Lecture 3-4 CV Anatomy Flashcards
Sternal angle
Sternal angle is the line junction between manubrium and sternal body. 2nd rib articulates there.
Which vein is over the 1st rib?
The subclavian v.
Why is it problematic to kick someone in the back?
Kidney anterior to the floating ribs 11&12!
what is the landmark used for Aspiration/Needle in the Sac around the Heart ?
Do so by using the xiphoid process as a landmark
Palpate xiphoid process by feeling the medial process of the rib cage and going superior
Needle between costal margin of rib cage and xiphoid process and go obliquely and superior laterally
** long story short: put needle lateral to typhoid process *
What is above the first rib?
Lung apex is above the first rib.
How do we put in a central line?
Feel jugular notch with one finger and palpate collarbone until feel the concavity of the bone going posteriorly. Insert there to reach the subclavian vein.
True or False. 1st rib articulates with the manubrium and is under the clavicle.
True
True or False. VPR from spinal column is coming around and using ________ travel where it needs to get to from posterior spine to anterior body way. The intercostal space is between the ribs to get where they need to go.
intercostal space
Which artery can be harvested?
Internal thoracic a. = posterior intercostal anastomosis with the anterior via this artery. Can be removed as you would still have blood flow from the posterior to anterior to serve the body wall, and can also harvest this artery (aka cabbage surgery)
Where is neurovasculature bundle? Where should a tap be done?
The VAN is below the rib. The tap should be done above the rib to avoid nerves (nerves are only inferior the rib)!
How does the rib move during respiration?
Inspire = diaphragm descends, pulling inferiorly and raises the ribs to pull up and forward and that will increase the thoracic volume
Expire – let diaphragm relax, ascend, and elastic recoil pushes out and rib cage falls anterior posterior and inferiorly
** easy way to know this demonstrate it during the exam, know that what I feel moving is my ribcage and that the opposite direction is the way the diaphragm moves.
What do external and internal intercostals do?
External intercostal muscles of forced inhalation.
Internal intercostals are the primary muscles of forced exhalation.
** EI, IE pneumonic **
Which arteries serve the thoracic organs
Thoracic aorta a. and intercostal branches.
What artery is taken for coronary artery bypass?
Internal Thoracic Arteries
Mediastinum
collection of spaces between the lungs bounded by anterior chest wall sternum, posterior spinal column, lateral lungs.
What is in the anterior mediastinum?
Pericardial sac is the anterior mediastinum, the thymus gland lives there.
True or False. Superior mediastinum has major blood vessels like aortic arch. The root of those structures here in mediastinal space.
Middle: heart located.
Anterior: thymus gland
Posterior: major blood vessels descend to get to throax, abdomen, etc i.e. descending thoracic aorta
True
What are the major veins of the posterior body wall and anterior body wall?
Azygos v.: MAJOR vein of POSTERIOR body wall
Internal thoracic v.: serves ANTERIOR body wall
True or False. Vagus PS serves the heart and lungs! It serves everything PS in thorax and abdomen.
True
What serves the heart?
Thoracic aorta
What CN serves the carotid sinus?
CN 9 and 10
How many layers in heart vs. lung
Lung (2): visceral, parietal
Heart (3): visceral, parietal, fibrous
Where do lymph nodes end?
Region around pectorals major
True or False.
Left heart back. Bulk in posterior.
Right heart comes to front. Bulk in anterior.
True.
- she got Left Back (posterior) because she was bulky or LB**
- step Right to the Front (anterior) **
- *LB, RF**
Path of blood through the heart
Subclavian + IJV –> Brachiocephalic left and right –> superior vena cava–> right atrium –> right ventricle –> pulmonary artery –> lungs —> pulmonary v. –> left atrium –> left ventricle –> aorta –> systemic circulation
True or False. We never hear valves. We can hear changes in flow though.
True
Where does the right heart provide blood?
To the lungs.
What does chorda tendinae attach to?
On ventricle walls papillary muscle bands attach to chordae tendinae which are attached to the leaflet of the valves.
Pulmonary and aortic valves
Pulmonary: left, right, anterior cusp
Aortic: left, right, posterior cusp
HEART STUFFF.
Blood moves through the aortic valve to serve the body…
Systolic = contracts Diastolic = at rest
Chamber contraction
Ventricle = right pushes into lungs and left pushes into body.
Atria = right pushes blood into right ventricle and left atrium into left ventricle
Aortic Valve
Cardiac output = into aortic arch (left in particular). When heart is at rest, the column of blood slams down onto the aortic valve cusps
3 cusps:
1. Right = superior to this is the opening to the right coronary a.
2. Left = superior to this is the opening to the left coronary a.
3. Posterior = no opening near this
Systolic vs. Dystolic
The whole body eats food, gets blood etc. when the heart contracts
Heat beats and blood moves through pipes but the heart itself is not served at the same time
Systolic = when the heart is in systolic and contracts itself it does not serve itself, it just squeezes out blood
Diastolic = heart is served only when at rest, blood slams down and forces blood inferiorly
Heart pain = due to the heart only feeding itself at rest, heart pain and chest pain from coronary a. blockage is during eating, working out, sex etc. When the heart needs the most food it gets the least amount because it is contracting and so the heart beat increases to serve the rest of the body instead of serving itself
Coronary sinus
biggest vein posterior, mostly everything drains here, and it drains directly into the right atrium
Which artery is most commonly blocked?
Left anterior descending (LAD)/ ’widowmaker’: left heart, anterior heart, and bulk of interventricular septum.
LAD + LCA
Circumflex branch:
serves space between atria and ventricle= superolateral aspect of left heart
Right coronary artery
Right coronary artery (RCA) travels between right atrium and right ventricle and first sends marginal branch on inferolateral aspect of the right heart, right ventricle, and atrium.
Right marginal Posterior descending artery (PDA):
posterior right heart, and posterior aspect of interventricular septum.
