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Clinical Anatomy 2021 > Mediastinum Heart & lungs > Flashcards

Mediastinum Heart & lungs Flashcards

1
Q

The descending (thoracic) aorta passes ____ to the left main bronchus.

A

posterior

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2
Q

The descending (thoracic) aorta is positioned _____ to the pericardial sac.

A

posterior

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3
Q

The descending (thoracic) aorta is positioned to the ____ of the vertebral bodies

A

left(lateral)

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4
Q

The superior vena cava is positioned ____ to the ascending aorta

A

lateral (right)

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5
Q
  1. The inferior vena cava is positioned _____ the descending aorta
A

to the right of

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6
Q
  1. The arch of the aorta passes _____ to the pulmonary trunk
A

superior

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7
Q
  1. The left vagus nerve passes directly ____ to the arch of the aorta
A

lateral

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8
Q
  1. The left recurrent laryngeal nerve passes _____ to the ligamentum arteriosum
A

posterior

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9
Q
  1. The left recurrent laryngeal nerve passes directly ______ to the arch of the aorta.
A

inferior

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10
Q
  1. The azygos vein (arch) passes _____ to the right main bronchus
A

superior

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11
Q
  1. The left vagus nerve passes _____ to the left main bronchus
A

posterior

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12
Q
  1. The right vagus nerve is positioned _____ to the trachea.
A

lateral

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13
Q
  1. The right vagus nerve passes _____ to the arch of the azygos vein and posterior to the right main bronchus.
A

medial

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14
Q
  1. At the hilum of the left lung, the pulmonary artery is positioned _____ to the main bronchus.
A

superior

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15
Q
  1. At the hilum of the left lung, the pulmonary veins are positioned _____ and _____ to the main bronchus.
A

anterior, inferior

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16
Q
  1. At the hilum of the right lung, the pulmonary artery is positioned ____ to the main bronchus.
A

anterior

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17
Q
  1. At the hilum of the right lung, the pulmonary veins are positioned ____ to the main bronchus.
A

anterior

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18
Q
  1. At the hilum of the right lung, the pulmonary veins are positioned ___ and _____ to the pulmonary arteries.
A

anterior, inferior

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19
Q
  1. The descending (thoracic) aorta passes ___ to the left main bronchus
A

posterior

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20
Q
  1. The descending (thoracic) aorta is positioned ______ to the pericardial sac.
A

posterior

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21
Q
  1. The descending (thoracic) aorta is positioned to the _____of the vertebral bodies
A

left (lateral)

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22
Q
  1. The esophagus is positioned ______ to the trachea.
A

posterior

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23
Q
  1. The esophagus passes ______ to the left main bronchus
A

posterior

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24
Q
  1. The esophagus is positioned ______ to the pericardial sac
A

posterior

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25
Q
  1. The right vagus nerve is positioned ____ to the trachea.
26
Q
  1. The right vagus nerve passes ____ to the azygos vein and ____ to the right main bronchus.
A

medial, posterior

27
Q
  1. The left vagus nerve passes directly _____ to the arch of the aorta.
28
Q
  1. The left vagus nerve passes _____ to the left main bronchus
29
Q
  1. The azygos vein passes _____ to the right main bronchus.
30
Q
  1. The thoracic duct is positioned directly _____ to the thoracic vertebral bodies.
31
Q
  1. The right posterior intercostal arteries pass _____ to the vertebral bodies.
32
Q
  1. The sympathetic chain is positioned _____ to the thoracic vertebral bodies
33
Q
  1. The greater splanchnic nerve is positioned ____ to the sympathetic chain.
A

anterior-medial

34
Q

L Lung features

A

lingula
superior + inferior lobes
apex
oblique fissure

35
Q

R lung features

A

superior + inferior + middle lobe
apex
oblique fissure
horizontal fissure

36
Q

What is included in the R lung medial surface?

A

Super vena cava
Espohagous
azygous vein
heart

37
Q

What is included in the L lung medial surface?

A 
aortic arch
thoracic aorta
esophagus
heart
lingula
38
Q

Describe the L lung root

A

includes: pulmonary arteries, pulmonary veins, bronchi

The pulmonary artery is superior to the primary bronchus

39
Q

Describe the R lung root

A

The pulmonary artery is anterior to the primary bronchus

40
Q

What are the layers of pericardium? From superficial to deep

A 
superficial: fibrous pericardium
parietal pericardium
visceral pericardium
myocardium
deep: endocardium
41
Q

What are the surface features of the heart?

A 
Ascending aorta
ligamentum arteriosum
pulmonary trunk
left auricle
pericardium
anterior interventricular sulcus
cardiac apex
inferior vena cava
right ventricle
coronary sulcus
right atrium
right auricle
superior vena cava
pulmonary veins
coronary sinus
left atrium, ventricle, auricle 
arch of aorta
42
Q

What are the internal features of the heart? Right ventricle

A 
valve of pulmonary trunk
septal papillary muscle
anterior papillary muscle
posterior papillary muscle
septomarginal trabecula
interventricular septum
trabeculae carneae
right AV valve(tricuspid vale)
supraventricular crest
conus arteriosus
43
Q

What are the internal features of the heart? left atrium and ventricle

A 
pecintate muscles
anterior papillary muscle
posterior papillary muscle
trabeculae carneare
chordae tendinae
left AV valve (bicuspid)
left auricle
left superior pulmonary v
valve of forman ovale
interatrial septum
44
Q

What are the cardiac auscultation sites?

