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Block 2 Anatomy > The heart and mediastinum > Flashcards

The heart and mediastinum Flashcards

1
Q

Which 2 veins join to form the brachiocephalic veins?

A

Internal jugular veins and subclavian veins

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2
Q

The brachiocephalic veins are formed behind what?

A

The sternoclavicular joint

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3
Q

The brachiocephalic veins join to form what?

A

Superior vena cava

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4
Q

Where is the SVC formed?

A

Behind the right costal cartilage of rib 2

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5
Q

Which procedure involves both the venous system and liver biopsy?

A

Transjugular liver biopsy

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6
Q

What are the 3 main arteries that branch off the aortic arch in the superior mediastinum?

A

Brachiocephalic trunk

Left common carotid artery

Left subclavian artery

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7
Q

The ligamentum arteriosum is a remnant of what?

A

Ductus arteriosus

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8
Q

Which 2 structures did the ductus arteriosus join together?

A

Pulmonary trunk and aortic arch

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9
Q

What was the function of the ductus arteriosus?

A

Allowed blood to bypass the lungs during embryological development

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10
Q

What can happen if the ductus arteriosus fails to close after birth?

A

It results in a patent ductus arteriosus, which allows for mixing of low oxygenated blood from the pulmonary trunk with high oxygenated blood in the aorta, therefore decreasing the oxygen content of the blood heading towards systemic circulation

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11
Q

The internal thoracic arteries branch off from which arteries?

A

Subclavian arteries

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12
Q

The internal thoracic arteries can be grafted for use in which procedure? Why are these arteries particularly beneficial for this procedure?

A

CABG – coronary artery bypass graft

They resist atherosclerotic plaque build up

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13
Q

What happens to the thymus gland after childhood?

A

Atrophies

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14
Q

What surrounds the heart?

A

Pericardial sac

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15
Q

The fibrous pericardium is attached to what inferiorly?

A

Central diaphragmatic tendon

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16
Q

What are 2 things that are most likely to cause a blockage of the SVC?

A

Extrinsic compression by a tumour

Metastasis to mediastinal lymph nodes

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17
Q

Which levels of the sympathetic chain carry fibres to the heart?

A

T1 – T4

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18
Q

Why does cardiac pain occur in the T1 – T4 dermatomes, mainly on the left?

A

Cardiac visceral sensory fibres travel back to the CNS with the sympathetic nerves T1 – T4

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19
Q

What 2 layers is the pericardium composed of?

A

Fibrous pericardium

Serous pericardium

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20
Q

The parietal layer of the serous pericardium lines what?

A

The inside of the fibrous pericardium

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21
Q

The visceral layer of the serous pericardium lines and forms what?

A

The heart and forms the epicardium

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22
Q

What innervates the fibrous pericardium?

A

Phrenic nerve

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23
Q

Describe how a haemopericardium can lead to cardiac tamponade?

A

In a haemopericardium, blood accumulates in the pericardial sac. The fibrous pericardium is relatively inelastic, so blood in the sac can compress the heart and prevent it from being able to fill properly during diastole due to external compression – this is cardiac tamponade

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24
Q

What are the 2 sinuses of the heart?

A

Transverse pericardial sinus

Oblique pericardial sinus

25
Q

What clinical manoeuvre can the transverse pericardial sinus be used for?

A

Can be used during cardiac surgery (e.g. coronary artery bypass graft) to pass a surgical clamp around the aorta and pulmonary trunk to control blood flow while on a heart-lung machine

26
Q

Which 3 vessels deliver blood to the right atrium of the heart?

A

Superior vena cava

Inferior vena cava

Coronary sinus

27
Q

Which valve does blood pass through as it passes from the right atrium to the right ventricle?

A

Tricuspid valve

28
Q

At which point is the tricuspid valve closed?

A

During ventricular contraction / systole

29
Q

What does the crista terminalis mark the boundary between?

A

The embryonic sinus venosus and primitive atrium

30
Q

The anterior wall of the right atrium contains which muscles?

A

Pectinate muscles

31
Q

Other than the anterior wall of the right atrium, where else in the right atrium are the pectinate muscles found and what pathology can occur in this structure?

A

Atrial appendage / auricle – a muscular pouch-like extension of the right atrium

In cases of atrial fibrillation, blood clots can form here

32
Q

Which structure can be found on the interatrial septum of the right atrium? What is it a remnant of and what was its function?

