Mediastinum and the Heart

Question 1

Where is the mediastinum

Answer 1

Between right and left lungs, Superior thoracic aperture and diaphragm

Question 2

Divisions of mediastinum?

Answer 2

Superior and inferior

Question 3

Where does the mediastinum divide?

Answer 3

Transverse sternal angle plane

Question 4

What does the mediastinum contain?

Answer 4

Thymus, heart, great vessels, trachea/bronchi, esophagus, thoracic duct, etc.

Question 5

Where is the transverse thoracic plane at the sternal angle?

Answer 5

T4 disc

Question 6

Somatic pericardial cavity does what?

Answer 6

fixes heart to central tendon of diaphragm

Question 7

visceral pericardium is also known as what?

Answer 7

epicardium

Question 8

What do the pericardium do?

Answer 8

lubricate for smooth movement of heart in the cavity

Question 9

What are the somatic pericardiums?

Answer 9

fiberous pericardium and parietal pericardium

Question 10

Cardiac wall has what three layers?

Answer 10

Epicardium, myocardium, endocardium

Question 11

Epicardium is somatic. True or false?

Answer 11

False. This is a visceral pericardium.

Question 12

Myocardium is for what?

Answer 12

cardiac muscles

Question 13

The heart is shaped like a _____

Answer 13

cone

Question 14

Where is the apex of the heart in relation to ribs?

Answer 14

The left 5th intercostal space

Question 15

What is the base of the heart?

Answer 15

Left atrium

Question 16

What is the right pulmonary surface of the heart?

Answer 16

right atrium

Question 17

What is the left pulmonary surface of the heart?

Answer 17

Left ventricle

Question 18

Right heart (right ventricle and atrium) has ____ oxygen blood

Answer 18

low oxygen blood

Question 19

Left atrium and ventricle have _____ oxygen blood

Answer 19

high oxygen blood

Question 20

Which two sinuses are important surgical landmarks?

Answer 20

The oblique pericardial sinus and the transverse pericardial sinus

Question 21

What are the two veins that are great cardiac vessels?

Answer 21

Superior vena cava, pulmonary veins

Question 22

What two arteries are great cardiac vessels?

Answer 22

Pulmonary trunk and ascending aorta to aortic arch

Question 23

Which of the following structures can be seen on transverse CT scans at the sternal angle?

Answer 23

T4 disc

Question 24

What does the right atrium contain?

Answer 24

Auricle, crista terminalis, fossa ovalis, openings of SVC and IVC, opening of coronary sinus, tricuspid valve

Question 25

What does the right ventricle contain?

Answer 25

Trabeculae carneae, papillary muscles, Anterior/Posterior/Septal valve, Pulmonary valves

Question 26

What does the left atrium contain?

Answer 26

Auricle, 4 or more pulmonary veins, fossa ovalis, left AV valve (bicuspid)

Question 27

Which intercostal space does the apex of the heart point to?

Answer 27

Left 5th intercostal space

Question 28

What does the left ventricle contain?

Answer 28

Trabeculae carneae, papillary muscles, Anterior/posterior valve (bicuspid), aortic valves

Question 29

Where are the pulmonary and aortic valves located?

Answer 29

Between the ventricles and the great arteries

Question 30

What are the AV valves?

Answer 30

Tricuspid and bicuspid

Question 31

What is the function of the valves in the heart?

Answer 31

Prevention of blood backflow

Question 32

where do you auscultate for the aortic valve?

Answer 32

right second intercostal space

Question 33

where do you auscultate for the pulmonary valve?

Answer 33

Left 2nd intercostal space

Question 34

Where do you auscultate for the tricuspid valve?

Answer 34

5h intercostal space lateral to sternum

Question 35

Where do you auscultate for the mitral valve?

Answer 35

5th intercostal space, mid-clavicular line

Question 36

Where does moderate/septomarginal band locate and connect which structures? Why is it important?

Answer 36

right ventricle connects to papillary muscles, assists in valve opening and closure at same time

Question 37

What is the goal of pulmonary circulation

Answer 37

exchange of CO2 and O2

Question 38

Where does pulmonary circulation flow?

