Session 2: Blood and Lymph Flashcards
what is the anatomical surface landmark at the level of the start and end of the aortic arch?
The sternal angle (angle of louis)
Important because it marks a number of other anatomical features such as the bifurcation of the trachea, ligamentum arteriosum, loop of left recurrent laryngeal nerve
What does the line from the angle of louis run though in the thorax and vertebral column?
Joins the manubriosternal joint (second pair of costal cartilages) anteriorly to T4/5 intervertebral disc posteriorly
What is the compartment above and below the sternal angle
Above the sternal angle is the superior mediastinum. Below is the inferior mediastinum
What are the branches of the aorta?
Brachiocephalic artery - right
left common carotid
left subclavian artery
What are the branches of the brachiocephalic artery?
Right common carotid and right subclavian
What important cranial nerve branch is found at the arch of the aorta?
left recurrent laryngeal leaves the vagus nerve at the level of the arch of the aorta and recurs upwards to supply muscles controlling the left vocal cord.
Apart from thoracic pain, what other complaint might a patient with an undiagnosed aneurysm of the arch of the aorta present with?
Hoarseness of voice - damage to left recurrent laryngeal nerve. Unilateral palsy of the recurrent laryngeal nerve will result in ipsilateral paralysis of the vocal cord.
Which cranial nerve branch courses around the right subclavian artery? What would the consequences of unilateral damage to this nerve?
The right recurrent laryngeal nerve. It recurs upwards to supply muscles controlling right vocal cord. Unilateral palsy of the recurrent laryngeal nerve will result in ipsilateral paralysis of the vocal cord and thus hoarseness of the voice.
Which arteries supply the viscerocranium and neurocranium?
Common carotid arteries
Which specific branch of the common carotid supplies the neurocranium?
internal carotid
Which specific branch of the common carotid supplies the viscerocranium?
External carotid
What physiological response might arise if you were to put pressure on the carotid pulse in the area of the carotid sinus? How could this be utilised clinically?
Carotid sinus is found at the origin of the internal carotid artery.
It contains baroreceptors that act as feedback monitors to help maintain circulation to cerebral structures
It is innervated by the glossopharyngeal nerve
Carotid massage will lead to activation of the vagus nerve resulting in slowing of the heart rate. Supraventricular tachycardia can be neutralised by carotid massage.
What must you listen for prior to doing a carotid sinus massage?
A carotid bruit which suggests atherosclerotic plaque. If this is present DO NOT perform a CSM may lead to it rupturing and stroke.
Why might you wish to listen to the arterial pulses of the neck?
to find out if there is carotid artery stenosis. Plaques in the carotid artery can lead to narrowing therefore causing turbulent sounds (carotid bruit)
