mediastinum

Question 1

what are the 3 parts of the thoracic cavity from l to r

Answer 1

plueral, mediastinum, pleural

Question 2

what are the upper and lower boundaries of the mediastinum

Answer 2

sternum, diaphragm

Question 3

why does the pericardial sac elongate

Answer 3

attached to diaphragm, stretches on inspiration

Question 4

what is the transthoracic plane

Answer 4

angle of Louis thru T4/5

Question 5

when supine, what does the transthoracic plane pass through

Answer 5

aortic arch, carina

Question 6

which nerves innervate the diaphragm

Answer 6

C3,4,5 phrenic nerve

Question 7

whst else does the phrenic nerve innervate and what sort of nerves are they

Answer 7

diaphragm - motor
pericardium - sensory
mediastinal pleura - sensroy

Question 8

what is in the superior mediastinum

Answer 8

aortic arch
phrenic nerves
vagus nerve
recurrent laryngeal nerves
oesophagus
trachea
thoracic duct

Question 9

what is in the posterior mediastinum

Answer 9

goose x 3
duck
(vagus, azygous, oesophagus, thoracic duct)

Question 10

where do the thyrocervical arteries branch from

Answer 10

subclavian

Question 11

what is supplied by the thyrocervical arteries (5)

Answer 11

Inferior part of the thyroid gland, parathyroid glands, larynx, pharynx, platysma, brachial plexus, deep cervical and shoulder muscles, skin of the neck and shoulders

Question 12

where does the recurrent laryngeal nerve branch from

Answer 12

vagus

Question 13

where do R and L recurrent laryngeal nerves go

Answer 13

L under aortic arch
R under subclavian

Question 14

why is paralysis of phrenic nerve after surgery usually transient

Answer 14

peripheral nerves can regenerates

Question 15

what are the vertebral levels of the trachea

Answer 15

C6-T4

Question 16

where is the bifurcation of the trachea

Answer 16

T4/5

Question 17

what does the aorta branch over

Answer 17

primary branch of L bronchus and L hilum

Question 18

what are the vertebral levels of the oesophagus

Answer 18

C6 (same as trachea)-T10

(count letters of oesophagus)

Question 19

what are the vertebral levels of the oesophagus

Answer 19

C6 (same as trachea)-T10

(count letters of oesophagus)

Question 20

what is a feature of the oesophagus that aids digestion

Answer 20

indentations

Question 21

where are the indentations in the oesophagus

Answer 21

pharyngoesophagal jct
arch of aorta
transverse diaphragm

Question 22

what do azygous and hemi-azygous veins provide

Answer 22

venous drainage to thoracic area

Question 23

what relative space should the heart occupy on an x-ray

Answer 23

1/3 R, 2/3 L, no more than 50% of thoracic space

Question 24

which arteries supply C1and C2

Answer 24

Costocervical arteries, directly from subclavian

Question 25

where do the posterior intercostal arteries get their blood from?

Answer 25

descending aorta

Question 26

where do coronary arteries get their blood from

Answer 26

first dibs from aorta

Question 27

how do coronary arteries get blood

Answer 27

after systole, blood falls back into aortic valve cusps and can trickle down into coronary arteries

Question 28

what supplies the anterior intercostal arteries

Answer 28

internal thoracic artery

Question 29

where does the internal thoracic artery originate

Answer 29

subclavian

Question 30

what goes in the little groove at the bottom of each rib?

Answer 30

one vein, one artery, one nerve "neurovascular bundle"

Question 31

where would you take a sample of pleural fluid?

Answer 31

T9/10

Question 32

why would you take a sample of pleural fluid there and what should you be aware of

Answer 32

lungs don't go all the way down. Not diaphragm, not liver go in teh middle/towards the bottom of the space to avoid the neurovascular bundle

Question 33

how would you reinflate a pneumothorax

Answer 33

needle in T9/10 space

Question 34

what are the functions of the pericardium

Answer 34

fixes heart in place prevents heart stretching too much lubrication protects heart from infection (eg muck brought into lungs)

Question 35

what is a pericardial infusion called and what is it

Answer 35

tamponade, fluid/blood between visceral and parietal layers of pericardium

Question 36

what's the difference between acute and chronic tamponade

Answer 36

acute very bad: 150ml=death chronic: pericardium can stretch and accommodate up to 1l without death

Question 37

what are pulmonary crackles called

Answer 37

rales

Question 38

what happens in acute tamponade

Answer 38

RV collapse

Question 39

what is the thing between the atria and ventricles called and what is in it

Answer 39

atrioventricular sulcus - fat and coronary arteries

Question 40

what is the thing between the ventricles called and what's in it

Answer 40

interventricular sulcus - fat and more coronary arteries. overlies internetricular septum

Question 41

where are auricles

Answer 41

inferior part of atria

Question 42

how many pulmonary veins feed into the L atrium

Answer 42

4

Question 43

what is the venous return of the coronary arteries

Answer 43

coronary sinus

Question 44

what feeds into the r atrium

Answer 44

IVC SVC coronary sinus

Question 45

what is the indentation in the atria

Answer 45

fossa ovale

Question 46

what does the fossa ovale allow in foeti

Answer 46

blood to pass between atria

Question 47

where is the SAN

Answer 47

jct between SVC and r atrium

Question 48

what is the dense band of connective tissue between the Purkinje fibres and the intervemtricular septum called

Answer 48

moderator band

Question 49

which is the smoothest chamber of the heart

Answer 49

LA

Question 50

what is the LAD

Answer 50

left coronary artery

Question 51

where do the majority of myocardial infarctions happen

Answer 51

LAD

Question 52

what can be a consequence of RCA myocardial infarction

Answer 52

SAN damage -> heart block

Question 53

what holds the heart together

Answer 53

fibrous skeleton; 2 figures of 8

Question 54

which vlavled are open during diastole

Answer 54

AV

Question 55

what happens in systole

Answer 55

papillary muscles contracted chordae tendinae taut A and P valves open AV valves shut

Question 56

when is first heart sound

Answer 56

start of systole

Question 57

when is second heart sound

Answer 57

start of diastole

Question 58

when is second heart sound

Answer 58

start of diastole

Question 59

does the heart feel pain

Answer 59

no. only referred pain to relevant dermatomes and other sensory nerves

Question 60

does the heart feel pain

Answer 60

no. only referred pain to relevant dermatomes and other sensory nerves

Question 61

where do you get pain with posterior wall MI

Answer 61

epigastric T7,8,9

Question 62

what is ischaemia

Answer 62

decreased blood flow & therefore O2 to heart muscle

Question 63

what causes pain in MI

Answer 63

ischaemia and heart muscle damage