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Cardiovascular > Surface anatomy of mediastinum and structure of heart > Flashcards

Surface anatomy of mediastinum and structure of heart Flashcards

1
Q

Trans thoracic plane

A

Divide mediastinum into superior and inferior - horizontal line runs through manubirosternal joint at level of T4

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2
Q

What is the mediastinum

A

The central compartment or a median septum between the two pleural cavities within the thoracic cavity
contains visceral structures - air of fluid filled united by loose connective tissue

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3
Q

what are the boundaries of the mediastinum

A

superior thoracic aperture/outlet superiorly and diaphragm inferiorly
sternum and costal cartilages anteriorly to thoracic vertebrae posteriorly

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4
Q

inferior mediastinum is subdivided into what

A

anterior
middle
posterior

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5
Q

what does the mediastinum contain

A 
oesophagus 
trachea 
great vessels 
heart 
pericardium 
nerves 
sympathetic chain 
lymphatic vessels 
thoracic duct 
lymph nodes
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6
Q

is the diploid process in the mediastinum

A

no below inferior

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7
Q

in the supine position the mediastinum - arch of the aorta lies superior to the transverse thoracic plane and bifurcation of the trachea is transected by the transverse thoracic plane. The central tendon on the diaphragm lies at the level od what

A

xiphersternal junction and vertebra T9

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8
Q

in the standing position the arch of the aorta is transected by the transverse thoracic plane and tracheal bifurcation lies inferior to thoracic plane to what level does the central tendon of the diaphragm fall to

A

level of the middle xiphoid process and T9-10 intervertebral discs

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9
Q

on chest X-ray the mediastinum can be shown to widen what 3 things could this be due to

A

haemorrhage into the mediastinum from lacerated great vessels
enlargement of the mediastinal lymph nodes due to a malignant lymphoma
hypertrophy of the heart due to congestive heart failure

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10
Q

what is the pericardium

A

a fibroserous membrane covering the heart and parts of the great vessels.

it is a closed sac made of 2 layers
fibrous and serous pericardium

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11
Q

the serous( internal) pericardium is made of two layers what are they

A

parietal layer

visceral layer

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12
Q

what are the two pericardial sinuses

A

transverse pericardial sinus

oblique pericardial sinus

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13
Q

what is the fibrous pericardium a continuation of

A

central tendon of diaphragm

prevents overfilling of the heart but can contribute to cardiac tamponade

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14
Q

what is the internal visceral layer that forms the outer layer of the heart called

A

epicardium

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15
Q

what is found between the inner and outer serous layers of the pericardial cavity

A

lubricatign serous fluid - minimises friction generated by the heart as it contracts

Fat police smell villains
fibrous , partial layer , serous fluid, visceral

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16
Q

4 major function of the pericardium

A

fixes the heart limiting motion
prevents overfilling
lubrication
protection from infection

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17
Q

what is the transverse pericardial sinus

A

formed as a result of embryological folding of the heart tube - passage through pericardial cavity
located posterior to ascending aorta and pulmaory trunk , anterior to SVC anf superior to LA

it separates the hearts atrial outflow from its venous inflow

it can be used to identify and subsequently locate the arteries of the heart during coronary artery bypass grafting

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18
Q

what nerve innervates the pericardium

A

phrenic nerve

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19
Q

where can pain be felt in pericarditis

A

shoulder

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20
Q

what is cardiac tamponade

A

inextinsible fibrous pericardium cause problem is pericardial effsusion as can’t expand therefore increasing pressure compremissign CO

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21
Q

pericarditis

A

inflammation of the pericardium , caused by infection and MI. Main symptom is chest pain, can cause acute cardiac tampiande due to accumulation of fluid in pericardial cavity

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22
Q

what is the oblique pericaral sinus

A

cul-du-sac behind heart which opens into pericardial space

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23
Q

what are the receiving chambers of the heart

A

RA and auricle

LA and auricle

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24
Q

what are the discharging chambers of the heart

A

RV and LV

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25
Q

what side of the heart receives poorly oxygenated blood

A

right

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26
Q

what is the purpose of the atrial auricles

A

atrial appendage is same name

increase capacity of atrium and also increase volume of the blood that it is able to contain

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27
Q

what are the 3 layers that make up the heart

A

endocardium
myocrdium
epicardium ( visceral pericardium )

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28
Q

what is the coronary sulcus

A

also called atrioventricular groove , groove separating the atria and ventricles

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29
Q

what do the anterior and posterior interventicualr sulci separate

A

ventricles

30
Q

the apex of the heart is formed by the inferolateral part of the left ventricle where does it lie

A

5ht intercostal space about 9cm from the median plane

31
Q

the base of the heart is formed by the right atria mainly and receives the pulmonary veins at its left atrial portion - what does it receive from its right atrial position

A

superior and inferior venae cavae

apex and base different

32
Q

Anterior (sternocostal) – right ventricle (mainly)
Diaphragmatic (inferior)- left (mainly) and right ventricle
Right pulmonary – right atrium (mainly)
Left pulmonary – left ventricle (mainly)

A

four surfaces of the heart

four borders
Right – right atrium, extends between SVC and IVC
Inferior – right (mainly) and left ventricle
Left – left ventricle (mainly) and left auricle
Superior – right and left atria and auricles.

33
Q

landmarks for border of the heart depend on position of diaphragm and the physical condition of the individual
where is the superior borer

A

From the inferior border of the 2nd left costal cartilage to the Superior border of the 3rd right costal cartilage, 1 - 2cm from the margin of the sternum on each side.

