SM 106a - Heart and Mediastinum Anatomy (Incl. Lab Objectives) Flashcards

1
Q

Which part of the heart is cut open in this picture?

How do you know?

A

Left ventricle and Left Atrium

Ventricle has thick muscular walls, no opening for coronary sinus to drain into

Left atrium sits on top of left ventricle

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2
Q

What structure is labeled by #8?

A

Costal Pleura

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3
Q

What structure is labeled by #1?

A

Ascending Aorta

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4
Q

Which structure is labeled by #16

A

Right ventricle

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5
Q

Which structure is labeled by #13?

A

Pectinate muscles (in the left auricle)

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6
Q

Which structure is labeled by #10?

A

Left atrium

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7
Q

Which structure is labeled by #7?

A

Opening of inferior vena cava and valve

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8
Q

Which of the three major coronary arteries supplies blood to the left ventricle?

A

Front and bottom of LV: Anterior interventricular artery (aka Left anterior descending artery)

Back and side of LV: Circumflex artery

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9
Q

Where is the Aortic Semi-Lunar Valve?

Where do you place your stethoscope to listen?

A

Valve: Between the left ventricle and the aorta

Stethoscope: In the second intercostal space to the right of the patient’s sternum

(Circled A)

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10
Q

Which structure is labeled by #14?

A

Right coronary artery

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11
Q

What is cardiac tamponade?

A

Cardiac tamponade = fluid in the pericardial cavity that compresses the heart

Parietal pericardium has low compliance; increased volume in the sac puts pressure on the heart, rather than expanding the pericardial sac.

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12
Q

Describe the pathway of sympathetic innervation of the heart

A
  • Presynaptic neuron
    • Spinal cord
    • Lower cervical or uppor thoracic sympathetic trunk
  • Synapse in sympathetic trunk
    • Cell body is here in the stellate ganglion
  • Postsynaptic neuron
    • Sympathetic trunk
    • Cardiopulmonary splanchnic nerves
    • Plexus at the bifurcation of the trachea
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13
Q

What structure is labeled by #12?

A

Right Ventricle

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14
Q

What structure is labeled by #9?

A

Left Internal Jugular Vein

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15
Q

Which structure is lableled by #7?

A

Right coronary artery

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16
Q

Which coronary artery suplies the left atrium?

A

Circumflex artery

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17
Q

Why does angina sometimes radiate down a person’s arm?

A

The left ventricle is supplied by nerves from T1

Nerves from T1 also supply the brachial plexus

Therefore, anginal pain can be referred to nerves in the arm

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18
Q

Which structure is labeled by #5?

A

Interventricular septum

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19
Q

Which structure is labeled by #1?

A

Ligamentum Arteriosum

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20
Q

What structure is labeled by #16?

A

Right Brachiocephalic Vein

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21
Q

Which part of the lung does the heart interface on the…

Left side?

Right side?

A

Right side = middle lobe of the right lung

Left side = lingula of the upper lobe of the left lung

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22
Q

What structure is labeled by G?

A

Left subclavian artery

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23
Q

Which structure is labeled by #3?

A

Opening of the left coronary artery

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24
Q

List the differences between the left and right ventricles

A
  • Smooth top of chamber
    • Left is called the aortic vestibule
    • Right is called the conus arteriosus
  • Left is round with thicker walls
  • Right is bellow-shaped with thinner walls
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25
Q

Which structure is labeled by #7?

A

Cusp of bicuspid aka mitral aka left atrioventricular valve

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26
Q

Visceral sensory fibers from which spinal segment supply the ventricles?

A

T1

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27
Q

Which structure is labeled by #11?

A

Anterior cusp of the tricuspid valve (right atrioventricular valve)

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28
Q

Which structure is labeled by #9?

A

Apex of the heart

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29
Q

Which structure is labeled by #2?

A

Crista Terminalis

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30
Q

What structure is labeled by #5?

A

Cervical Pleura

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31
Q

What structure is labeled by #1?

