The Thorax (2) Flashcards
1
Q
State the boundaries of the upper thorax.
A
The thoracic inlet is named the superior thoracic aperture. It is bound by the vertebra of T1 and the 1st rib.
2
Q
State the boundaries of the lower thorax.
A
The thoracic outlet is named the inferior thoracic aperture. It is bound by ribs 7 to 12, T12 and the xiphoid process.
3
Q
State the functions of the thoracic wall.
A
Respiration (intrinsic/extrinsic muscles), protects organs, supports the breast.
4
Q
What is the thoracic wall?
A
The thoracic wall is the muscles and bones enclosing the thoracic cavity.
5
Q
What is endothoracic fascia?
A
The endothoracic fascia is loose connective tissue that separates the ribs from underlying fascia.
6
Q
Describe the composition of the endothoracic fascia.
A
It contains various amounts of fat. It thickens over the top of each lung as suprapleural (Sibson’s) fascia. This Sibson’s fascia attaches to the internal border of the 1st rib and the TP of C7.
7
Q
Label the diagram
A
1=neck
2=head
3=superior facet
4=crest of head
5=inferior facet
6,7=site of articulation with costal cartilage
8=internal surface
9=external surface
10=costal groove
11=body/shaft
12=costal angle
13=non-articular part
14=articular facet
15=tubercle
8
Q
The 1st rib has an extra tubercle, name it and its location. What neurovascular structures lie next to it?
A
Scalene tubercle, medial to the regular tubercle. Medially lies the subclavian vein, laterally lies the subclavian artery.
9
Q
State the sex differences in the anatomy of the sternum.
A
The sternum is shorter in females.
10
Q
State the sex differences in the anatomy of the thoracic inlet.
A
The thoracic inlet is more oblique in females.
11
Q
State the sex differences in the anatomy of the suprasternal (jugular) notch.
A
It is at the level of T2 in males and T3 in females.
12
Q
State the anterior thoracic lines.
A
The anterior median line (down the middle) and the midclavicular lines (passing through the midpoint of either clavicle).
13
Q
State the lateral thoracic lines.
A
The anterior, posterior and mid axillary line
14
Q
State the posterior thoracic lines.
A
The midvertebral line and the right and left scapular lines (passing the inferior angle of the scapulae).
15
Q
What does the infrasternal angle describe.
A
The infrasternal angle, localised at the xiphoid process, is the angle between the costal margins.
16
Q
At what level is the sternal angle (the manubriosternal junction)?
A
The sternal angle is at the point of junction of the 2 costal cartilage (T4/5).
17
Q
What major vein passes behind the manubrium?
A
The superior vena cava
18
Q
What is auscultation?
A
Auscultation is the act of listening to internal body sounds.
19
Q
Label the diagram.
A
C=aortic valve
D=pulmonary valve
E=tricuspid valve
F=mitral valve (male)
G=mitral valve (female)
20
Q
What is interchondral subluxation.
A
Interchondral subluxation is the dislodgement of the rib from the interchondral joint.
21
Q
Explain the abbreviation RIPE, in relation to chest X-rays.
A
RIPE is used to evaluate the quality of a chest X-ray image.
Rotation-ensure the patient isn’t rotated-by ensuring that each medial clavicle is equidistant from the spinous process.
Inspiration-inspiration must be of an adequate level-apices, costophrenic angles and 5-6 anterior ribs should be visible.
Penetration/Exposure-ensure there is appropriate exposure in the image-vertebrae must be just visible behind the heart (AP).
22
Q
Explain the abbreviation ABCDDE, in relation to chest X-rays.
A
ABCDDE is a systematic approach to interpreting chest X-rays.
Airways-trachea, bronchi, carina
Breathing-lungs, apices, costophrenic angle
Circulation-heart size, mediastinum
Diaphragm-right hemidiaphragm ought to be higher than the left
Disability-fractures, deformities
Everything else-tubes, pacemakers, foreign objects, sub-diaphragmatic free air(indicates perforation of a hollow abdominal organ)
23
Q
Label this diagram of a PA chest X-ray.