34
Q

right border of the heart

A

From the 3rd right costal cartilage to the 6th right costal cartilage – slightly convex to the right, 1 - 2cm from the margin of the sternum on each side.

35
Q

inferior border of the heart

A

From the inferior end of the right border to a point in the 5th intercostal space close to the midclavicular line – apex of the heart/apex beat.

36
Q

left border of the heart

A

A line connecting the lefts ends of the superior and inferior borders.

37
Q

what is the fibrous skeleton of the heart

A

A complex framework of dense collagen fibres that form four rings around the orifices of the cardiac valves.

38
Q

3 functions of the fibrous skleeton of the heart

A

Provides structural foundation of the heart valves – keeps patent and prevents overstretching.

Anchors the myocardium.

Acts as electrical insulator between the atria and ventricles.

39
Q

what is the sinus venarum ( sinus of the vena cavae)

A

thin walls from right sinus horn that connects below right ventricle and medially with LA

40
Q

function of pectate muscles - primitive atrium

A

increasing power of contraction without increasing heart mass

41
Q

what is the right atrioventricular orifice

A

is a large oval aperture of communication between the right atrium and ventricle situated at base of atrium about 4cm wide

42
Q

what is the crust terminalis

A

thick heart muscle on external aspect of right atrium - terminal sulcus - spertaes between the smooth and rough parts

43
Q

oval fossa is what

A

remnant of oval foramen

44
Q

what feature is a coinical such formed from the upper and left angle of right lenticel n the chordate heart - from which the pulmonary trunk arises - delves from bulbs cordis

A

infundibulum

45
Q

the trabecular carneae

A

muscular columns project from inner ventricles - different from pectinate muscles which are found in atria

46
Q

supraventricular crest separates the trabeculated and smooth wall parts and as important function in guiding blood flow - true or false?

A

true

47
Q

three cusps of tricuspid valve

A

anterior
posterior
septal

48
Q

papillary muscles attach to what

A

atrioventricular valves via chordae tendineae and contract to prevent inversion of prolapse of these valves on systole ( ventricular contraction

49
Q

intraventicualr septum separates what

A

ventricles

50
Q

the moderator band know as septomarginal trabecula is a band of cardiac muscle in RV carries part of what

A

branch of AV bundle of His

51
Q

the pumaory valve has semilunar cusps what are they

A

anterior
right
left

52
Q

mitral valve has 2 cusps what are they

A

anterior and posterior

53
Q

the aortic valve has semilunar cusps what are they

A

poster right and left

54
Q

right coronary artery has many perforating interventicualr spatial branches what is the dominant right coronary artery with 67%

A

poster inter ventricular ( poster for descending) artery

55
Q

left coronary artery from the LAD which gives rise to what branches

A

interventrciualr septal branches
lateral ( diagonal) artery

Circumflex artery - sine-atrial nodal artery and left marginal artery

56
Q

the RCA supplies what

A 
RA 
most of ventricle 
part of LV ( diaphragmatic surface) 
part of interventricualr septum) 
SA node - 60% cases 
AV node -80%
57
Q

the LCA supplies what

A 
LA 
most LV 
part of RV 
most of interventicualr septum 
SA node - 40%
58
Q

where are the
Cardioacceleratory (pressor) centre – Sympathetic.
Cardioinhibitory (depressor) centre – Parasympathetic.
located

A

medulla oblongata

59
Q

what increases the rate and force of contractions

A

Sympathetic fibres through the cardiac plexus to the SA and AV nodes, cardiac muscles and coronary arteries.

60
Q

what fibres slow the heart

A

Parasympathetic fibres through the cardiac plexus to the SA and AV nodes, cardiac muscles and coronary arteries.

Afferent parasympathetic fibres run with the Vagus nerve and are concerned with cardiac reflexes (Baroreceptor, Aortic arch and Carotid sinus reflexes for blood pressure homeostasis).

61
Q

do afferent sympathetic fibres go to T1,2-4 - referring pain here across chest and upper limbs ?

A

yes

62
Q

where are the sounds of the heart best heard

A

The valves of the heart are located deep to the sternum. The sounds of the heart and great vessels are best heard superficial to the chamber or vessel into which the blood has passed, and in a direct line with the valve in the direction of blood flow.

63
Q

where can you find he pulmaory valve

A

Pulmonary Area:

the sternal end of the 1st or 2nd left intercostal space.

64
Q

where can you listen to arctic valve

A

Aortic Area:

The sternal end of the 1st or 2nd right intercostal space.

65
Q

where can you listen to mitral valve

A

Mitral Area:

Near the apex of the heart in the 5th left intercostal space.

66
Q

where can you listen to tricuspid valve

A

the sternal edge at the level of the 4th or 5th intercostal space right or left of the sternum.

67
Q

where can you listen to aortic valve

A

aortic area is found second right intercostal space

68
Q

when can you listen to the pulmonary valve

A

pulmonic area is second left intercostal space

69
Q

where can you listen to the mitral valve

A

the mitral area or apex is the 5th left intercostal space in the midclavicual line

70
Q

where can you listen to the tricuspid valve

A

this area is found in the fourth tnerocstalspace in the left lower sternal border

71
Q

where is erbs point

A

third left intercostal space ( left sternal border)
5th point of auscultation -hear both sounds S1 from closure of mitral and tricuspid and S2 from closure or aortic and pulmonary valves

72
Q

what Is the role of the aortic sinuses

A

The aortic sinuses are small openings found within the aorta behind the left and right flaps of the aortic valve. When the heart is relaxed, the back-flow of blood fills these valve pockets, therefore allowing blood to enter the coronary arteries.

Cardiovascular (20 decks)

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