A

Left Phrenic Nerve

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32
Q

Describe the general flow of blood into and out of the azygous vein

A

From left side

  • Left posterior intercostal veins
  • Hemiazygous vein
  • Azygous vein
  • Superior vena cava
    • Must arch over root of the right lung to get here

From right side

  • Intercostals drain directly into azygous vein
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33
Q

Which structure is labeled by #6?

A

Right cusp of the aortic semi-lunar valve

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34
Q

Which structure is labeled by #1?

A

Nodule of the posterior cusp of the aortic semi-lunar valve

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35
Q

What structure is labeled by #4?

A

Left Subclavian Artery

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36
Q

Which structure is labeled by #4?

A

Left ventricle

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37
Q

Which structure is labeled by #14?

A

Conus arteriosus

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38
Q

Which structure is labeled by #12?

A

Right atrium

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39
Q

Which structure is labeled by #3?

A

Remnants of foramen ovale

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40
Q

Which structure is labeled by #3?

A

Marginal branch of the right coronary artery

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41
Q

What structure is labeled by #15?

A

Right Vagus Nerve

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42
Q

Which structure is labeled by #10?

A

Chordae tendineae

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43
Q

What is the function of the papillary muscles?

A

Located in the ventricles

Stabilize the AV (tricuspid and bicuspid) valves via chordae tendineae to prevent flaps from swinging into the atrium when the ventricle contracts

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44
Q

Which structure is labeled by #13

A

Right pulmonary veins

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45
Q

What is the name of the valve shown in this picture?

What is the name of this valve on the other side of the heart?

A

Shown (left side): Bicuspid aka Mitral aka Left Atrioventricular Valve

Other (right) side: Tricuspid aka Right Atrioventricular valve

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46
Q

Which structure is labeled by #8?

A

Remnants of the fossa ovalis

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47
Q

Describe the structure and function of the atrioventricular valves

A
  • Structure:
    • Flat cusps that are stabilized by papillary muscles and chordae tendineae
    • Right: Tricuspid = 3 flaps
    • Left: Bicuspid (mitral) = 2 flaps
  • Function:
    • ​Prevent backflow into the atrium during ventricular contraction
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48
Q

Which blood vessel is cut open in this picture?

How do you know?

A

The aorta

The pulmonary trunk woudl look similar, but the aorta has openings for the left and right coronary arteries

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49
Q

Describe the pathway of visceral sensory innervation of the heart

A
  • Heart
  • Cardiopulmonary splanchnic nerves
  • Sympathetic trunk
  • Joins spinal nerve
  • Enters spinal curve via dorsal root
    • Cell body is in the dorsal root ganglion
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50
Q

What structure is labeled by #10?

A

Esophagus

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51
Q

What structure is labeled by #13?

A

Right Phrenic Nerve

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52
Q

List the differences between the right and left atria

A
  • Right has the crista terminalis
    • Contains pace maker tissue
  • Right recieves blood from systemic circulation (vena cavae)
  • Left receives blood from the pulmonary circulation
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53
Q

Which structure is labeled by #5?

A

Anterior papillary muscle

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54
Q

What structure is labeled by B?

A

Thymus

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55
Q

Which structure is labeled by #1?

A

Right atrial “nodal” branch of the right coronary artery

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56
Q

What structure is labeled by #11?

A

Left Ventricle

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57
Q

What structure is labeled by #3?

A

Right Phrenic Nerve

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58
Q

Which structure is labeled by #9?

A

Left ventricle

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59
Q

Which structure is labeled by #11?

A

Trabeculae carneae

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60
Q

What structure is labeled by #3?

A

Diaphragm

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61
Q

What structure is labeled by #7?

A

Left Subclavian vein

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62
Q

Which section of the mediastinum contians the heart?

A

Middle mediastinum

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63
Q

Which structure is labeled by #5

A

Left atirum

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64
Q

What is the coronary sinus?

A

An endothelial-lined venous channel imbedded in the cardiac muscle in the posterior AV groove

(Not a vein)

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65
Q

What structure is labeled by D?

A

Trachea

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66
Q

What is epicardium?

A

Viscerial pericardium

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67
Q

Which structure is lableled by #4?

A

Great cardiac vein

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68
Q

Which structure is labeled by #2?