A
1=right apex
2=spinous process
3=trachea
4=carina
5=right hilum
6=right cardiac border
7=vertebral body
8=right hemidiaphragm
9=right costophrenic angle
10=1st anterior rib
11=left clavicle
12= posterior rib
13=aortic knuckle
14=left hilum
15=left cardiac border
16=gastric bubble
17=left costophrenic angle
24
Q
State the pathophysiology, symptoms and treatment of tension pneumothorax.
A
Pathophysiology: air builds up in the pleural space, causing lung collapse on the affected side. Increased intrathoracic pressure compresses heart, mediastinum and contralateral lung.
Symptoms: shortness of breath (absent breath sounds on affected side), cyanosis, hypotension, tachycardia, distended neck veins, hyper resonant percussion due to air.
Treatment: immediate needle thoracostomy (14-16G needle in the 2nd intercostal space, midclavicular line), later, install chest tube.
25
Explain the abbreviation O/E.
On examination
26
Explain the abbreviation B/G.
Background
27
Explain the abbreviation NSCLC.
Non-small-cell lung cancer
28
Describe the movement of the sternum during external respiration.
Pendulum-like
29
Where are the layers of the pleura (parietal and visceral) continuous with one another?
Around the hilum of the lung
30
What does the ligamentum arteriosum connect?
The arch of the aorta and the pulmonary trunk. It is the remnant of the ductus arteriosus which connected the pulmonary trunk and the aorta in intra-uterine life.
31
Which 2 major veins contribute to the superior vena cava?
The subclavian and internal jugular veins of the right and left side, join behind the medial end of the clavicle. This then forms the right and left brachiocephalic veins, contributing to the superior vena cava.
32
Which of the brachiocephalic veins is longer and more oblique?
Left
33
What vein minorly contributes to the superior vena cava, and in what way?
The azygos vein merges with the superior vena cava posteriorly before the SVC pierces the pericardial sac.
34
What are the only branches of the ascending aorta and where do they arise?
The only branches of the ascending aorta are the coronary arteries which arise at its start.
35
What are the 3 major arteries that arise of the arch of the aorta?
The brachiocephalic trunk (innominate artery), the left common carotid artery and the left subclavian artery
36
What does the brachiocephalic trunk divide into?
The innominate artery divides into the right subclavian and the right common carotid arteries.
37
What does the azygos vein arch over before merging with the superior vena cava?
The right main bronchus
38
On which side of the mediastinum are the 2 hemi-azygos veins localised?
Left. Only azygos on the right
39
List the branches of the trachea in order.
Trachea, primary main bronchi, secondary lobar bronchi (2/3), tertiary segmental bronchi (8/10), bronchioles, terminal bronchioles.
40
Name the lobes of the right and left lungs.
Right: superior, middle and inferior lobes
Left: superior and inferior lobes
41
What structure only occupies the mediastinum in childhood?
The thymus gland
42
How does blood enter the right atrium other than the 2 venae cavea?
By way of the coronary sinus (anterior to the venae cavae)
43
What is the wall between the left and right atria called?
The intra-atrial septum (lying obliquely)
44
What is the fossa ovale?
The fossa ovale is a thin oval patch on the inner intra-atrial septum. It is a remnant of the foramen ovale that connected the 2 atria in intrauterine life.
45
How many pulmonary veins enter the left atrium?
4, 2 from the right lung and 2 from the left
46
What is the left atrioventricular valve called?
The bicuspid, mitral valve
47
What is the right atrioventricular valve called?
The tricuspid valve
48
Name the 3 valves of the tricuspid valve.
Septal, anterior, posterior cusps
49
Where do the chordae tendineae arise?
