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Medicine > The heart > Flashcards

The heart Flashcards

1
Q

What is the mediastinum

A

the part of the thoracic cavity that lies between the lungs

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2
Q

What does the mediastinum contain

A

heart (pericardium), trachea, main bronchi, oesophagus, thymus gland

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3
Q

What are the divisions of the mediastinum

A

Superior
Inferior - anterior (in front of heart), middle (heart), posterior (behind heart)

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4
Q

Where is the division between superior and inferior mediastinum

A

sternal angle

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5
Q

Parts of the aorta

A

Ascending, aortic arch, descending

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6
Q

Where do the coronary arteries stem from

A

ascending aorta

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7
Q

Branches of the aortic arch (right to left)

A
  • Braciocephalic artery (right subclavian + right common carotid artery)
  • Left common carotid
  • Left subclavian
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8
Q

What does the right subclavian artery supply

A

Right upper limb

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9
Q

What does the right common carotid supply

A

Right side of head, neck, brain

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10
Q

What does the left common carotid supply

A

Left side of head, neck, brain

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11
Q

What does the left subclavian artery supply

A

left upper limb

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12
Q

Ligamentum arteriosum

A

Connection between the arch of the aorta and pulmonary trunk. Remnant of the ductus arteriosus

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13
Q

What forms the superior vena cava

A

l + r brachiocephalic vein = (l+r) internal jugular vein and subclavian vein

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14
Q

Where is the trachea palpable

A

Just above the suprasternal notch

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15
Q

What innervates the diaphragm

A

the left and right phrenic nerve (C3,C4,C5) - only motor innervation of diaphragm

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16
Q

Is the phrenic nerve somatic or autonomic

A

somatic

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17
Q

Where does the phrenic nerve move through

A

the superior thoracic aperture, then over the pericardium

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18
Q

What are the branches of the vagus nerve (CNX)

A

Pharyngeal , superior laryngeal nerve, recurrent laryngeal nerve, cardiac branches

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19
Q

What is the course of the right recurrent laryngeal nerve

A

Descends. Goes over the right subclavian artery, loops underneath it. Ascends up to the larynx

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20
Q

What is the course of the left recurrent laryngeal nerve

A

Descends. Goes over the aorta, loops underneath it. Goes back up to the larynx

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21
Q

What do the recurrent laryngeal nerves do

A

innervate the larynx. Motor to all intrinsic muscles except the cricothyroid muscle + sensory innervation below vocal cords

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22
Q

Where does the thoracic duct drain into

A

Into the venous system at the union of the left internal jugular and left subclavian veins for form left braciocephalic

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23
Q

What happens to the thymus gland with age

A

it atrophies

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24
Q

What are the layers of the pericardium

A

tough outer fibrous layer, inner serous layer (parietal + visceral)