A

Pulmonary semi-lunar valve

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69
Q

Which structure is labeled by #4

A

Pulmonary arteries

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70
Q

What structure is labeled by C?

A

Superior vena cava

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71
Q

Which structure is labeled by #3?

A

Aortic arch

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72
Q

Which structure is labeled by #6?

A

Opening of coronary sinus and valve

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73
Q

What structure is labeled by #13?

A

Right Atrium

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74
Q

Trace the flow of blood through the heart

A
  1. Enters via superior and inferior vena cavae
  2. Right atrium
  3. Through tricuspid valve
  4. Right ventricle
  5. Through pulmonary semi-lunar valve
  6. Pulmonary trunk
  7. Pulmonary arteries
  8. Lungs (Lobes -> Bronchopulmonary segments)
  9. Pulmonary veins
  10. Left atrium
  11. Bicuspid (mitral) valve
  12. Left ventricle
  13. Aortic semi-lunar valve
  14. Aorta
  15. Systemic circulation
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75
Q

What is the effect of sympathetic innervation on the hearth/

A

Increase heart rate by stimulating the SA node

Act on myocardial cells to increase force of contraction

  • Increase myocyte metabolism
  • Dilate coronary arteries
  • Increase blood flow to muscles

Sympathetic innervation = helps us run away from scary things

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76
Q

What is the effect of parasympathetic innervation on the heart?

A

Decrease heart rate by inhibiting the SA node

Parasympathetic = rest and digest

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77
Q

Trace the pathway of the conductive system that regualtes the heart beat

A
  1. SA node = pacemaker
  2. Three nodal pathways
  3. AV node = backup pacemaker
  4. AV bundle (bundle of hiss)
  5. Right and left branch bundle (septal branch)
  6. Right and left purkinje fibers
  7. Right and left ventricular muscle
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78
Q

What structure is labeled by #11?

A

Trachea

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79
Q

Where does blood from the coronary sinus drain into?

A

Right atrium

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80
Q

Which structure is labeled by #2

A

Left inferior pulmonary vein

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81
Q

What structure is labeled by #12?

A

Right Internal Jugular Vein

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82
Q

What structure is labeled by #7?

A

Aortic Arch

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83
Q

What structure is labeled by #4?

A

Serous Visceral Pericardium (Epicardium)

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84
Q

What structure is labeled by #7?

A

Descending Aorta

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85
Q

Which structure is labeled by #7 (the space)?

A

Aortic sinus (there are 3 sinuses shown in this picture)

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86
Q

What structure is labeled by #17?

A

Superior Vena Cava

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87
Q

What structure is labeled by B?

A

Manubrium of the sternum

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88
Q

Which structure is lableled by #6?

A

Right marginal artery and vein

89
Q

Where is the Tricuspid valve?

Where do you place your stethoscope to listen?

A

Valve: Between the right atrium and the right ventricle

Stethoscope: Left 5th intercostal space

(Circled T)

90
Q

What are the arrows pointing to?

A

Right (lower arrow) and left (upper arrow) phrenic nerves

91
Q

What structure is labeled by I?

A

Esophagus

92
Q

Which structure is labeled by #10?

A

Brachocephalic trunk

93
Q

Which structure is labeled by #5?

A

Circumflex branch of the left coronary artery

94
Q

What is the name of the colored structure as a whole?

A

Pericardial Sac

95
Q

Which structure is labeled by #9?

A

Anterior papillary muscle

96
Q

Which ventricle is the right?

Which is the left?

How do you know?

A

A = Left; thicker walls, round

B = Right; thinner walls, crescent shaped

97
Q

Which structure is the red arrow pointing to?

A

Pulmonary Trunk

98
Q

What structure is labeled by #8?

A

Left Phrenic Nerve

99
Q

What structure is labeled by E?

A

Esophagus

100
Q

Which structure is labeled by #1?

A

Left superior pulmonary vein

101
Q

List the structures of the heart supplied by the right coronary artery

A

Posterior of the heart

  • Right atrium and ventricle
  • Posterior part of the left ventricle (adj. to IV septum)
  • Posterior 1/3 of IV septum
  • SA and AV nodes (usually)
102
Q

Which structure is labeled by #7?

