Pericardium and Heart

Question 1

What is the mediastinum? What covers it? What does it contain?

Answer 1

• The mediastinumis the central compartment of the thoracic cavity
• Covered by mediastinal pleura on each side
• Contains all the thoracic viscera structures except lungs

Question 2

What vertebral level divides superior and inferior mediastinum

Answer 2

Between T4 and T5

Question 3

Middle mediastinum contents

Answer 3

• Heart
• Roots of great vessels( Ascending aorta, Pulmonary trunk, SVC)
• Pericardium

Question 4

Pericardium layers (sac)

Answer 4

Question 5

Fibrous pericardium attaches to diaphragm via

Answer 5

pericardiophrenic ligament

Question 6

Transverse sinus is between …

Answer 6

• Aorta and pulmonary trunk
• Superior vena cava

Question 7

Excess fluid in the pericardial cavity

Answer 7

Pericardial effusion

Question 8

Heart volume is compromised by the rapid increase of fluid within pericardial cavity

Answer 8

Cardiac tamponade

Question 9

Pericardium arteries and veins

Answer 9

• Supplied by pericardiacophrenic A (runs with phrenic nerve)
• Drained via pericardiacophrenic V

Question 10

Pericardium innervation

Answer 10

Innervation via phrenic N (C3-C5)

Question 11

Name Sulci

Answer 11

Question 12

Location of apex of heart

Answer 12

• Anterior and to left
• Posterior to 5thintercostal space

Question 13

3 heart surfaces

Answer 13

Question 14

Answer 14

Question 15

Answer 15

Question 16

Answer 16

Question 17

Answer 17

Question 18

Answer 18

Question 19

Location of tricuspid valve. What attache to it?

Answer 19

• Occupies right AV orifice
• Bases of cusps are attached to fibrous ring
• Ventricular surfaces of cusps are attached to chordae tendinae (from papillary M)

Question 20

Biscuspid valve location

Answer 20

•Occupies left AV orifice

Question 21

Where do the pulmonary arteries branch off of?

Answer 21

Aortic semilunar valve

Question 22

Wall layers

Answer 22

Question 23

Cardiac cycle phases

Answer 23

• Diastole (Dub)
• Systole (Lub)

Question 24

Diastole

Answer 24

• Diastole (ventricular filling and elongation)
• Closing of SL valves
• Opening of AV valves
• Blood passively fills atria, ventricles
• Atrial contraction forces blood into ventricles

Question 25

Systole

Answer 25

* Systole(ventricular shortening and emptying) * Ventricular contraction closes AV valves * Opening of SL valves, blood ejected

Question 26

Borders of heart (surface)

Answer 26

Question 27

Remnant of the ductus arteriosus

Answer 27

Ligamentum arteriosium

Question 28

Answer 28

Question 29

Answer 29

Question 30

Answer 30

Question 31

Answer 31

Question 32

Coronary dominance is based on ...

Answer 32

The vessel that gives rise to posterior interventricular A * Right dominant – 67% * Left dominant – 15% * Codominance – 18%

Question 33

Two nodes of heart conduction

Answer 33

* Sinoatrial node (SA) node- initiates and regulates impulses for heart contractions * Atrioventricular (AV) node – distributes signal through AV bundle

Question 34

Conduction bundles become what? How do they behave on each side?

Answer 34

* Bundles become Purkinje fibers * Right side – ant papillary M through moderator band, R vent. wall * Left side – ant/post papillary M, L vent. wall

Question 35

COnducting node blood supply

Answer 35

* From R coronary A * Sinoatrial nodal A (SA node) * Atrioventricular nodal A (AV node)

Question 36

Heart innervation. Function of para/sympathetics

Answer 36

Question 37

Answer 37

Question 38

Lymph from the heart passes to the ...

Answer 38

Subepicardial lymphatic plexus

Question 39

Series for cardial lymph

Answer 39

1. Subepicardial lymphatic plexus 2. Into coronary sulcus, follows coronary arteries 3. Ascends b/t the pulmonary trunk and L. atrium, then collects in tracheobronchial lymph nodes 4. Passes to bronchomediastinal lymph trunks to thoracic duct (left side) or right lymphatic duct (right side)