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M103 T1 > M103 T1 L3 > Flashcards

M103 T1 L3 Flashcards

1
Q

What are the boundaries of the middle mediastinum?

A

anterior: anterior pericardium
posterior: posterior pericardium
lateral: mediastinal pleura
inferior: diaphragm
superior: sternal angle

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2
Q

What are the contents of the middle mediastinum?

A

heart, pericardium
ascending aorta
pulmonary veins, arteries, nerves and trunk (VANT)
(HP.AA.Pvant)

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3
Q

What are the structures of the heart chambers?

A

4 chambers - 2 receiving atria and 2 discharging ventricles

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4
Q

What is the process of the cardiac cycle?

A

RA receives poorly oxygenated blood from SVC and IVC
RV discharges this to lungs via pulmonary trunk
LA receives well oxygenated blood from the pulmonary veins
LV discharges this to body initially through aorta

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5
Q

What can be found on the anterior view of the heart (RHS)?

A

[PAVAra.C]

pulmonary trunk
aorta
right ventricle
auricle of the right atrium
coronary vessels
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6
Q

What can be found on the posterior view of the heart (LHS)?

A 
Pulmonary veins
Auricle of the left atrium
Left ventricle
Left coronary artery
[PAlaVCa]
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7
Q

What are the structures found in the atria of the heart? (FoAP.Cs)

A

fossa ovalis
auricle
pectinate muscle
valve and opening of the coronary sinus

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8
Q

What are the structures found in the right ventricle?

A

pulmonary trunk & pulmonary valve
chordae tendineae
myocardium & papillary muscle
tricuspid valve

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9
Q

What are the structures found in the left ventricle?

A

aorta & valve
chordae tenideae
myocardium & papillary muscle
bicuspid valve

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10
Q

What influences the movement of the pericardium?

A

the great vessels, sternum and diaphragm

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11
Q

What are the layers of the pericardium?

A

serous - internal (parietal and visceral)

fibrous - external

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12
Q

Where does the pericardium attach to?

A

the first part of great vessels

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13
Q

Where is the pericardial cavity located?

A

between the parietal and visceral pericardium and contains small amounts of serous fluid

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14
Q

What arteries are responsible for supplying the heart?

A

the coronary arteries

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15
Q

Where do anastomoses occur on the heart?

A

Between coronary artery branches

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16
Q

What is the process by which venous drainage occurs in the heart?

A

four major cardiac veins drain into the coronary sinus, which drains into right atrium

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17
Q

How are nerve impulses conducted in the heart?

A

the SA node produces excitation signals causing atrial muscle to contract
Impulses spread through atrial wall to AV node via internodal tracts
Continues directly into AV bundle (of His) penetrating the fibrous skeleton
AV bundle divides in muscular inter-ventricular septum into the left and right bundle branches
and continues into the walls of the ventricles to the purkinje fibres

SA / AV / L,R Bundle branches / bundle of His / pkj fibres

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18
Q

What is the structure of the fibrous skeleton of the heart?

A

there is a framework of four fibrous rings of dense connective tissue

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19
Q

What is the conducting system of the myocardium regulated by?

A

the autonomic NS (subconscious)

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20
Q

What levels of the conducting system of the heart is the sympathetic innervation from?

A

T1-5, symp trunk, cardiac plexus

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21
Q

How does the pulmonary trunk branch?

A

into the left and right pulmonary arteries and enters the hilum

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22
Q

What are the different pulmonary veins and what is their function?

A

Two veins from each side - inferior (R&L) and superior (R&L)
to transport oxygenated blood from lungs to left atrium

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23
Q

How does the inferior vena cava travel to the heart?

A

it pierces up through the diaphragm then doesn’t have a long way to travel to get to the right atrium

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24
Q

What are the two regions of the right atrium?

A

Sinus venarum

Pectinate muscle

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25
Q

What are the three sources of venous blood flowing into the right atrium?

A

Superior vena cava
Inferior vena cava
Coronary sinus

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26
Q

Why is the sinus venarum smooth walled?

A

the smooth walled parts of the heart often lie where the inflow and outflow of blood is occurring so it’s really important in these regions to have nice, smooth surfaces for allow the flow of blood

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27
Q

What is the function of the trabeculae carneae?

A

they prevent surface adhesion between the walls of the ventricles
they help with the contraction of the ventricles

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28
Q

What are the two cusps in both AV valves (and what is the third cusp in the tricuspid / right valve)?

A

anterior
posterior
(septal)

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29
Q

What are the three leaflets of the SL valves?

A

Left
Right
Anterior

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30
Q

Where do the left and right leaflets of the SL valves lead to?

A

the left and right coronary arteries

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31
Q

In what orientation is the pericardium attached to the great vessels and to the diaphragm?

A

great vessels - superiorly

diaphragm - inferiorly

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32
Q

What three structures influence the pericardium on movement?

A

thoracic viscera
sternum
diaphragm

33
Q

Where is the phrenic nerve in relation to the pericardium?

A

the phrenic nerve travels over the pericardium

34
Q

What are the functions of the pericardium?

A

protects cardiac distension

retains the heart in position via its ligaments

35
Q

Why don’t the sternopericardial ligaments allow for cardiac expansion of the heart?

A

bc the heart is so fibrous / rigid

36
Q

What are the two main layers of the pericardium?

