Key Points Flashcards
Apex beat
Left 5th intercostal space, mid-clavicular line
Right heart border
SVC – right atrium
Left heart border
Aortic knuckle – left pulmonary artery – LA appendage – left ventricle
Anterior surface of heart
mainly right ventricle
Posterior surface of heart
mainly left atrium and pulmonary veins
Mediastinum division
Area between right and left pleura, divided as follows:
- Plane between sternal angle and T4/5 divides superior and inferior mediastinum
- Pericardium divides anterior, middle and posterior mediastinum
Pericardium
Consists of fibrous (parietal) and visceral layers
Pericardial space is a potential space
Cardiac tamponade
Rapid collection of pericardial fluid is restricted and impairs filling
Pleural reflection
allows drainage of pericardial fluid from the left of the xiphisternum
Atrioventricular valves
mitral and tricuspid are an intrinsic part of their ventricle
- Disorders of the ventricle often affect function of the relevant Atrioventricular valve
Papillary muscles
(part of ventricle) attach to atrioventricular valves via chordae tendinae
Semilunar valves
(aortic and pulmonary) are an intrinsic part of their great artery
- Disorders of the aorta or pulmonary artery often affect function of their respective valves
Pulmonary artery
carries deoxygenated blood from the heart
Pulmonary veins
carry oxygenated blood back to the heart
- Four pulmonary veins (usually 4) drain into the left atrium
Coronary sinus
drains blood from the heart muscle into the right atrium
Right atrium
has smooth (from sinus venosus) and trabeculated (from original atrium) portions
Fossa ovalis
the remains of the foramen ovale which was patent in foetal life
Crista terminalis
separates smooth and trabeculated portions of right atrium
Cardiac muscle cells
cross link and join at intercalated discs
Coronary arteries
arise from the aortic root sinuses and supply the heart itself
- Coronary arteries are epicardial and therefore accessible to the surgeon (bypass surgery)
- Two main coronary arteries, left and right
- Coronaries are functional end arteries, unless collateral supply has developed
Left main artery stem divides into…
left anterior descending (LAD) and circumflex (Cx) branches
Left anterior descending
runs in the anterior interventricular groove
- The LAD gives off septal and diagonal branches to the septum and left ventricular myocardium
Circumflex artery
runs in the left atrioventricular groove
- The Cx gives off obtuse marginal branches to the posterolateral LV wall
- In 10% the Cx provides the posterior descending artery (PDA)
Right coronary artery
runs in the right atrioventricular groove
- Usually supplies sinus node, AV node and branches to the anterior RV wall
- Distal RCA branches into posterolateral and posterior descending arteries (latter in about 70% of people)
Posterior interventricular artery
runs in the posterior interventricular groove and supplies inferior septum and LV
- Dominance refers to the artery (RCA or Cx) which supplies the posterior descending artery
- Most people (70%) are right dominant – RCA supplies the PDA
- About 20% are co-dominant – RCA and Cx both help supply the PDA
- About 10% are left dominant – Cx supplies the PDA
The superior and inferior mediastinum are separated by a line that connects the sternal angle to the junction between which two vertebrae?
T4-5
The descending (thoracic) aorta passes through the diaphragm at which vertebral level?
T12
Where is the azygos vein located
Posterior mediastinum
The inferior vena cava passes through the diaphragm at which vertebral level?
T8
The oesophagus passes through the diaphragm at which vertebral level?
T10
Where is the ascending aorta located
Anterior mediastinum
Where is the internal thoracic artery located
Posterior aspect of anterior thoracic wall
Where is the pericardium located
Middle part of mediastinum
Where is the phrenic nerve located
Along the antero-lateral surface of the mediastinum
Where do the posterior intercostal arteries branch from
Descending (thoracic) aorta
Where do the anterior intercostal arteries branch from
Internal thoracic arteries
Where do the inferior phrenic arteries branch from
Abdominal aorta
Where do the internal thoracic arteries branch from
The subclavian artery
Where do the thyrocervical trunks branch from
Subclavian arteries
Into which structure does the azygos vein drain?
Superior vena cava
Where does the thoracic duct drain into?
junction between the left internal jugular vein and the left subclavian vein.
There is only one thoracic duct and it is located on the left side of the posterior thorax.
Sympathetic fibres that join the sympathetic trunk have their cell bodies in which parts of the spinal cord?
