (majority of septum)

26
Q

What is the LAD artery supply? What is another name for it?

A

Anterior interventricular artery
(aka Left Anterior Descending (LAD))
R & L ventricles
Anterior 2/3rds of septum

27
Q

Where does blood from the coronary veins drain into?

A

Right atrium via coronary sinus

28
Q

What are the surface anatomy points for the 4 edges of the heart?

A

2nd L CC - 1cm lateral to sternum
5th L ICS - Just medial to MCL
3rd R CC - 1cm lateral to sternum
6th R CC - 1cm lateral to sternum

29
Q

What sympathetic chain nerves cause increase in heart rate and contractility?

A

T1-4 nerves

30
Q

What are the branches of the RCA?

A
  • Sinoatrial node artery (supplies SAN node and both atria)
  • Anterior ventricular arteries
  • Marginal artery (reaches apex)
  • PIVA in RCA dominant people (supplies posterior 1/3 of septum, supplies AV node)
31
Q

What are the branches of the LCA?

A
  • Sinoatrial node artery (supplies both atria)
  • Circumflex artery​ (supplies left atrium & ventricle​, continues as PIVA in 40%)
  • Anterior interventricular artery​ aka LAD (supplies R+L ventricles, anterior 2/3 of septum)
  • Marginal artery (left ventricle to apex)
  • PIVA in LCA dominant (supplies posterior 1/3 of septum, supplies AV node)

Blood, Heart and Lungs (33 decks)

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