Lab 9 Middle Mediastinum Flashcards by Emily Rogers

External layer of pericardium is the ____ pericardium and the internal layer of the pericardial sac is the ____ pericardium. The heart is covered in _____ pericardium.

Fibrous

Parietal

Visceral

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The ____ nerves and _____ vessels run along the lateral margins of the middle mediastinum. They are located between the mediastinal pleura and the pericardium, ____ to the root of the lung.

Phrenic

Pericardiacophrenic

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The right atrium forms the ____ border of the heart and is situated slightly ____, _____ and to the right of the right ventricle.

Right

Superior, posterior

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The right ventricle is the most ____ of all 4 chambers. It forms the ____ border of the heart.

Inferior (thin/sharp, oriented nearly horizontal)

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The left ventricle forms the ___ border of the heart while the left atrium is the most _____ chamber.

Left

Posterior

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What forms the superior border of the heart?

Atria and their auricle

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What surface is anterior and is formed mainly by the right ventricle?

Sternocostal

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What surface is inferior and is formed mainly by the “posterior” surface of the left ventricle (____) and a little of the right ventricle (___)?

Diaphragmatic

2/3 left

1/3 right

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What surface is formed mainly by the left ventricle and a bit of the left atrium? It contacts the ____ impression of the ___ lung.

Left pulmonary surface

Cardiac

Left

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What surface is formed by the right atrium?

Right pulmonary surface

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The acute margin is between the ___ and ___ surfaces while the obtuse margin is between the ___ and ____ surfaces.

Acute- sternocostal and diaphragmatic

Obtuse- sternocostal and left pulmonary

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The apex of the heart is formed by the ____ _____ and is located deep to the ____ ____ intercostal space. This is 8 cm from midline

Left ventricle

Left 5th intercostal space

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The base of the heart is the anatomical posterior surface of the heart. It is formed by the ____ atrium mostly and a bit of the _____ atrium. This is where great vessels interface with the heart.

Left atrium (mostly)

Right atrium (some)

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What is found between the pulmonary trunk and superior vena cava?

Ascending aorta

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What is most anterior and to the left of the aorta?

Pulmonary trunk

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The right pulmonary artery is the right branch of the pulmonary trunk and passes (anterior/posterior) to the ascending aorta, (superior/inferior) to the aortic arch. The left pulmonary artery is the left branch of the trunk.

Posterior

Inferior

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What is furthest to the right of all the great vessels and projects vertically?

Superior vena cava

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What is a prominent groove separating the atria and the ventricle externally?

Coronary sulcus

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What is a shallow groove between the left and right ventricles, ANTERIORLY, on the sternocostal surface? The anterior aspect of the ____ _____ is just deep to the sulcus.

Anterior interventricular sulcus

Interventricular septum

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What is between the left and right ventricles, POSTERIORLY, on the diaphragmatic surface? The posterior aspect of the _____ ____ is just deep to the sulcus.

Posterior interventricular sulcus

Interventricular septum

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The interventricular sulci denote the position of the interventricular septum and join the ____ ____ at right angles. This is situated along a more vertical/oblique plane.

Coronary sulcus

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The posterior interventricular sulcus meets the coronary sinus at the ________________.

Crux of the heart

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Each sulcus contains what?

Coronary vessels

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The heart sits on the _____ surfaces of the left and right _____. This surface is also referred to as the posterior surface even though they face ____.

Diaphragmatic

Ventricles

Inferior

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The apex of the heart points diagonally: ____, _____, and to the ____.

Anterior, inferior, and to the left

The atria form the base of the heart which faces ____.

Posteriorly

The heart is turned so the right side is slightly more ____ than the left.

What is found in the coronary sulcus between the left atrium and the left ventricle on the diaphragmatic surface? It is thin walled and is a 2.5 cm long dilatation that opens into the ____ ____.

Coronary sinus Right atrium

What starts near the apex, up the anterior interventricular sulcus to the anterior/sternocostal surface, then to the coronary sulcus? This becomes the coronary sinus when then _____ ____ vein joins this.

The great cardiac vein Oblique cardiac vein joins the great cardiac vein --> coronary sinus

What is found in the posterior interventricular sulcus? This can be traced to the right end of the coronary sinus adjacent to the opening of the IVC.

Middle cardiac vein (posterior interventricular vein)

What is found on the diaphragmatic surface of the left venticle and merges near the junction of the great cardiac vein and coronary sinus with either structure?

Posterior vein of the left ventricle (posterior cardiac vein)

On the right side within the coronary sulcus, what can be seen? Where does it likely terminate? Where does it come from?

Small cardiac vein Terminates on the coronary sulcus The inferior border of the heart (margin of the right ventricle)

ALL cardiac veins send their blood to the ____ ____ except a set of small veins from the sternocostal surface of the right ventricle called the _____ _____ veins. These dump directly into the ____ ____ through small perforations between the pectinate muscles. ***Possible question

Coronary sinus Anterior cardiac veins Right atrium

Near the external base of the aorta, deep to the right auricle you will see the ______________.

Right coronary artery

What arises from the "superior" edge of the right coronary artery near its origin? What is a major branch of this and what does it feed?

Anterior right atrial branch The sinuatrial nodal artery feeds the sinuatrial node

What is a large inferior branch of the right coronary artery? This can arise from the RCA more sternocostally and angle toward the acute margin (____ border of the heart). What should it be adjacent with along the acute margin?