The chordae tendineae arises from papillary muscle.
50
State the function of the chordae tendinaea.
To prevent the cusps of the valve from prolapsing into the atrium during systole.
51
What muscles forms a lining of criss-crossed pattern on the wall of the right ventricle?
Trabeculae carnae
52
What is the tapering part of the right ventricle that leads up to the pulmonary valve called?
It is called the infundibulum or the conus arteriosus. Uniquely, its lining is smooth.
53
Compare the shapes of the left and right ventricles in cross section.
The left ventricle's walls are thicker and it has circular shape. The right ventricle is in a C-shape. Hence, the interventricular septum is curved.
54
How does the right coronary artery arise and terminate?
It arises from the right aortic sinus. It terminates at the right interventricular artery.
55
State the 3 arteries that supply each intercostal space.
The posterior intercostal artery, its collateral branch, anterior intercostal arteries.
56
From where are the posterior intercostal arteries derived?
The descending aorta (T3-12) and supreme intercostal artery (T1,2)
57
From where are the anterior intercostal arteries derived?
Internal thoracic (T1-6) and musculophrenic (T7-9) artery, which is derived from the subclavian artery.
58
Where do the anterior intercostal veins drain?
The musculophrenic and internal thoracic veins
59
Where does the posterior intercostal vein of T1 drain?
Direct to the brachiocephalic trunk
60
Where do the posterior intercostal veins of T2,3 drain?
T2,3's veins unite to form the superior intercostal vein and enter the brachiocephalic trunk.
61
List the neurovascular structures of each intercostal space from superior to inferior.
Vein, artery, nerve
62
How are intercostal spaces innervated?
Intercostal nerves are numbered T1-11 corresponding to T vertebrae. The subcostal nerve, T12, runs below the 12th rib. Each nerve gives rise to a collateral nerve near the angle of the rib, which runs along the superior surface of the rib below. They originate from the anterior rami of the corresponding spinal nerves.
63
What are acini?
Saclike cavities in the gland, they are surrounded by secretory cells that produce milk.
64
On which quadrant of the breast is breast cancer most likely?
Superolateral quadrant - 60%
65
What are the atria and ventricles divided by superficially?
The coronary sulcus
66
What are the pectinate muscles?
The pectinate muscles arise from the crista terminalis and line the atria (mostly right).
67
Where does blood from the right atrium go to the right ventricle?
The right AV orifice/tricuspid orifice
68
What are the smooth and rough parts of the right atrium divided by?
The sulcus terminalis
69
Label the Y-shape formed by the semilunar valves.
The stems are called lunules. Their confluence is called a nodule.
70
Observe this diagram illustrating the attachments of the papillary muscles and cusps in the right ventricle.
71
Why is there a sinus at the semilunar valves of the pulmonary trunk and the aorta?
This sinus collects blood between the arterial wall and the cusps, to prevent the cusps from sticking to the wall and to help in closing the cusps. In the aorta, this is where the coronary arteries arise. The backflow of blood from the aorta fills these arteries.
72
The pericardiophrenic ligament is a continuous structure formed from the fibrous pericardium and what other structure?
The central tendon of the diaphragm
73
Compression of the heart due to pericardial effusion is termed what?
Cardiac tamponade
74
The thickest area of myocardium is found in which structure?
The left ventricle (fucking obviously)
75
Parasympathetic innervation of the heart is provided by which nerve?
The vagus nerve
76
In an intercostal space, where can the neurovascular bundle be found?
It is located in the costal groove on the inferior border of the upper rib. It is located between the internal intercostal and innermost intercostal muscles.
77
State the innervation of the diaphragmatic pleura of the lungs.
Central part: phrenic nerve (C3,4,5)
Peripheral part: lower intercostal nerves (T7-12)
78
Where do pulmonary lymphatic nodes drain?
They drain to the bronchopulmonary (hilar) nodes.
79
At what level does the hilum of the lung lie?