A
  • valves can be assesed by taking advantage of the fact that blood carries sound in the direction of flow
  • sites are located superficial to the vector blood follows as it passes through each chamber/vessel
  • intercostal spaces
  • 2nd intercostal for semilunar
  • 5th intercostal space for AV valves
45
Q

Explain blood flow through the heart

A
  1. SVC and IVC > R atrium
  2. through tricuspid valve > R ventricle
  3. through pulmonary valve >pulmonary trunk
  4. then, > pulmonary arteries > lung
  5. oxynegated in the lungs
  6. pulmonary veins > L atrium
  7. through the mitral valve, > L ventricle
  8. through the aortic valve, > ascending aorta, > arch of aorta, > throacic aorta
46
Q

Explain the conduction system of the heart

A
  • the heart has specifically developed cells that have lost their contractile proteins, but effective in transmitting electrical signals
  • they are interconnected cardiac cells
47
Q

Explain cardiac referred pain

A

-someone having a heart attack- they are having cardiac/myocardium stimulus but they are telling you that they have pain in their skin

  • pain also comes from viscera
  • pain receptors in myocardium, visceral afferent axons, cell bodies in DRG, shared with general somatic axons, brain interprets pain from skin

-usually in L pec, shoulder, medial UE

48
Q

Describe fetal circulation

A
  • lungs are not fully developed, no respiration is happening
  • pulmonary circulation can be bypassed to a large extent
  • Ductus arteriosus>ligamentum arteriosum (pulmonary trunk to arch of aorta)
  • Foramen Ovale> fossa ovalis (Right to left atrium)
  • post birth, you will have closure of these structures that were formally patent
49
Q

Explain the arrangement between chordae tendineae and the valves of the heart

A

the atrioventricular valves (aka tricuspid and bicuspid) are the valves that go from the atria to the ventricles. The cordinae tendineae attach from the flaps of the valves and anchor to the papillary muscles in the ventricles. When blood flows through the valves, the pressure causes the flaps to shut and the cordinae tendinae/papillary muscles seal the valves shut by not allowing the flaps to reverse back into the atria

50
Q

What are the internal features of the R atrium?

A 
SVC
interatrial septum
fossa ovalis
pectinate muscles
crista terminalis
right auricle
51
Q

what are the internal features of the R ventricle?

A 
conus arteriosus 
supraventricular crest
tricuspid valve
chordae tendinae
anterior, posterior, septal papillary muscles
interventricular septum
trabeculae carneae
valve of pulmonary trunk
pectinate
52
Q

What are the left atrium internal features?

A

left auricle
left superior pulmonary v
valve of foramen ovale
interatrial septum

53
Q

what are the internal features of the L ventricle?

A 
pecintate muscles
anterior and posterior papillary muscles
Bicuspid valve
trabeculae carneae 
chordae tendineae
54
Q

What structures are found in the superior mediastinum?

A

organs: thymus, trachea, esophagus
Arteries: aortic arch, brachiocephalic trunk, left common carotid artery, left subclavian artery
Veins and lymphatics: superior vena cava, brachiocephalic veins, the arch of the azygos, thoracic duct
Nerves: left and right vagus, recurrent laryngeal, cardiac, left and right phrenic nerves

55
Q

What structures are found in the anterior mediastinum?

A

Organs: thymus
Arteries: internal thoracic branches
Veins and lymphatics: internal thoracic branches, parasternal lymph nodes
Nerves: none

56
Q

What structures are found in the middle mediastinum?

A

Organs: the heart and its great vessel roots, trachea and main bronchi
Arteries: ascending aorta, pulmonary trunk, pericardiacophrenic arteries
Veins and lymphatics: superior vena cava, pulmonary veins, pericardiacophrenic veins
Nerves: phrenic, vagus, sympathetics

57
Q

What structures are found in the posterior mediastinum?

A

Organs: esophagus
Arteries: descending thoracic aorta
Veins and lymphatics: azygos hemiazygos veins, thoracic duct
Nerves: vagus, splanchnic, sympathetic chain

58
Q

Why is the anterior interventricular (LAD) so important?

A

it is the largest artery of the heart

  • serves largest amount of cardiac tissue
  • w/blockage= loss of cardiac tissue
59
Q

Describe the pleural coverings of the lungs

A

parietal=outer
visceral=inner

the pleural coverings are a serrous membrane

60
Q

Describe the regions of the pleural coverings

A

superior aspect= cervical
most extensive portion= costal part that wraps from posterior to lateral+anterior
diaphragmatic= overlying diaphragm
most medially= mediastinal part

61
Q

Describe the parietal pleura recesses

A

recesses are the site of fluid accumulation, maybe seen from infection. they are where parts of the parietal pleura take a change in direction

  • Costomediastinal= costal pleura transitioning into mediastinal
  • costodiaphragmatic= costal pleura transitioning into diaphragmatic

Clinical Anatomy 2021 (11 decks)

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