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Anatomy > Quiz 3- Autonomic nervous system, Mediastinum, Heart, Cardiac Embryology > Flashcards

Quiz 3- Autonomic nervous system, Mediastinum, Heart, Cardiac Embryology Flashcards

1
Q

how would you classify all neurons within the ANS? (afferent/efferent/visceral/somatic

A

all visceral efferent

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2
Q

describe the make up of a nerve

A

epineurium- surrounds the outside of the nerve. fasicles- a bundle of axons bound together by perineurium within a nerve. endoneurium is found between individual neurons within the nerve

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3
Q

where are the cell bodies of the somatic afferent nerves?

A

PNS- pseudounipolar

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4
Q

where are the cell bodies of the visceral afferent nerves?

A

PNS- pseudounipolar

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5
Q

where are the cell bodies of the somatic efferent nerves

A

CNS- multipolar

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6
Q

where are the cell bodies of the visceral efferent nerves?

A

CNS and PNS. it is a two neuron chain. multipolar

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7
Q

where are the cell bodies of sympathetic nerves located?

A

T1-L2/3

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8
Q

where are cell bodies of the parasympathetic nerves?

A

brainstem and s2-s4

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9
Q

compare the post ganglionic fibers of sympathetic and parasympathetic nerves

A

parasympathetic nerves synapse much closer to the target organ and thus have much smaller sympathetic neurons

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10
Q

what structures does the visceral efferent system innervate?

A

smooth muscles of organs, smooth muscle of blood vessels, cardiac muscles, glands, arrector pili muscles

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11
Q

list effects of the sympathetic nervous system

A

increase heart rate, dilated pupils, increased sweating, dilating bronchial tree, diverting blood to skeletal muscles

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12
Q

what is the thorcolumbar division

A

another name for the sympathetic nervous system d/t the fact that it starts from t1-l2/3

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13
Q

what 2 places do you find post ganglionic cell bodies of sympathetic nerves

A

sympathetic chain ganglia and prevertebral ganglia (associated with plexuses in the abdomen and pelvis

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14
Q

how far does the sympathetic chain extend?

A

base of the brain to the coccyx

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15
Q

what is the name of the structures that connects the sympathetic chain to the spinal nerves?

A

rami communicantes

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16
Q

difference between white and gray rami communicantes

A

white- neurons entering the sympathetic chain/ grey- neurons exiting the sympathetic chain

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17
Q

how often are ganglia found in the sympathetic chain? what are the exceptions?

A

one associated with each vertebrae. the exception is in the cervical vertebrae. these have merged to form the superior, middle and inferior cervical ganglia.

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18
Q

which is closer to the spinal cord: the white or gray communicantes?

A

gray

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19
Q

describe how sympathetic nerves enter the head

A

travel up to the superior sympathetic ganglia, synapse, leave on the internal and external carotid nerves running alongside major vessels

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20
Q

where do the sympathetic nerves that innervate the heart originate? where do they leave the sympathetic chain?

A

they originate in the t1-t4, and while some leave from the t1-t4 cardiac nerves, some also travel up to cervical vertebrae and leave from there.

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21
Q

describe the splanchnic nerves

A

they collectively innervate the abdominopelvic cavity. they arise from anywhere from t5-L2 and do not synapse in the sympathetic chain but rather in the prevertebral ganglia

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22
Q

describe parasympathetic effects on the body

A

decreasing the heart rate, constricting the pupils, constricting the bronchial tree, increasing peristalsis, increasing secretion of digestion enzymes

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23
Q

what is the craniosacral division?

A

parasympathetic nervous system

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24
Q

where are the preganglionic cell bodies found in the parasympathetic nervous system?

A

brainstem and sarcral spinal cord

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25
Q

are cranial/pelvic splanchnic pre or post ganglionic?

A

pre

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26
Q

which cranial nerves are parasympathetic?

A

3 7 9 10

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27
Q

what are the borders of the mediastinum?

A

superior thoracic aperture; sternum, diaphragm, thoracic vertebrae, lungs

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28
Q

describe how the pericardium is used to segment the mediastinum

A

the top of the pericardium divides the mediastinum into superior and inferior sections along the transverse thoracic plane. posterior to the pericardium is the posterior mediastinum, inside the pericardium is the middle mediastinum, and anterior to the pericardium is the anterior mediastinum

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29
Q

where is the thymus? what does it do?

