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Heart, Lungs and Blood > Middle mediastinum > Flashcards

Middle mediastinum Flashcards

1
Q

What is the mediastinum?

A

The mediastinum is the central compartment located in the thoracic cavity.

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2
Q

How is the mediastinum divided?

A

The mediastinum is divided into two parts: superior and inferior.

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3
Q

How many parts are there in each division of the mediastinum?

A

The superior mediastinum has no division but the inferior has three parts: anterior, middle, and posterior.

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4
Q

What is the boundary between the superior and inferior divisions of the mediastinum?

A

The boundary between the superior and inferior divisions of the mediastinum is the T4/5 transthoracic plane/sternal angle.

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5
Q

What are the boundaries of the superior and inferior divisions of the mediastinum?

A

The superior division of the mediastinum is bounded by the superior thoracic aperture, while the inferior division is bounded by the diaphragm. The lateral boundaries are the pulmonary cavities.

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6
Q

What is the middle mediastinum?

A

The middle mediastinum is a division of the mediastinum located between the anterior and posterior mediastina.

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7
Q

What is the middle mediastinum?

A

The middle mediastinum is a division of the mediastinum located between the anterior and posterior mediastina.

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8
Q

What are the boundaries of the middle mediastinum?

A

The superior boundary of the middle mediastinum is the superior mediastinum, the inferior boundary is the diaphragm (at T8/9 in the supine position or T9/10 in the standing position), and the lateral boundaries are the pulmonary cavities.

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9
Q

What are the surface landmarks of the middle mediastinum?

A

The surface landmarks of the middle mediastinum are the left costal cartilage and the anterior rib end III-V.

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10
Q

What is the pericardium?

A

The pericardium is a fibroserous sac that surrounds the heart and the root of the great vessels

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11
Q

What are the layers of the pericardium?

A

The pericardium consists of two layers: the fibrous pericardium and the serous pericardium.

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12
Q

What is the fibrous pericardium?

A

The fibrous pericardium is the outer layer of the pericardium, which is composed of tough fibrous connective tissue.

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13
Q

What is the serous pericardium?

A

The serous pericardium is the inner layer of the pericardium, which is composed of two layers: the parietal layer and the visceral layer.

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14
Q

What is the heart?

A

The heart is a muscular organ that pumps blood throughout the body.

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15
Q

What are the chambers of the heart?

A

The heart has four chambers: the right atrium, the right ventricle, the left atrium, and the left ventricle.

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16
Q

What are the valves of the heart?

A

The heart has four valves: the tricuspid valve, the pulmonary valve, the mitral valve, and the aortic valve.

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17
Q

What is the origin/root of the great vessels?

A

The great vessels (the aorta, pulmonary artery, superior vena cava, and inferior vena cava) arise from the base of the heart.

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18
Q

What is the function of the fibrous pericardium?

A

The function of the fibrous pericardium is to prevent overfilling of the heart.

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19
Q

What are the boundaries of the fibrous pericardium?

A

The fibrous pericardium is superiorly continuous with the adventitia of the great vessels, inferiorly adhered to the central tendon of the diaphragm (pericardiophrenic ligament), anteriorly attached to the sternum (sternopericardial ligaments), and posteriorly loosely adhered to the posterior mediastinum by loose connective tissue.

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20
Q

What is cardiac tamponade?

A

Cardiac tamponade is a condition in which excess fluid within the pericardial cavity prevents filling of the heart.

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21
Q

What are the two layers of the serous pericardium?

A

The two layers of the serous pericardium are the parietal layer and the visceral layer (epicardium).

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22
Q

What is the site of reflection of the parietal onto the visceral layer of the serous pericardium?

A

The site of reflection of the parietal onto the visceral layer of the serous pericardium is the origin of the great vessels, including the aorta, pulmonary trunk, superior and inferior vena cava, and pulmonary veins.

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23
Q

What are the pericardial sinuses?

A

The pericardial sinuses are reflections of the parietal onto the visceral layer of the serous pericardium that form around the great vessels. There are two pericardial sinuses: the transverse pericardial sinus and the oblique pericardial sinus.

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24
Q

What is the relevance of the transverse pericardial sinus?

