Mediastinum: Heart & Lungs

Question 1

External features of right lung

Answer 1

Apex
Lobes: superior, middle, inferior
Fissures: horizontal, oblique

Question 2

External features of left lung

Answer 2

Apex
Lobes: superior, inferior
Fissures: oblique
Lingula

Question 3

Bronchial tree branching

Answer 3

Trachea -> Bronchi: primary (R&L main) -> secondary (lobar) -> tertiary (segmental)

Question 4

Right lung medial surface related structures

Answer 4

Superior vena cava
Esophagus
Azygous vein
Heart

Question 5

Left lung medial surface related structures

Answer 5

Aortic arch
Thoracic aorta
Esophagus
Heart
Lingula

Question 6

Lung root structures
What’s different from L to R?

Answer 6

Hilum - region that the root is passing in
Pulmonary artery - Right anterior, Left superior
Pulmonary veins
Primary bronchus
Pulmonary ligament

Question 7

Pleural coverings of lungs
+ recesses

Answer 7

Parietal pleura - outer
- Cervical part
- Costal part
- Mediastinal part
- Diaphragmatic part
Visceral pleura - inner
Recesses: costomediastinal, costodiaphragmatic

Question 8

Layers of pericardium (superficial to deep)

Answer 8

Fibrous pericardium
Serous pericardium, parietal layer
Serous pericardium, visceral layer

Question 9

Surface features of heart Anterior

Answer 9

A: Ligamentum arteriosum
B: Left auricle
C: Pericardium
D: Anterior interventricular sulcus
E: Left ventricle
F: Cardiac apex
G: Right ventricle
H: Coronary sulcus
I: Right atrium
J: Right auricle

Question 10

Surface features of heart Posterior

Answer 10

A: Left auricle
B: Left atrium
C: Left ventricle
D: Coronary sinus
E: Pericardium
F: Right atrium

Question 11

Right atrium internal features

Answer 11

A: Crista terminalis
B: Pectinate muscles
C: Coronary sinus
D: Inferior vena cava
E: Fossa ovalis

Question 12

Right ventricle internal features

Answer 12

A: Pulmonary semilunar valve
B: Septal papillary muscle
C: Trabeculae carneae
D: Septomarginal trabecula
E: Posterior papillary muscle
F: Anterior papillary muscle
G: Chordae tendineae
H: Tricuspid valve (right atrioventricular valve)
I: Supraventricular crest
J: Conus arteriosus

Question 13

Left atrium & ventricle internal features

Answer 13

A: Left superior pulmonary vein
B: valve of foramen ovale
C: Left atrium
D: Interatrial septum
E: Bicuspid valve ( left atrioventricular valve)
F: Posterior papillary muscle
G: Chordae tendineae
H: Trabeculae carneae
I: Anterior papillary muscle
J: Pectinate muscles

Question 14

Arrangement between chordae tendinea and valves of the heart

Answer 14

When valves are closed the chordae tendinea are taut

Question 15

Cardiac auscultation sites

Answer 15

A: Aortic
B: Pulmonary
C: Left atrioventricular valve, mitral valve
D: Right atrioventricular valve, tricuspid valve

Question 16

Blood Flow through the heart

Answer 16

Superior & inferior vena cava -> right atrium -> tricuspid valve -> right ventricle -> pulmonary semilunar valve -> pulmonary trunk to lungs -> from lungs through pulmonary veins -> left atrium -> bicuspid valve -> left ventricle -> aortic semilunar valve -> aorta to body

Question 17

Draw the arterial supply of the heart

Answer 17

Check against image

Question 18

Draw the venous drainage of the heart

Answer 18

Check against image

Question 19

Conduction system of heart

Answer 19

Sinoatrial node - at the christa terminalis in the right atrium
Atrioventricular node - at the right atrioventricular valve
Bundle of His - between AV valves
Bundle branches - through septa to ventricular walls

Question 20

Explain the anatomy underlying cardiac referred pain

Answer 20

L pectoral, shoulder, medial upper extremity

Question 21

Location of remnants of fetal circulation

Answer 21

Fossa ovalis - was the foramen ovale between the right and left atria
Ligamentum arteriosum - was the ductus arteriosus between the pulmonary trunk and arch of aorta