A

Membranous interventricular septum

103
Q

Which structure is lableled by #2?

A

Left coronary artery

104
Q

Which side of the heart is shown in this picture?

How do you know?

A

Left

The ventricle has a thick muscle layer

105
Q

Which structure is labeled by #13?

A

Supraventricular crest

106
Q

Which structure is labeled by #8?

A

Posterior papillary muscles

107
Q

Which coronary artery typically supplies the SA and AV nodes?

A

Right coronary artery

108
Q

What structure is labeled by D?

A

Left brachiocephalic vein

109
Q

Which structure is labeled by #6?

A

Anterior interventricular branch of the left coronary artery

110
Q

Which structure is labeled by #8?

A

Posterior papillary muscle

111
Q

Which structure is labeled by #4?

A

Posterior papillary muscle

112
Q

Which structure is labeled by #7?

A

Circumflex artery

113
Q

What does the left coronary artery divide into?

A

Circumflex artery & Left anterior descending artery

114
Q

Which structure is labeled by #11

A

Superior vena cava

115
Q

Which structure is labeled by #2?

A

Posterior cusp of the mitral valve

116
Q

Which structure is labeled by #7?

A

Septomarginal trabecula (aka moderator band)

117
Q

Which structure is labeled by #3

A

Coronary sinus

118
Q

What structure is labeled by A?

A

Body of the sternum

119
Q

Which structure is lableled by #5?

A

Anterior interventricular artery

(Left anterior descending artery)

120
Q

Which chamber is labeled by #1?

A

Left atrium

121
Q

What structure is labeled by #3?

A

Left Recurrent Laryngeal Nerve

122
Q

What structure is labeled by #5?

A

Diaphragm

123
Q

What structure is labeled by #6?

A

Intercostal Muscles

124
Q

What structure is labeled by #2?

A

Superior Vena Cava

125
Q

Which structure is lableled by #1?

A

Left auricle

126
Q

What structure is labeled by #9?

A

Greater Splanchnic Nerve

127
Q

What structure is labeled by #1?

A

Serous Parietal Pericardium

128
Q

What structure is labeled by #13?

A

Right Vagus Nerve

129
Q

Which structure is labeled by #6?

A

Muscular interventricular septum

130
Q

Wich structure is supplied by #8?

A

Sinoatrial node

131
Q

Which structure is labeled by #1?

A

Right auricle

132
Q

What structure is labeled by #14?

A

Right Subclavian Vein

133
Q

What structure is labeled by #3?

A

Left Common Carotid Artery

134
Q

List the layers of the pericardium from outermost to innermost

A

From outermost to innermost:

  1. Fibrous parietal pericardium
  2. Serous parietal pericardium
  3. Visceral pericardium (aka epicardium)
135
Q

Which structure is labeled by #4?

A

Right ventricle

136
Q

What is the function of the coronary sinus?

A

Drains blood from most of the heart to the right atrium

137
Q

What structure is labeled by #6?

A

Superior Vena Cava

138
Q

What structure is labeled by #11?

A

Splanchnic Nerves

139
Q

Which structure is labeled by #10?

A

Chordae tendineae

140
Q

Which structure is labeled by #4

A

Left pulmonary artery

141
Q

Which structure is labeled by #3?

A

Pectinate muscles

142
Q

What structure is labeled by #4?

A

Pericardial Sac

143
Q

What structure is labeled by #6?

A

Ligamentum Arteriosum

144
Q

In a posterior-anterior x-ray, pneumonia in which lung lobe would obscure the right margin of the heart?

Which structure of the heart would be ill-defined?

A

Middle right lobe

This would make it difficult to define the right atrium

145
Q

Which structure is labeled by #6?

A

Trabeculae carneae

(muscle columns)

146
Q

Which structure is labeled by #8?

A

Interatrial septum

147
Q

Which structure is labeled by #6

A

Left pumonary veins

148
Q

Where is the Bicuspid Valve??

Where do you place your stethoscope to listen?