A

The relevance of the transverse pericardial sinus is that it is the reflection between the arterial and venous groups of great vessels, and it can be cross-clamped for coronary bypass.

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25
Q

What is the blood supply of the heart?

A

Pericardiophrenic a., musculophrenic a., coronary a., bronchial a./oesophageal a./superior phrenic a. direct from thoracic aorta

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26
Q

What is the venous drainage of the heart?

A

Pericardiophrenic v., azygos venous system tributaries

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27
Q

What are the layers of the heart?

A

Endocardium, myocardium, epicardium (visceral serous pericardium)

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28
Q

What are the structures of the heart?

A

Two sides (right and left), four chambers (atria and ventricles), and four valves (atrioventricular and semilunar)

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29
Q

What is the cardiac cycle?

A

Blood in to atria, blood through atrioventricular valves into ventricles (diastole), atrial contraction, atrioventricular valves close (first heart sound), ventricular contraction (systole) and blood through semilunar valves, semilunar valves close (second heart sound)

30
Q

What is the function of the right side of the heart?

A

Receives venous blood and circulates de-oxygenated blood to the lungs.

31
Q

What is the function of the left side of the heart?

A

Receives arterial blood and circulates oxygenated blood to the body.

32
Q

What are the four surfaces of the heart?

A

Anterior surface (sternocostal), inferior surface (diaphragmatic), right pulmonary surface, left pulmonary surface.

33
Q

What are the four borders of the heart?

A

Right border, inferior border, left border, superior border.

33
Q

What are the four borders of the heart?

A

Right border, inferior border, left border, superior border.

34
Q

What are the two pericardial sinuses?

A

Transverse pericardial sinus and oblique pericardial sinus.

35
Q

What is the cardiac cycle?

A

The sequence of events that occur during one heartbeat.

36
Q

What is the orientation of the heart?

A

Trapezoid from anterior and posterior views.

37
Q

What are the structures that can be found in the right atrium of the heart?

A

Right auricle
Sinus venarum (smooth walled)
Pectinate muscle
Crista terminalis (internal)
Sulcus terminalis (external)
Vessel openings: SVC, IVC, coronary sinus
Fossa ovalis (foramen ovale)

38
Q

What are the structures that can be found in the right ventricle of the heart?

A

Conus arteriosus (infundibulum)
Trabeculae carneae
Supraventricular ridge
Tricuspid valve, cusps, and orifice
Chordae tendineae
Papillary muscles x3: anterior, septal, posterior
Moderator band (septomarginal trabecula)
Pulmonary valve, semilunar cusps, and sinuses

39
Q

What are the structures that can be found in the left atrium of the heart?

A

Left auricle
Pectinate muscle
Fossa ovalis (foramen ovale)

40
Q

What are the structures that can be found in the left ventricle of the heart?

A

Trabeculae carneae
Papillary muscles x2: anterior and posterior
Mitral valve, cusps, and orifice
Chordae tendineae
Aortic vestibule
Aortic valve, semilunar cusps, and sinuses
Coronary artery orifices: right and left

41
Q

what is the location of the right and left coronary arteries

A

arise from aortic sinuses and coronary orifces

42
Q

what is the pathway of the RCA

A

in coronary sulcus/atrioventricular sulcus/groove

43
Q

what is the pathway of the LCA

A

between pulmonary trunk and left auricle in coronary sulcus

44
Q

what are the branches of the RCA

A

SA node br. (60%)
Right marginal br.
AV node br. (80%)
Posterior interventricular br. CARDIAC DOMINANCE (67%)

45
Q

what are the branches of the LCA

A

Anterior IV br. (left anterior descending LAD)
Diagonal br. (from the anterior IV br.)
Circumflex br.
Left marginal br. (from circumflex br.)

46
Q

What are the cardiac veins and where do they drain into?

A

All cardiac veins drain into the coronary sinus, which lies in the posterior coronary sulcus
Tributaries include:
Great cardiac v. (anterior IV br.)
Small cardiac v. (R marginal br.)
Middle cardiac v. (posterior IV br.)
L posterior ventricular/cardiac v.

47
Q

What is the cardiac dominance and which coronary artery is typically dominant?