A

anterior to the pericardium. it is especially active during childhood developing the immune system (t-cells) and is replaced by fat in adults

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30
Q

describe the pericardium

A

the fibrous pericardium surrounds the outside of the parietal pericardium. it is rigid and continuous with the tunica adventitia of the great vessels. the parietal and visceral serous membranes create a potential space called the pericardial cavity

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31
Q

describe the 3 layers of the heart

A

epicardium- visceral membrane; myocardium- heart muscle; endocardium- internal lining of the heart

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32
Q

what are the great vessels?

A

IVC, SVC, aorta (ascending and descending), pulmonary trunk

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33
Q

describe the vasculature converging on the SVC starting with the subclavian vein

A

the left and right subclavian veins merge with the internal jugular veins to form the brachiocephalic veins. The brachiocephalic veins merge to form the SVC

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34
Q

where does the IVC enter the diaphragm?

A

t8

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35
Q

what defines the ascending aorta, descending aorta, and aortic arch?

A

transverse thoracic plane (top of the pericardium)

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36
Q

describe the vasculature that extends off the aortic arch

A

the first branch is the brachiocephalic trunk, which then splits to the left (subclavian artery) and right (right common carotid). the next branch from the aorta is the left common carotid, followed by the left subclavian artery

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37
Q

what branches off the descending aorta?

A

bronchial arteries, esophogeal arteries, and posterior intercostal arteries

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38
Q

at what level does the aorta pass through the diaphragm?

A

t12

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39
Q

distinguish between the ligamentum arteriosum and the ductus arteriosus

A

ductus arterious is a shunt in the developing heart that moves blood from pulmonary trunk to the descending aorta

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40
Q

at what level does the trachea bifurcate?

A

t4/t5

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41
Q

where are the tracheobronchial and paratracheal nodes?

A

tracheobroncial- at bifurcation. paratracheal- along the lateral aspect of the trachea

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42
Q

where is the esophagus located and where does it exit the diaphragm?

A

posterior to trachea and t10

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43
Q

describe the azygous venous system

A

receives drainage from the thoracic wall and from viscera. travels along the right anterolateral surface of the vertebral column. hemizygous and accessory hemizygous run parallel on the left anterolateral surface. can form an anastomosis w/ superior vena cava

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44
Q

cisterna chyli

A

a dilatoin in the upper abdomen that becomes the thoracic duct

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45
Q

thoracic duct

A

travels left of the azygous and right of the thoracic aorta through the thorax and merges with the venous system at the junction between the left internal jugular and left subclavian vein

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46
Q

what do cardiac nerves innervate?

A

the heart AND the thorax (post ganglionic)

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47
Q

where do visceral nerves go in the mediastinum?

A

the cardiac, pulmonary, and esophageal plexii

48
Q

describe the thoracic splanchnic nerves

A

greater t5-9, lesser t10-11, and lease splanchnic nerves t12

49
Q

what is the origin of the phrenic nerves and what do they innvervate

A

c3-c5. travel anterior to pericardium. the are somatic efferent nerves on the diaphragm, and somatic afferent for central diaphragm, fibrous and parietal pericardium, mediastinal and diaphragmatic pleura

50
Q

what are the preicardiacophrenic vessels?

A

travel with the phrenic nerve and provide blood to ther pericadium and diaphragm

51
Q

describe the path of the vagus nerve

A

left- travels down along the aorta and posterior to the root of the lung. right- down side of trachea (still posterior to lung). left vagus enters esophogeal plexus anteriorly, right enters posteriorly

52
Q

what are the efferent effects of the vagus nerve?

A

decrease heart rate, constrict bronchial tree, stimulate GI

53
Q

what are the afferent effects of the vagus nerves?

A

sense stretch in lungs, pain from heart, and participate in visceral reflexes

54
Q

anterior and posterior vagal trunks

A

after traveling through the esophogeal plexus, the nerves reassemble and travel with the esophogus

55
Q

left recurrent laryngeal nerve

A

branches off vagal nerve around aortic arch and ascends back through aortopulmonary window posterior to ligamentum arteriosus to innvervate larynx muscles

56
Q

list the openings to the right atrium

A

IVC, SVC, coronary sinus, tricuspid valve

57
Q

list the features inside the right atrium

A

pectinate muscles- along the anterior wall; crista terminalis- separation between smooth wall and pectinate muscles; fossa ovalis- remnant of foramen ovalis in fetal heart