A

Valve: Between the left atrium and the left ventricle

Stethoscope: Left 5th intercostal space near the mid clavicular line

(Circled M)

149
Q

What structure is labeled by #4?

A

Left Vagus Nerve

150
Q

Which structure is labeled by #1?

A

Right pulmonary artery

151
Q

Which structure is labeled by #4?

A

Left cusp of the aortic semi-lunar valve

152
Q

Which structure is lableled by #3?

A

Circumflex artery

153
Q

Which structure is labeled by #3?

A

Chordae tendineae

154
Q

What structure is labeled by #2?

A

Ligamentum Arteriosum

155
Q

List the structures of the heart supplied by the left coronary artery

A

Anterior of the heart

  • Left atrium and ventricle
  • Anterior part of the right ventricle (adj. to IV septum)
  • AV bundle branches in the IV septum
156
Q

What structure is labeled by #10?

A

Left Atrium

157
Q

What structure is labeled by #9?

A

Pulmonary Trunk

158
Q

Which structure is labeled by #15?

A

Left pulmonary artery

159
Q

What structure is labeled by #14?

A

Superior Vena Cava

160
Q

What structure is labeled by A?

A

Thymus

161
Q

Describe the composition of each layer of pericaridum

A

Parietal pericardium

  • Fibrous parietal pericardium = outermost layer
    • Dense connective tissue
    • Protects the serous parietal pericardium
  • Serous parietal pericardium
    • Fused to the fibrous parietal pericardium
    • Interfaces with the visceral pericardium
    • Simple cuboidal epithelium

Visceral pericardium aka epicardium

  • Attached to the heart
  • Simple cuboidal epithelium
162
Q

What structure is labeled by C?

A

Right brachiocephalic vein

163
Q

Which structure is labeled by #5

A

Inferior vena cava

164
Q

Which structure is labeled by #2?

A

Left auricle

165
Q

Which structure is labeled by #7?

A

Posterior interventricular branch of the right* coronary artery

*Usually the right coronary artery suppolies the posterior interventricular artery = right dominance

If the left coronary artery supplies, it is called left dominance

166
Q

What structure is labeled by #6?

A

Left Brachiocephalic Vein

167
Q

Which part of the heart is cut open in this image?

A

Right ventricle

168
Q

Describe the pathway of parasympathetic innervation to the heart

A
  • Pre synaptic neuron
    • Vagus nerve
  • Synapse
    • Plexus on the bifurcation of the trachea
  • Post synaptic neuron
    • Begins after synapse (very short neuron)
169
Q

An atherosclerotic occlusion in which artery will affect the function of the AV bundle branches?

A

The anterior interventricular branch of the left coronary artery

170
Q

What structure is labeled by #12?

A

Sympathetic Trunk aka Sympathetic Chain

(specifically a ganglion)

171
Q

Which structure is labeled by #2?

A

Left subclavian artery

172
Q

Which cardiac chamber has the greatest muscle mass?

A

Left ventricle

173
Q

Which structure is labeled by #3?

A

Sepatal papillary muscle

174
Q

What structure is labeled by #5?

A

Fibrous Pericardium

175
Q

What structure is labeled by #10?

A

Esophagus

176
Q

What is the AV node?

What does it do?

A

A secondary conduction site for electrical signals through the heart

Normally, signal goes from SA node -> AV node -> rest of heat

If the SA node isn’t working, the AV node and purkinje fibers together can generate a beat, but it is slower.

177
Q

Which structure is labeled by #2?

A

Lunule of the posterior cusp of the aortic semi-lunar valve

178
Q

Which structure is labeled by #5?

A

Right atrioventricular valve + orifice

179
Q

What is the azygous vein?

Where is it located?

A

A vein located on the right side of the body that delivers blood to the superior vena cava

180
Q

Where in the body is the crista terminalis found?

A

Right atrium of the heart

181
Q

What is the SA node?

A

The pacemaker that initiates heartbeat without any other stimulation

(Sympathetic and parasympathetic influence can alter the heart beat)

182
Q

What is #14 called in the left ventricle?

A

The aortic vestibule

183
Q

What structure is labeled by H?