T1 -L2
Which spinal nerves contribute to the formation of the greater splanchnic nerve?
T5-T9
Which nerve roots contribute to the brachial plexus
C5-T1
Sympathetic fibres that travel to the cardiac plexus originate from which segments of the spinal cord?
T1-T5
Where is the phrenic nerve located
Posterior triangle of the neck
The sternocleidomastoid muscle is innervated by which nerve(s)?
Accessory nerve (CN XI)
What nerves Innervate the infrahyoid muscles
Ansa cervicalis (fibres from C1-C3)
What does the Glossopharyngeal nerve innervate
Posterior 1/3 of tongue (general sensation and taste) and pharynx (sensation)
What does the Hypoglossal nerve innervate
Motor muscles to the tongue
What does the vagus nerve innervate
sensory to the larynx, motor to the pharyngeal muscles, motor to the intrinsic muscles of the larynx and supplies parasympathetic fibres to the thoracic viscera.
Which artery gives rise to the superior thyroid artery?
External carotid artery
Which artery gives rise to the inferior thyroid artery?
Thyrocervical trunk (branch of subclavian artery)
Which nerve carries visceral sensory fibres from the carotid sinus baroreceptors to the medulla?
Glossopharyngeal
Typical cervical vertebra
foramen in each transverse process which transmits the vertebral artery.
horizontal, bifid spinous processes, oval-shaped vertebral bodies and a triangular-shaped vertebral foramen. They do not have costal facets for the ribs.
Typical thoracic vertebrae
long, obliquely-angled spinous processes; heart-shaped vertebral bodies, a round vertebral foramen and costal facets for articulation with the ribs.
The infrahyoid (‘strap’) muscles depress which TWO structures during speech and swallowing?
move the hyoid bone and larynx inferiorly during speech and swallowing.
The internal carotid artery supplies which region / structure?
Brain
Which nerve descends in the neck in the carotid sheath?
Vagus nerve
What is the name for the space between the true vocal folds?
Rims glottidis
What is the vestibule
narrow space between the vestibular fold (false vocal cord) and the true vocal cord.
What is the vallecula
space between the posterior surface of the tongue and the anterior surface of the epiglottis.
What requires adduction of the vocal folds?
Normal speech
Contraction of the cricothyroid results in
Lengthening of the vocal chords
lengthens the cords and places tension on them.
Contraction of the posterior cricoarytenoids results in
abduct the cords and open the rima glottidis.
The transverse arytenoid…
adducts the cords and closes the rima glottidis.
Which bone forms the inferior part of the nasal septum?
Vomer
Which nerve supplies sensory innervation to the internal nasal cavity?
Trigeminal
Into which region does the maxillary sinus drain?
Middle meatus
The auditory tube connects which two regions?
Middle ear and nasopharynx
Which nerve innervates the muscles of the soft palate?
Vagus nerve
What is the name of the space between the posterior aspect of the tongue and the epiglottis?
Vallecula
piriform recesses
located in the larynx lateral to the epiglottis.
oral vestibule
space between the teeth and the cheek.
sublingual space
space below the tongue where the sublingual salivary gland is located.
Which nerve carries taste sensation from the anterior 2/3 of the tongue?
Facial nerve
Where are the palatine tonsils located?
Lateral wall of the oropharynx
Which nerve supplies secretomotor fibres to the submandibular salivary gland?
Facial
Mumps is a viral infection that classically causes painful inflammation of which structure?
Mumps is a viral infection that can cause swelling of the salivary glands (primarily the parotid gland).
The palatine tonsil may become inflamed and infected as a result of viral or bacterial infection. This is called tonsillitis.
tubal tonsils
lie around the opening of the auditory tube.
pharyngeal tonsil (‘adenoid’)
lies in the roof of the nasal cavity.
lingual tonsil
lies on the posterior part of the superior surface of the tongue.
nasolacrimal duct drains into
inferior meatus.
The inferior border of the lung is located at the level of which rib posteriorly?
10th
The inferior border of the lung is located at the level of which rib anteriorly?
6th
The inferior border of the lung is located at the level of which rib laterally?
8th
The right recurrent laryngeal nerve loops under which structure, before ascending back into the neck?
Right subclavian artery
The inferior border of the heart is formed mostly by which structure?
Right ventricle
Under which rib does the horizontal fissure lie
4
Which side of the vertebral column does the azygous vein lie
Right