A

Cardiac dominance refers to which coronary artery gives rise to the posterior interventricular branch. If the right coronary artery gives rise to this branch, it is considered to be right dominant, while if the left circumflex artery gives rise to this branch, it is considered to be left dominant. The right coronary artery is typically dominant.

48
Q

What is the coronary sinus and what are its tributaries?

A

The coronary sinus is a vein that lies in the posterior coronary sulcus and drains blood from the heart muscle. Its tributaries include the great cardiac vein, small cardiac vein, middle cardiac vein, and left posterior ventricular/cardiac vein.

49
Q

What happens on day 18 during cardiac development?

A

Paired heart tubes develop from cardiac progenitor cells to meet the nutritional needs of the embryo.

50
Q

What happens on day 21/22 during cardiac development?

A

The heart tubes fuse in the midline, and the heart starts to beat. The bulbus cordis and truncus arteriosus, ventricle, primordial atrium, and sinus venosus form.

51
Q

What is the bulboventricular loop?

A

The bulboventricular loop is the dextral looping of the heart tube that occurs between days 22-28 of cardiac development.

52
Q

What happens at the end of week 4 during cardiac development?

A

Endocardial cushions form to divide the AV canal, primordial atrium, and ventricle.

53
Q

What happens at the end of week 5 during cardiac development?

A

The truncus arteriosus is partitioned and undergoes 180° spiraling. The bulbus cordis is incorporated into the ventricle walls.

54
Q

What happens at the end of week 7 during cardiac development?

A

The interventricular septum closes.

55
Q

What is the ductus venosus?

A

The ductus venosus is a fetal blood vessel that connects the umbilical vein to the inferior vena cava, allowing oxygenated blood from the placenta to bypass the liver.

56
Q

What is the ductus arteriosus?

A

The ductus arteriosus is a fetal blood vessel that connects the pulmonary artery to the descending aorta, allowing most of the blood to bypass the lungs.

57
Q

What is the foramen ovale?

A

The foramen ovale is an opening in the interatrial septum of the fetal heart, allowing blood to flow from the right atrium to the left atrium.

58
Q

What is the umbilical vein?

A

The umbilical vein is a fetal blood vessel that carries oxygenated blood from the placenta to the fetus.

59
Q

What are the umbilical arteries?

A

The umbilical arteries are fetal blood vessels that carry deoxygenated blood from the fetus to the placenta.

60
Q

What are the remnants of the pre-natal circulation in the adult heart and vessels?

A

Foramen ovale > fossa ovalis
Ductus arteriosus > ligamentum arteriosum
Ductus venosus > ligamentum venosum
Left umbilical vein > ligamentum teres hepatis
Umbilical arteries > median umbilical ligament

61
Q

What is the function of the conducting system of the heart?

A

The function of the conducting system is to generate and transmit electrical impulses across cardiac myocytes.

62
Q

What is the primary pacemaker of the heart?

A

The primary pacemaker of the heart is the sinoatrial (SA) node.

63
Q

Where is the SA node located?

A

The SA node is located at the superior end of the sulcus terminalis.

64
Q

What is the normal rate of the SA node?

A

The normal rate of the SA node is 70 beats per minute.

65
Q

What is the location of the atrioventricular (AV) node?

A

The AV node is located near the opening of the coronary sulcu

66
Q

What are the components of the cardiac conduction system?

A

The components of the cardiac conduction system are the SA node, AV node, AV bundle, bundles (right and left), and Purkinje fibers (subendocardial branches).

67
Q

What is the function of the cardiac plexus?

A

The function of the cardiac plexus is to regulate heart rate and cardiac function.

68
Q

What nerves innervate the heart?

A

The phrenic nerve (C3-5), the sympathetic trunk (T1-5/6), and the vagus nerve (CN X) innervate the heart.

69
Q

What is referred pain?

A

Referred pain is pain that is felt in a different part of the body than the source of the pain.

70
Q

What is the difference between somatic and visceral pain?

A

Somatic pain is sharp and localized and is felt in the skeletal muscles, bones, and connective tissue. Visceral pain is dull and poorly localized and is felt in the viscera of body cavities and vessels.

71
Q

Label what these areas of referred pain are caused by

A

Heart, Lungs and Blood (51 decks)

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