Mediastinum: Heart & Lungs Flashcards
Identify the external features of the right and left lungs.
R Lung:
- apex
- superior, middle, inferior lobes
- oblique and horizontal fissures
L Lung:
- apex
- superior and inferior lobes
- oblique fissure
- lingula (tongue-like protuberance)
Explain the pattern of branching and the structural anatomy of the bronchial tree.
Trachea (rings, carina) —> Primary Bronchi (R & L main) —> Secondary Bronchi (lobar) —> Tertiary Bronchi (segmental)
*10 bronchopulmonary segments
Identify the right and left lungs using only the related structures of their medial surfaces.
R Lung:
- superior vena cava - where the brachiocephalic trunk merges
- azygos v. - arching up and over root of R lung
- esophagus - midline
- heart impression - below SVC and left
L Lung:
- aortic arch
- thoracic aorta
- esophagus
- heart
- lingula
Name the structures that comprise the root of the lung and explain how they vary between right and left lungs.
Lung Root:
- pulmonary aa. & vv.
- primary bronchus
- bronchial aa.
- pulmonary ligament
R: pulmonary aa. anterior to primary bronchus
L: pulmonary aa. are superior to primary bronchus
Describe the pleural coverings of the lungs including the regions and recesses.
Serous Membrane:
- Parietal pleura: outer layer adjacent to thoracic wall, diaphragm, mediastinum (cervical, costal, diaphragmatic, and mediastinal part)
- Visceral pleura: inner layer, on lung itself
Costodiaphragmatic Recess: costal part transitioning to diaphragmatic part
Costomediastinal Recess: costal part transition to mediastinal part)
Identify the surface features of the heart.
- R/L auricle
- R/L atrium
- R/L atrium
- coronary sulcus
- cardiac apex
- anterior interventricular sulcus
- pericardium
- ligamentum arteriosum
- coronary sinus
- S/I vena cava
Name the internal features of each chamber of the heart.
R Atrium:
- interatrial septum
- fossa ovalis
- crista terminalis
- pectinate mm.
- R atrioventicular orifice (AV valve)
R Ventricle:
- valves of pulmonary trunk
- conus arteriosus
- supraventricular crest
- R AV valve (tricuspid)
- chordae tendineae
- anterior, posterior, septal papillary mm.
- septomarginal trabecula (moderator band)
- trabeculae carneae
- interventricular septum
L Atrium & Ventricle:
- pectinate mm.
- anterior/posterior papillary mm.
- trabeculae carneae
- chordae tendineae
- valve of fossa ovalis
- left AV valve (bicuspid/mitral valve)
Explain the arrangement between chordae tendineae and the valves of the heart.
The chordae tendineae anchor the AV valves in the R & L ventricles to the papillary mm. to prevent the valves from blowing out
Identify cardiac auscultation sites.
Sites are located superficial to the path blood follows as it passes through each chamber/vessel.
- Aortic, pulmonary, R AV, L AV
Describe the blood flow through the heart including all chambers and valves.
SVC/IVC - R atrium - R AV valve - R ventricle - Semilunar valves - R pulmonary trunk - lungs - Pu
Describe the pattern of venous drainage of the heart including locations of major cardiac veins.
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Describe the pattern of arterial supply of the heart.
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Explain the conduction system of the heart.
The SA node, AV node, and AV bundle interconnect cardiac mm. And adapt to assist with timing
Explain the anatomy underlying [cardiac] referred pain.
- pain receptors in the myocardium
- visceral afferent axons (symp)
- cell bodies in DRG
- shared w/general somatic axons
- brain interprets pain from skin, L pectoral, shoulder, medial UE
Describe the location of the remnants of fetal circulation (fossa ovalis & ligamentum arteriosum) and what structures they shunted blood between.
Ductus Arteriosus —> ligamentum arteriosum
- pulmonary trunk to arch of aorta
Foramen ovale —> fossa ovalis
- R to L atrium