Right marginal artery Inferior Small cardiac vein

The RCA travels along the coronary sulcus toward the _____ surface. It will most likely take a 90˚ turn and run along the posterior interventricular sulcus as the as the _______ _______ artery.

Diaphragmatic surface Posterior interventricular artery (posterior descending artery)

The the posterior interventricular artery is a branch of the ____, then the heart is considered right dominant. If it is a branch from the _____ then it is left dominant. ***Possible question

RCA Circumflex branch of the LCA

The left coronary artery is found ___ to the pulmonary trunk.

Posterior

Within the coronary sulcus, the LCA usually bifurcates into the ___ and ____ arteries.

Circumflex and LAD arteries

The anterior interventricular artery (LAD) follows the ____ ____ ____ toward the apex of the heart. What two thinks anastomose near the apex of the heart?

Anterior interventricular sulcus LAD and PDA

What is superficial and to the left of the LAD?

The great cardiac vein

What crosses the anterior surface of the left ventricle obliquely?

Diagonal branch of the LAD

What is found along the coronary sulcus toward the diaphragmatic surface? What two things parallel this?

Circumflex branch of the LCA Great cardiac vein and LAD parallel the circumflex artery

What is a descending branch typically from the circumflex artery that feeds the margin of the left ventricle?

Left marginal artery

What is the terminal end of the circumflex that deflects from the coronary sulcus to be found not he diaphragmatic surface of the left ventricle? What does it parallel?

Posterior left ventricular artery Posterior vein of the left ventricle

What are the 4 pulmonary veins?

Left superior and inferior Right superior and inferior

Ridges of muscle on the inferior of the anterior wall of the right atrium

Pectinate muscle

Vertical, smooth ridge at the edge of the pectinate muscle of the right atrium

Crista terminalis

Superior large opening of the right atrium? Inferior opening? Flap of tissue over this?

Opening of the SVC Opening of the IVC Valve of the IVC

What is adjacent and anterior to the opening of the IVC of the right atrium? What is the flap of tissue adjacent to the opening?

Opening of the coronary sinus Valve of the coronary sinus

What is the smooth wall between the atria?

Interatrial septum

What is the small, oval-shaped depression on the interatrial septum of the right atrium? The rim border of this is called what?

Fossa ovalis Limbus fossa ovalis

The SA node is found at the superior end of the ___ ____, near the superior vena cava. The AV node is found in the _____ _____ superior to the opening of the coronary sinus, anterior to the fossa ovalis.

Crista terminalis Interatrial septum

What is the wall between the left and right ventricles?

Interventricular septum

What is the most anterior of the 3 cusps (in right ventricle)?

Anterior cusp of the right atrioventricular (tricuspid) valve

What is the cord like tendon between the tip of an anterior papillary muscle and the anterior and posterior valve cusps? (Right ventricle)

Anterior chords tendinea

What is one of several and projects from the wall of the ventricle and its tip has a set of chordae tendinea? Which only has one? (Right ventricle)

Anterior and posterior papillary muscles Septal papillary muscles Anterior- anterior/posterior Posterior- posterior/septal Septal- septal/anterior

What is adjacent to the interventricular septum? (Right ventricle)

Septal cusp of the right atrioventricular (tricuspid) valve

What is a cord like tendon between the tip of the septal papillary muscle and the septal and anterior valve cusps? (Right ventricle)

Septal chorda tendinea

What is the most posterior of the 3 cusps in the right ventricle?

Posterior cusp of the right atrioventricular (tricuspid) valve

Cord like tendon between the tip of the posterior papillary muscle and the posterior and septal valve cusps of right ventricle

Posterior chorda tendinea

What is the rough inner surface of the wall of the right ventricle?

Trabeculae carneae of the right ventricle

What extends from the interventricular septum to the base of the anterior papillary muscle?

Septomarginal trabecula of the right ventricle (moderator band)

What is a cone-shaped portion of the right ventricle leading to the pulmonary valve? What is the inner wall like?

Conus arteriosus of the right ventricle SMOOTH

What are the components of the pulmonary semilunar valve?

Anterior cusp (nodule and lunule) Right cusp- same stuff Left cusp- same stuff

The inner surface of the left atrium is smooth except for the ____ ____.

Left auricle

What is the smooth wall between the atria? (Left atrium)

Interatrial septum

What can be seen in the left auricle of the left atrium?

Pectinate muscle of the left atrium

How many cusps on the left ventricle?

2- mitral, bicuspid

What is the inferior portion of the wall between the left and right ventricles with trabeculae carneae? (Left ventricle)

Muscular interventricular septum

What is immediately below the right aortic valve cusp? Smooth wall (left ventricle)

Membranous interventricular septum

The wall of the ___ ventricle is much thicker than the ____ ventricle due to ____ pressures found in systemic circulation (_______) versus pulmonary circulation(______).

Left thicker than right Systemic- left ventricle Pulmonary- right ventricle

The papillary muscles contract during ____ contraction of the ventricles thus restricting valve cuts movement into the ____. If a chorda tendinea snaps, a portion of the cusp will allow blood to regurgitate back through the valve into the ____ leading to inefficient cardiac output and a heart ____.

Systolic Atrium Atrium Murmur