Answer 38

Right atrium Right ventricle Pulmonary trunk Right and left pulmonary arteries Right and left lungs Right and left pulmonary veins Left atrium: high oxygen

Question 39

what is the goal of systemic circulation?

Answer 39

delivery of O2 and nutrition to whole body

Question 40

Do pulmonary and systemic circulation take place simultaneously?

Answer 40

yes

Question 41

Does systemic circulation include the lungs?

Answer 41

Yes

Question 42

what structure in systemic circulation is in charge of nutrition?

Answer 42

Liver

Question 43

What structure in systemic circulation is in charge of waste?

Answer 43

Kidneys

Question 44

What are the right Coronary arteries?

Answer 44

Nodal branch, marginal branch, posterior interventricular artery

Question 45

What are the left coronary arteries?

Answer 45

Anterior interventricular arteru/ left anterior descending artery circumflex branch

Question 46

Venous drainage follows which pathway?

Answer 46

Great cardiac vein to middle cardiac vein to small cardia vein to coronary sinus to right artium

Question 47

What veins directly drain into right atrium?

Answer 47

anterior cardiac veins

Question 48

What is the cardiac cycle?

Answer 48

beginning one one heartbeat to beginning of next

Question 49

What happens in diastole?

Answer 49

Open AV valves, close pulmonary/aortic valves negative pressure causes blood to drain into ventricles

Question 50

What happens in systole?

Answer 50

Open pulmonary/aortic valves, close AV valves atria contact to drain more blood into the ventricles, then ventricular contraction to project blood to lungs and whole body

Question 51

SA node base heart rate?

Answer 51

80~100 BPM

Question 52

AV node base heart rate?

Answer 52

40~60 BPM

Question 53

Conduction system of heart:

Answer 53

SA node to AV node to Bundle of His to right and left bundle branches to purkinje fibers to cardiac muscles

Question 54

Sympathetic intrinsic innervation of the heart does what?

Answer 54

Increases heart rate.

Question 55

What are the sympathetic nerves of the heart?

Answer 55

Cervical cardiac sympathetic nerves and thoracic cardiac sympathetic nerve

Question 56

What provides parasympathetic innervation of the heart?

Answer 56

Vagus nerve

Question 57

Vagus nerve does what to heart rate?

Answer 57

Decreases

Question 58

What are the branches of the vagus nerve?

Answer 58

Cervical cardiac, thoracic cardiac, left vagus nerve, and right vagus nerve

Question 59

What is the left vagus nerve responsible for?

Answer 59

Recurrent laryngeal nerve = why we are able to speak

Question 60

Where can patients sometimes feel referred pain after heart surgery?

Answer 60

Right shoulder from the c4 dermatome

Question 61

How many patients have right bicipital groove pain

Answer 61

1 in 1000

Question 62

What does the umbilical vein do?

Answer 62

takes high oxygen blood from placenta through liver for nutrient stoarge and detoxification

Question 63

What forms when umbilical vein closes after birth?

Answer 63

Ligamentum teres/ round ligament

Question 64

Which nerve provides parasympathetic support for the heart?

Answer 64

Vagus nerve

Question 65

What causes heart burn?

Answer 65

Gastroesophogeal reful, cardiac notch of stomach causes us to feel it in heart area

Question 66

What structure has impressions on both lungs?

Answer 66

Esophagus

Question 67

What is the largest lymphatic channel?

Answer 67

Between azygos vein and esophagus

Question 68

What percentage does the thoracic duct drain?

Answer 68

75% of body lymph fluid

Question 69

What provides the innervation for the three cavities?

Answer 69

Splanchnic nerve: preganglionic axons to form synapses in prevertebral ganglion Greater splanchnic nerve: T5~T9 Lesser splanchnic nerve: T10~T11 Least splanchnic nerve: T12 Lumbar/sacral splanchnic nerve: L1~L2

Question 70

Which fetal structures degenerate to form the ligamentum arteriosum and ligamentum venosum?

Answer 70

ductus venosus and ductus arteriosus

Question 71

Where does thoracic duct deliver the contents into blood circulating system?

Answer 71

left subclavian and internal jugular veins