58
Q

what valve separates the RA and RV

A

tricuspid

59
Q

list the features of the right ventricle

A

trabecular carnae- “web” along the wall; papillary muscles- hold the valve; chordae tendineae- connect papillary muscle to valve; conus arteriosus- smooth wall leading to pulmonary valve; moderator (septomarginal trabecula)- band w/ purkinje fibers attaching ventricular septum to ventricular wall

60
Q

which valves are semilunar?/

A

pulmonary and aortic

61
Q

list the features of the left atrium

A

pectinate muscles- only found in the left auricle; valve of the foramen ovale- indentation on atrial septum remnant of foramen ovale in fetus

62
Q

which valve separates the left atrium and left ventricle

A

mitral (bicuspid)

63
Q

list features of the left ventricle

A

trabeculae carneae- “web” along walls; papillary muscles- holds the valves; chordae tendineae- tendons attaching papillary muscles to valves

64
Q

where are the base and apex of the heart?

A

apex- anteroinferior point of LV. base- superior posterior of atria

65
Q

where is the apex located relative to the ribs?

A

5th intercostal space

66
Q

what makes up the anterior surface of the heart and what is it adjacent to?

A

right ventricle. sternum and costal cartilage

67
Q

what makes up the posterior surface of the heart and what is it adjacent to?

A

left atrium (and part of the right atrium)

68
Q

what makes up the right lateral surface of the heart

A

right atrium. adjacent to right lung

69
Q

what makes up the left lateral surface of the heart

A

left ventricle and left auricle adjacent to left lung

70
Q

what makes up inferior surface of the heart

A

adjacent to diaphragm, left and right ventricles

71
Q

what are the two main branches of the coronary arterial circulation?

A

left and right coronary arteries

72
Q

what are the major branches of the right coronary artery?

A

sinoatrial branch (SA node). marginal artery (runs down right border). posterior interventricular artery (runs down interventricular groove of the back of the heart)

73
Q

what are the major branches of the left coronary artery

A

circumflex (loops around posteriorly); left anterior descending (down interventricular groove)

74
Q

what is the coronary sinus?

A

where almost all coronary blood drains to. found in the posterior heart and drains into right atrium.

75
Q

great cardiac vein

A

originate near apex and runs up anterior interventricular sulcus, posteriorly through the coronary sulcus and into the coronary sinus

76
Q

middle cardiac vein

A

runs up w/ posterior interventricular artery in posterior interventricular sulcus

77
Q

small cardiac vein

A

travels with the marginal artery

78
Q

what is different about small anterior cardiac veins?

A

the drain directly into the atrium w/o going through the coronary sinus

79
Q

what is the point of maximum impulse

A

point on the chest wall closest to the heart during systole. usually apex and found at 5th intercostal at midclavicular line

80
Q

describe cardiac conduction

A

SA node- atrial myocardium- AV node- AV bundle of his (thru membranous interventricular septum)- atrioventricular branch bundles- purkinje fibres

81
Q

what can happen if coronary conduction is impeded

A

desynchronization of atrial and ventricular contraciton

82
Q

cardiac plexus

A

found on the aortic arch and anterior tracheal bifrication recieves afferent signals from heart and sends efferent signals

83
Q

cardiac nerves

A

sympathetic innervation of heart. originates from t1-5. some travel up to cervical level in sympathetic chain. ally synapse in ganglia and leave directly (not via GRC).

84
Q

what do cardiac nerves do on the heart

A

increase heart rate and contractility

85
Q

describe visceral afferent cardiac signals and how they travel

A

pain travel afferently along with cardiac nerves. usually d/t ischemia. reflexes also travel afferently from heart w/ information changing blood pressure. these travel via vagus

86
Q

describe referred pain

A

pain from visceral heart mixes with afferent fibers from t1-4 dermatomes and gets misinterpreted as pain in arm/chest

87
Q

what germ layer does the heart form from?

A

lateral plate mesoderm

88
Q

what are the first cells that differentiate into precursor heart cells called? what do they separate to form?

A

angiogenic clusters form two tubes- endocardial tubes and dorsal aortae

89
Q

where are the endocardial tubes relative to the dorsal aortae

A

endocardial are lateral. dorsal aortae are medial

90
Q

how does lateral folding affect the developing heart?

A

it folds the endocardial tubes together so they fuse into one

91
Q

do the endocardial tubes fuse completely?