4th to 5th costal cartilages
80
How does the phrenic nerve run relative to the hilum of the lung?
Anteriorly
81
Label this diagram of the thoracic cavity to the right of the mediastinum.
1=azygos vein
2=branch of right pulmonary artery to superior lobe
3=branches of sympathetic trunk to greater splanchnic nerve
4=diaphragm
5=inferior vena cava
6=shaft of 1st rib
7=oesophagus
8=pericardium over right atrium
9=costal pleura
10=right inferior pulmonary vein
11=right splanchnic nerve
12=right primary bronchus
13=right pulmonary artery
14=right subclavian artery
15=right superior pulmonary vein
16=right vagus nerve
17=6th, right, posterior, intercostal vessels under parietal pleura
18=right superior lobar bronchus
19=superior vena cava
20=sympathetic trunk and ganglion
82
State the arterial supply and venous drainage of the breast.
Arterial supply: internal thoracic artery, axillary arteries, posterior intercostal arteries
Venous drainage: axillary vein, internal thoracic vein
83
Where does lymph from the nipple, areola and lobules pass to?
Subareolar lymphatic plexus
83
Where does most of the lymph drain to in the breast? Where does the remaining lymph drain to?
In the breast at least 75% of lymph drains to the axillary lymph nodes.
Most of the remaining lymph drains to the parasternal lymph nodes or the opposite breast.
84
State the contents of the right and left carotid sheaths.
The right and left carotid sheaths contain the right and left internal jugular veins, the right and left common carotid arteries and the right and left vagus nerves.
85
What vessels run either side of the sternum?
The right and left internal thoracic arteries
86
Label this diagram.
1=cervical pleura
2=bronchial tree
3=costal pleura
4=pleural cavity
5=visceral pleura
6=costophrenic angles
7=diaphragmatic pleura
8=mediastinal pleura
9=lingula
10=cardiac notch
11=costal surface of left lung covered with visceral pleura
12=costal pleura
13=cervical pleura
14=trachea
7,8 and 12 are parts of the parietal pleura
87
What connects the diaphragmatic pleura to the diaphragm muscle?
The phrenicopleural fascia
88
What is special about mediastinal pleura?
At the mediastinal part of the pleura, parietal pleura is continuous with visceral pleura.
89
What are the attachments and functions of the pulmonary (pleural) ligament?
Attachments: connects the hilum of the lung to the diaphragm, formed by inferior pleural cuff
Functions: stability, movement and lymphatic drainage
90
What is thoracocentesis?
Thoracocentesis (pleural tap) is a procedure that aspirates excess pleural fluid.
91
What is the diagnostic standard for pleural effusions?
At least 300mL of pleural fluid in the pleural recesses
92
What are some causes of pneumothorax?
Spontaneous ruptured bulla (resulting from COPD) or open external trauma.
93
State the nerve supply of the mediastinal (parietal of the lungs) pleura.
Phrenic nerve (C3,4,5)
94
State the nerve supply of the costal pleura.
Intercostal nerves (T1-11)
95
State the nerve supply of the diaphragmatic pleura.
Phrenic nerve(C3,4,5) and lower intercostal nerves (T7-12)
96
State the nerve supply of the pulmonary visceral pleura.
Pulmonary plexus; vagus nerve and sympathetic trunk
97
State the arterial supply of the parietal pleura of the lungs.
Intercostal, internal thoracic and musculophrenic arteries
98
State the arterial supply of the visceral pleura.
Bronchial artery
99
What nodes are involved in the lymphatic drainage of the pleura?
Parietal pleura: intercostal, mediastinal and diaphragmatic lymph nodes
Visceral pleura: bronchopulmonary nodes
100
State the position of the phrenic nerve relative to the vagus nerve.
The phrenic nerve is lateral and anterior to the vagus nerve.
101
Name the fissures of the lungs.