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25
What innervates the fibrous pericardium
the phrenic nerve
26
What are the surfaces of the heart
base (posterior), diaphragmatic, right pulmonary, left pulmonary, anterior surface
27
Where is the apex beat palpable
At the left 5th intercostal space at the midclavicular line
28
Borders of the heart (chest x ray)
right = right atrium left = left ventricle inferior = right ventricle + part of left ventricle superior
29
What are auricles
outpouchings from the walls of the right and left atria
30
What are the grooves on the surface of the heart called
sulci
31
What is located in the sulci
the coronary arteries
32
What is patent ductus arteriosus
when the ductus arteriosus doesn't close. Increased blood flow through pulmonary vessels can cause **pulmonary hypertension**
33
How can lung cancer cause hoarseness
Cancer at apex of lung can damage recurrent laryngeal nerve which innervates larynx
34
What is pericardial effusion
a build up of fluid in the pericardial cavity
35
What can pericardial effusion cause
cardiac tamponade. Where the fibrous pericardium can't stretch so fluid puts pressure on heart
36
What is the importance of ductus arteriosus
allows blood to bypass the lungs in foetus
37
What are the branches of the right coronary artery
1) Branches to SAN and AVN 2) Right marginal artery - majority of right ventricle 3) Posterior interventricular artery - posterior 1/3 of interventricular septum
38
What are the branches of the left coronary artery
- Short left main stem 1) Left anterior descending 2) Circumflex artery --> left marginal artery
39
What does the left coronary artery supply
the left atrium, left ventricle, part of right ventricle, part of septum
40
What does LAD supply
Both ventricles
41
What does Cx supply
Left atrium and part of both ventricles
42
What is left vs right dominant
Where the posterior interventricular artery stems from. 85% stems from RCA, 7% stems from circumflex artery
43
What is the fossa ovalis
Remnant of the foramen ovale - hole in the interatrial septum
44
What is the function of the foramen ovale
shunt blood from the right atrium to left atrium to bypass the lungs
45
What is the crista terminalis
muscular ridge that separates the smooth posterior wall of the right atrium from the anterior muscular ridges
46
Is the crista terminalis in both atria
no, only the right
47
What are the pectinate muscles
muscular ridges on the anterior of BOTH atria
48
What are the parts of the right ventricle
trabeculae carnea, papillary muscles, chordae tendineae, moderator band
49
What is the trabeculae carnea (TC)
muscular ridges on the internal ventricular wall
50
What are the papillary muscles
modified TC which project into the lumen of the ventricle
51
What are the chordae tendineae
fibrous chords which connect the papillary muscles to the atrioventricular valves
52
What is the moderator band
modified TC which connects the interventricular septum to papillary muscles
53
Do both ventricles have a moderator band
no, only the right
54
What are the parts of the left ventricle
trabeculae carneae, papillary muscles, chordae tendineae
55
How many papillary muscles are there in each ventricle
3 in right, 2 in left
56
What keeps AV valves closed
Papillary muscles contracting putting pressure on the chordeae tendineae which attach to the atrioventricular valves
57
What are the semilunar valves
The aortic and pulmonary valves
58
How many cusps does each semi lunar valve have
3 semi circular cusps
59
How many cusps do the av valves have
Tricuspid - 3, Mitral - 2
60
Sinus + semi lunar valves
Sinus' are pockets formed by the semilunar valves, they catch blood and balloon into the lumen during diastole
61
Where do the coronary arteries stem from
From the aortic valve sinus
62
Where do the coronary veins flow into
the coronary sinus which enters the right atrium
63
When do the coronary arteries fill
during diastole
64
What are the auscultatory area for the aortic and pulmonary valves
2nd intercostal space, right, left
65
What are the auscultatory areas for the tricuspid and mitral valves
tricuspid = 5th space, just left of sternum mitral = 5th space, midclavicular line
66
What is the rate from the sino atrial node
70/min
67
What coronary artery supplies the sino atrial node
RCA in 60% of people, LCA in 40%
68
What supplies the atrioventricular node
the posterior interventricular artery
69
What supplies the bundle of his
the left coronary artery
70
What is contained in the posterior mediastinum
thoracic aorta, azygous vein, oesophagus, thoracic duct
71
What are the branches of the aorta in p mediastinum
posterior intercostal, bronchial, oesophageal, pericardial, phrenic arteries
72
What drains the posterior thoracic wall
the azygos system of veins - posterior intercostal veins, bronchial veins, oesophageal veins
73
Where does the azygos vein drain into
the SUPERIOR vena cava
74
Where does the azygous vein originate
lumbar azygous vein/inferior vena cava
75
What are the parts of the azygous system of veins
azygos vein on the right side of the vertebrae hemiazygos vein on the left side of the vertebrae (shorter)
76
Where does the thoracic duct drain into
Into the venous system at the union of the left internal jugular and left subclavian veins
77
What is the cisternae chyli
sac-like swelling which gives rise to thoracic duct
78
What are paravertebral ganglia
Ganglia (collection of cell bodies outside CNS) in the sympathetic trunk
79
Where do sympathetic neurones originate
T1 - L2/3. Leave the spinal chord in spinal nerve, then immediately enter sympathetic trunk
80
What do preganglionic axons do once they enter the sympathetic trunk
1) synapses in ganglion at level of entry 2) ascends/descends trunk before synapsing at ganglion 3) travels through trunk + ganglion without synapsing
81
What is the sympathetic innervation of the thoracic viscera
the cardiopulmonary splanchnic nerves
82
What is the sympathetic innervation of the abdomen
the abdominopelvic splanchnic nerves
83
What is the parasympathetic innervation of the thoracic viscera
vagus nerve
84
What are autonomic plexuses
a mesh of sympathetic and parasympathetic fibres
85
What are the autonomic plexuses in the thorax
the cardiac plexus, pulmonary plexus, oesophageal plexus
86
Where do the cardiopulmonary splanchnic nerves originate/go back to
T1-T5
87
What is cardiac referred pain
When cardiac problems are felt as pain in the central chest, left side of neck and left arm
88
Why does cardiac referred pain occur
Somatic sensory information from skin of chest wall, neck, arm also enters spinal chord at T1-T5, as well as cardiopulmonary splanchnic nerves. Hence, the brain interprets cardiac pain as pain in those areas
89
Where is pain from diaphragm felt
shoulder

Medicine (15 decks)

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