Learning Objectives Quick Recap

Question 1

Recognize the basic views of coronary angiography and describe how they are made

Answer 1

Contrast is injected into central line to illuminate blood leaving the heart for the lungs via the pulmonary arteries, series of rapid fire x-rays films blood dispersing throughout the lung, any blockages or complete occlusions can be seen because little or no blood with contrast can pass the occlusions leading to an immediate cutoff of the density of the x-rays; Is extremely stark

Question 2

Describe the intercostobrachial nerve and its clinical significance in relation to the upper limb and myocardial infarction

Answer 2

Intercostobrachial nerves arise from levels T1-T4, which also supply sensory afferent fibers for the upper limb via the brachial plexus; Myocardial infarction causes cell death; Visceral sensory fibers carry information back in to T1-T4 levels; Pain is referred to the T1-T4 dermatomes of those spinal levels which supply upper arm sensory information since visceral pain cannot be processed correctly and ends up as diffuse referred pain

Question 3

Describe the cardiac cycle and relate to the ECG

Answer 3

P wave= atrial depolarization causing atrial contractions, QRS wave= ventricular depolarization and contraction (also atrial repolarization but it is masked by the magnitude of the ventricle depolarization), T wave= ventricular repolarization

Question 4

Describe the electrical conducting system of the heart

Answer 4

SA nodes send signals conducting the heart’s rhythm, AV node sends bundles from right atrium to right ventricle into both the interventricular septum and right wall of the heart: this conduction solely listens to electrical signals from the AV node and causes ventricular contraction (while listening to heart sounds: S1-S4, but we can only hear S1 (atrioventricular valves closing) which is the “lub” and S2 (pulmonary and aortic valves closing) which is the “dub”

Question 5

Describe the anatomical location, mechanism, and clinical sequences of central venous line placements of the right and left subclavian veins and internal jugular veins

Answer 5

Central lines are catheters placed in large accessible veins and threaded into the heart for the distribution of drugs, transfusion of blood, etc.

Question 6

Describe the anatomical location, mechanism, and clinical sequences of thoracic duct laceration

Answer 6

Would cause edema in the lower body because all lymphatic flow from the lower limbs comes through the thoracic duct; with a laceration the Chyle would not be able to travel up the duct and would build up in the lower limbs causing edema

Question 7

Describe the relationships of the vagus nerves to the aortic arch, the root of the lung, and the esophagus

Answer 7

The vagus nerves run posterior and lateral to the aortic arch and lateral with the esophagus directly along the roots of the lungs

Question 8

Describe the relationships of the phrenic nerves to the aortic arch and the root of the lung

Answer 8

The aortic arch is deep to the phrenic nerve which runs along the pericardium laterally while in route to the diaphragm and the parietal pleura of the lungs

Question 9

Describe the course of the right and left recurrent laryngeal nerves in the thorax

Answer 9

Right recurrent laryngeal nerve branches off the right vagus nerve and hooks around a superior portion of the right subclavian artery; Left recurrent laryngeal nerve branches off the left vagus nerve and hooks around the aorta in between the aortic arch and pulmonary trunk

Question 10

Describe the four normal constrictions of the esophagus and related clinical significance

Answer 10

From pharynx to esophagus, behind the aortic arch, in the esophageal hiatus in the diaphragm, and into the stomach; All constrictions increase likelihood of blockages at these locations