A

Trachea

184
Q

A tumor near the root of the left lung would compress which major vessel in the mediastinum?

A

The arch of the aorta

185
Q

Describe the structure and function of the semi-lunar valves

A
  • Structure
    • Each valve has 3 half-moon shaped cusps
    • Blood-filled sinuses between the valve cusps and arterial walls prevent sticking
    • Aortic semi-lunar valve
      • Cusps: Left, Right, Posterior (non-coronary)
      • Left and Right = origins of left and right coronary arteries respectively
    • Pulmonary semi-lunar valve
      • Cusps: Left, Right, Anterior
  • Function
    • Prevent backflow from artery to ventricle after systole
186
Q

What does the septomarginal trabecula (moderator band) do?

A

Carries part of the right bundle branch to the anterior papillary muscles. This is important for electrical conduction throught the heart

187
Q

What structure is labeled by J?

A

Thoracic Duct

188
Q

What structure is labeled by F?

A

Left common carotic artery

189
Q

Which structure is labeled by #9?

A

Anterior cusp of the mitral valve

190
Q

What structure is labeled by #1?

A

Trachea

191
Q

Which structure is labeled by #6?

A

Inferior vena cava

192
Q

Which structure is labeled by #4?

A

Left atrium

(Interarterial septum separates left and right atrium)

193
Q

Heart muscle ischemia near which structure will impair the initiation of a normal heartbeat?

A

Superior vena cava

194
Q

Which structure is labeled by #4?

A

Left coronary artery

195
Q

What structure is labeled by #5?

A

Aortic Arch

196
Q

What is the stellate ganglion?

Where is it?

A

Sympathetic trunk

A large, star-shaped ganglion that supplies the heart and lungs

197
Q

Which organs do not have anastomosis?

Why is this significant?

A

End organs have no anastomosis

Ex: Renal arteries, central artery to retina of the eye

If the arteries reaching these organs are occluded, blood flow will stop; there is no backup

198
Q

Which structure is labeled by #9?

A

Interatrial septum

199
Q

What structures are supplied by the right coronary artery?

A

Right atrium

Right ventricle

Bottom portion of the left ventricle (near the apex)

Back of the Interventricular septum

200
Q

Which structure is the green arrow pointing to?

A

Superior Vena Cava

201
Q

What structure is labeled by #2?

A

Mediastinal Pleura

202
Q

Which structure is labeled by #12?

A

Anterior papillary muscles

203
Q

What structure is labeled by F?

A

Arch of the Aorta

204
Q

What structure is labeled by #7?

A

Neurovascular Bundle

(contains intercostal vein, intercostal artery, intercostal nerve)

205
Q

Which structure is labeled by #12?

A

Right atrium

206
Q

Which structure is labeled by #14?

A

Pulmonary trunk

207
Q

Which structure is the blue arrow pointing to?

A

Aorta

208
Q

What structure is labeled by E?

A

Brachiocephalic trunk

209
Q

Which structure is labeled by #8

A

Coronary sinus

210
Q

Failure of which valve will cause pooling in the left atrium?

A

The bicuspid (mitral) valve

211
Q

What physiological feature provides collateral circulation if one artery is occluded?

A

Anastomosis

212
Q

Which structure is labeled by #5?

A

Posterior cusp of the aortic semi-lunar valve

213
Q

Where is the Pulmonary Semi-Lunar Valve?

Where do you place your stethoscope to listen?

A

Valve: Between the right ventricle and the pulmonary trunk

Stethoscope: In the second intercostal space to the left of the patient’s sternum

(Circled P)

214
Q

What structure is labeled by #2?

A

Brachiocephalic Trunk

215
Q

What is anastamosis?

What is its significance?

A

End to end joining of the branches of 2 distinct vessels

It allows blood to reach an area even if one of the vessels is occluded

216
Q

Which structure is labeled by #1

A

Left common carotid artery

217
Q

Which structure is labeled by #2?

A

Right coronary artery

218
Q

What structure is labeled by #8?

A

Left Pulmonary Artery

219
Q

Which structure is labeled by #15?

A

Right posterior interventricular artery