A

Serous pericardium

Fibrous pericardium

37
Q

What does the pericardial cavity contain and what is its function?

A

small amount of serous fluid

to allow for uninhibited movement

38
Q

What two layers make up the serous pericardium?

A 
Parietal layer 
Visceral layer (or Epicardium)
39
Q

What is the function of the fibrous pericardium?

A

protects the heart
anchors it to the surrounding walls
prevents it from overfilling with blood

40
Q

What happens where the parietal and visceral layers of the serous pericardium meet?

A

the reflections form 2 sinuses

41
Q

Where are the transverse and oblique sinuses located?

A

transverse - between outflow vessels and inflow vessels of the heart
oblique - between pulmonary veins

42
Q

What can the transverse sinuses be used for?

A

in surgery to clamp the outflow of blood from the heart

43
Q

Where are the coronary vessels located?

A

in the AV and IVT grooves

44
Q

What are the two main coronary arteries that arise from the ascending aorta?

A

Right and left coronary arteries

45
Q

What are the three branches of the right coronary artery?

A

(SA.R.PoV)
SA node branch
Right marginal branch
Posterior Ventricular branch

46
Q

What are the four branches of the left coronary artery? (CLAD)

A

(Cir.LeM.AnIB.Diag’AIB)

circumflex branch
left marginal branch
anterior interventricular branch
diagonal branch of anterior interventricular branch

47
Q

What are the two types of anastamosis?

A

anatomic (true)

functional (potential)

48
Q

What percent of individuals are right and left coronary artery dominant for the PDA? Is coronary circulation varied?

A

67% - RCA dominant
15% - LCA dominant
Variation in the coronary circulation is common

49
Q

What % of individuals have an accessory CA? What % have the SA nodal branch coming off the circumflex?

A

4%

40%

50
Q

Where is the SA node located?

A

close to crista terminalis at junction between SVC and right atrium

51
Q

Where is the AV node located?

A

interatrial septum close to coronary sinus opening

52
Q

How do the SA and AV node perform a heart beat?

A

the SA node initiates contraction
impulses spread through right atrial wall to left atrium - AV node via internodal tracts
AV node continues into AV bundle (of His)
divides in the interventricular septum to travel to left and right ventricles
conducts the impulse to the left and right Purkinje fibres

53
Q

What are the features of the fibrous skeleton of the heart?

A

Framework of 4 fibrous rings of dense connective tissue

54
Q

What are the functions of the fibrous skeleton of the heart?

A

provides attachment for AV and SL valves

forms an electrical insulator between the atria and ventricles

55
Q

What is the innervation of the myocardium?

A

nerves from the ANS destined for the heart enter the Cardiac Plexus

56
Q

How do the parasympathetic fibres travel?

A

from the vagus nerve
enter the cardiac plexus
travel to the SA node

57
Q

How do the sympathetic fibres travel?

A

from the sympathetic trunk
levels T1-5 enter the cardiac plexus
travels to the SA node

58
Q

What is the largest vein draining the myocardium?

A

the coronary sinus

59
Q

What four major cardiac veins drain into the coronary sinus?

A

Great, middle, small, posterior

60
Q

Where do nerves from the ANS destined for the heart enter from and travel to?

A

the cardiac plexus

SA node

61
Q

What are the four parts of the aorta?

A

ascending (middle mediastinum)
arch (superior mediastinum)
descending thoracic (posterior mediastinum)
descending abdominal

62
Q

What are the two main coronary arteries that arise from the ascending aorta?

A

the right and left coronary arteries

63
Q

What is the left anterior descending artery otherwise known as?

A

anterior interventricular branch of left coronary artery

anterior descending branch

64
Q

What ligaments attach the fibrous pericardium to the sternum?

A

the superior and inferior sternopericardial ligaments

65
Q

Where does the superior sternopericardial ligament attach the fibrous pericardium to?

A

the manubrium

66
Q

Where does the inferior sternopericardial ligament attach the fibrous pericardium to?

A

the xiphoid process

67
Q

What might happen if there was bleeding into the pericardial cavity?

A

it could put pressure on the heart

any pressure within the pericardium is going to push on the heart rather than making the pericardium expand

68
Q

What is the difference between the trabeculae carneae and the pectinate muscles?

A

the pectinate muscles are only found in the atria

TC is only present in the ventricles

69
Q

What is the left marginal artery otherwise known as?

A

obtuse marginal branch

70
Q

What is the coronary sulcus otherwise known as?

A

coronary groove
AV groove
auriculoventricular groove

71
Q

What is the largest coronary artery?

A

(LADA)

left anterior descending artery

72
Q

How many pulmonary veins are there in total?

A

4 bc an inferior and superior main vein drains each lung

73
Q

What substance do the pulmonary veins transport and where to?

A

oxygenated blood from lungs to left atrium

74
Q

Where is parasympathetic innervation of the heart from?

A

vagus nerve to the SA node

75
Q

What is the function of the fibrous skeleton of the heart?

A

so that the AV and SL valves can attach

acts as an electrical insulator between the atria and ventricles

76
Q

What side of the heart is the anterior view on?

A

RHS

77
Q

What view is the left side of the heart on?

A

the posterior view

78
Q

Where are the right and left coronary arteries located?

A

coronary arteries in the AV and IVT grooves

M103 T1 (6 decks)

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