A

Fossa Ovalis – a remnant of the foramen ovale, which allowed oxygenated blood to bypass the lungs and travel directly from the right atrium to the left atrium in foetal circulation

33
Q

What is the smooth-walled region of the right ventricle which leads to the pulmonary valve and trunk?

A

Conus arteriosus / infundibulum

34
Q

What are the prominent muscular ridges on the inner wall of the right ventricle called?

A

Trabeculae carnae

35
Q

Which fibrous cords connect the valve leaflets to the papillary muscles in the right ventricle?

A

Chordae tendinae

36
Q

In the right ventricle, what are the papillary muscles and what is their function?

A

Muscle projections that anchor the chordae tendinae and prevent valve prolapse during ventricular contraction

37
Q

Which trabeculae carnae is essential for the rapid conduction of electrical impulses, where does it extend to and from, and what does it carry?

A

Moderator band – runs from the interventricular septum to the base of the anterior papillary muscle, and carries the right bundle of the atrioventricular bundle

38
Q

The left atrium receives oxygenated blood from how many pulmonary veins?

A

4

39
Q

Which valve does blood pass through as it passes from the left atrium to the left ventricle?

A

Mitral valve

40
Q

Describe when the papillary muscles do and do not contract.

A

The papillary muscles contract when the ventricles contract to prevent the cusps from being blown back into the atria during ventricular systole

They do not contract to open the valves – the valves open passively

41
Q

Describe the composition of the cardiac skeleton.

A

Dense collagen fibres that form a rigid, non-conductive framework

42
Q

List the 3 functions of the cardiac skeleton.

A

Mechanical stability

Attachment point for cardiac muscle and valve cusps

Electrical insulation

43
Q

How many cusps do the aortic and pulmonary semi-lunar valves each have?

A

3

44
Q

Name the 3 sections of the aortic valve.

A

Right coronary leaflet

Left coronary leaflet

Non-adjacent leaflet

45
Q

Name the 3 sections of the pulmonary valve.

A

Right-adjacent leaflet

Left-adjacent leaflet

Non-adjacent leaflet

46
Q

What are the 2 main pathologies that can affect the heart valves?

A

Stenosis and insufficiency (regurgitation)

47
Q

Which 2 heart valves are most commonly affected by valvular heart diseases?

A

Mitral and aortic

48
Q

What is the most common type of congenital heart disease in adults?

A

Mitral valve prolapse – one or both leaflets are enlarged, redundant, or floppy

49
Q

What sign would you be able to pick up using a stethoscope on someone with mitral valve prolapse?

A

Late systolic murmur

50
Q

What is the most frequent heart valve abnormality, what is it often caused by, and what does it result in?

A

Aortic stenosis – often the result of degenerative calcification, and results in left ventricular hypertrophy

51
Q

In which circumstances might the tricuspid and pulmonary valves be affected by disease?

A

As the result of an infection – rheumatic fever or infective endocarditis

52
Q

What sign could be seen on the nails of someone with right-sided valve disease?

A

Splinter haemorrhages

53
Q

Where do the coronary arteries arise from?

A

Coronary sinuses

54
Q

The main inflow of the coronary arteries is during which stage of contraction?

A

Diastole

55
Q

List the 4 main branches of the right coronary artery.

A

Sinoatrial nodal artery

Anterior ventricular arteries

Right marginal artery

Inferior interventricular artery (arises from RCA in 60% of people)

56
Q

List the 4 areas the right coronary artery supplies.

A

Right atrium + right ventricle

SA node + AV node

Conduction system up to AV bundles

Posterior 1/3rd of IV septum

57
Q

List the 5 main branches of the left coronary artery.

A

Sinoatrial nodal artery (in some people)

Circumflex artery

Anterior interventricular artery (left anterior descending (LAD) artery)

Marginal artery

Inferior interventricular artery (arises from LCA in 40% of people)

58
Q

List the 4 areas the left coronary artery supplies.

A

Left atrium + ventricle

AV bundle

Right + left bundle branches

Anterior 2/3rd of IV septum

59
Q

What are the 3 main veins which drain the heart? What do they drain into?

A

Great, middle and small cardiac veins

Drain into the right atrium via the coronary sinus

Block 2 Anatomy (8 decks)

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