A

no- remain separate at the caudal end (primitive sinus venosus)

92
Q

at what day do the endocardial tubes fuse?

A

20

93
Q

how does longitudinal folding affect developing heart?

A

forces the endocardial tubes into the thoracic region. move the heart so that it is cranial to the septum transversum

94
Q

where is the pericardial cavity relative to the developing heart?

A

ventral

95
Q

describe the heart tube at approximately 20 days of development from caudal to cranial

A

sinus venosus (left and right)- primaitive atrium- atrialventricular sulcus- primitive ventricle- interventricular sulcus- bulbus cordis- outflow through dorsal aortae

96
Q

transverse pericardial sinus

A

passage between inflow and outflow of heart

97
Q

describe the anatomy of the heart by day 25

A

growth, combined with the rigid cranial and caudal ends, has folded the heart so that the sinus venosus is on the right side, along with the prima\itive atrium and ventricle. the bulbus cordis is now anterior and right. new structures have developed cranial to the bulbus cordis- the conus cordis and truncus arteriosus

98
Q

what 4 things must happen for the separation of the heart into right and left tracts

A

1.. shifting of the AV valve 2. partitioning of atrium 3. partitioning of ventricle and bulbis cordis 4. division of the outflow tracts

99
Q

describe the shifting of the AV valve

A

there is a valve between the primitive atrium and primitive ventricle. it needs to shift right, so that is half in the primitive ventricle and half in the bulbus cordis. when the endocardial cushions form the interventricular septum, the AV valve will split into the primitive tricuspid and mitral valves

100
Q

describe the partitioning of the atria

A

septum primum (more left) grows down to meet endocardial cushions from ventricles. it does not close entirely at first and this is the ostium primum. As the ostium primum is closing, the septum secundum forms and grows inferiorly. it naturally leaves a hole called the foramen ovalis. the ostium secundum forms via cell death in the septum primum.

101
Q

describe the partitioning of the ventricle

A

the muscular portion is made of muscular tissue from the wall growing superiorly to the endcardial cushions. the membranous part of the septum is formed via the downgrowth of the endocardial cushions and aorticopulmonary septum.

102
Q

describe the division of the outflow tracts

A

the left and right trunconal ridges grow from the conus cordis and the truncus arteriosus to fuse with the endcoardial cushions and muscular interventricular septum. develops in a twist

103
Q

the pulmonary trunk is what and what of the aorta?

A

right and anterior

104
Q

is the ascending aorta in front of or behind the right pulmonary artery? what about the descending aorta and the left pulmonary artery?

A

posterior; anterior

105
Q

what is the difference between the cardinal, vitelline, and umbilical veins?

A

cardinal- drain blood from body; vitelline- drains yolk sac and gut tube; umbilical- oxygenated blood from mom

106
Q

what forms the SVC and IVC

A

right sinus venosus

107
Q

what are the 3 shunts in the fetus?

A

ductus arteriosus- pulmonary trunk to descending aorta; ductus venosus- umbilical vein to IVC, bypassing liver; foramen ovale- right atrium to left atrium

108
Q

2 big changes to the pressure and circulation after birth

A

left side becomes high pressure and pulmonary and systemic circulation are separated

109
Q

what happens to the 3 fetal shunts after birth?

A

foramen ovale is closed by the high pressure left heart, followed by fusion of the tissue to form the fossa ovalis. the ductus arteriosus closes to form the ligamentum arteriosum. the ductus venosus closes to form the ligamentum venosum

110
Q

what happens to the umbilical vessels?

A

form the medial umbilical ligaments (arteries) and ligamentum teres hepatis (umbilical veins)

111
Q

dextrocardia

A

the heart folds to the right instead, causing organs to develop on the opposite side of normal

112
Q

atrial septal defect

A

abnormality of septum between l and r atria - patent foramen ovale

113
Q

vententricular septal defect

A

most common in the membranous portion of the septum

114
Q

transposition of great vessels

A

aorta rises from right ventricle and pulmonary trunk from left ventricle

115
Q

patent ductus arteriosus

A

ligamentum arteriosum does not form

116
Q

coartation of the aorta

A

severe constriction of the aorta near ductus arteriosus- usually post ductus arteriosus

117
Q

tetralogy of fallot

A
  1. VSD 2. pulmonic stenosis 3. over-riding aorta- aortic valve is not restricted by left ventricle 4. right ventricle hypertrophy

Anatomy (5 decks)

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