In the right lung there is a horizontal fissure between the superior and middle lobes and an oblique fissure between the middle and inferior lobes. In the left lung, there is an oblique fissure between the superior and inferior lobes.
102
Label this diagram of the right lung.
1=subclavian artery
2=subclavian vein
3=right brachiocephalic vein
4=left brachiocephalic vein
5=superior vena cava (out of which emerges the arch of the azygos vein)
6=pulmonary artery
7=pulmonary veins (inferior to which lies the pulmonary ligament)
8=inferior vena cava
9=diaphragm
10=azygos vein
11=oesophagus
12=bronchus
13=bronchus to superior lobe
14=rib 1
103
Label this diagram of the left lung.
1=rib 1
2=bronchus
3=eosphagus
4=thoracic aorta
5=diaphragm
6=heart
7=pulmonary veins, inferior to which runs the pleural ligament
8=pulmonary artery
9=aortic arch
10=left brachiocephalic vein
11=left subclavian artery
104
What supplies blood to the bronchi, lung tissue and visceral pleura?
Bronchial arteries, contributing to 1% of total pulmonary blood supply.
105
Where do bronchial veins drain into?
Bronchial veins drain into the hemiazygos and azygos veins.
106
What is the source of nervous supply to the lungs?
Sympathetic and parasympathetic fibers from the pulmonary plexus
107
State the lymphatic plexuses of the lungs.
Superficial and deep lymphatic plexus
108
Describe the difference between the right and left main bronchus.
The right main bronchus is wider, shorter and courses more vertically.
109
What is pneumonia? State its symptoms, causes and treatment.
Pneumonia is inflammation of the lungs affecting alveoli. Symptoms include: dry cough, chest pain, fever, fatigue, tachycardia. It is caused by viruses or bacteria. Treatment involves antibiotics.
110
Define bronchoscopy.
Bronchoscopy allows visualization of the airways using a bronchoscope inserted through the mouth or nose.
111
Define segmental atelectasis.
Segmental atelectasis is the partial collapse of a lung segment due to airway obstruction, impaired surfactant function or compression.
112
Localize the apex and base of the lungs.
The apex lies above the clavicle. The base lies on the diaphragm.
113
State the position of the pulmonary artery relevant to the bronchus.
RALS
Right lung: PA is anterior to the bronchus
Left lung: PA is superior to the bronchus
114
Where is a foreign body most likely to pass in the airways system?
A foreign body is more likely to pass through the right main bronchus and into the right lung.
115
Where is the superior mediastinum?
Above the sternal angle.
116
How are the boundaries of the inferior mediastinum dictated?
They are dictated by the position of the heart and pericardium as anterior, middle and posterior to it.
117
Where is the thymus located?
The superior and anteroinferior mediastinum
118
State the major structures of the superior mediastinum from anterior to posterior.
Thymus, brachiocephalic veins, arteries, trachea, oesophagus, thoracic duct
119
Label this diagram of the inferior view of a cross-section of the mediastinum, viewed at the level of the middle of the manubrium (~T1)
1=manubrium
2=thymus
3=right brachiocephalic vein
4=right phrenic nerve
5=right vagus nerve
6=trachea
7=oesophagus
8=sympathetic trunk
9=thoracic duct
10=left recurrent laryngeal nerve
11=left subclavian artery
12=left vagus nerve
13=left common carotid artery
14=left phrenic nerve
15=brachiocephalic trunk
16=left brachiocephalic vein
17=sternoclavicular joint
120
Label this diagram of the inferior view of a cross-section of the mediastinum, viewed at the level of the superior portion of the body of the sternum (~T4).
1=body of sternum
2=lymph node
3=SVC
4=right phrenic nerve
5=trachea
6=right vagus nerve
7=oesophagus
8=thoracic duct
9=left recurrent laryngeal nerve
10=arch of aorta
11=left vagus nerve
12=left phrenic nerve
13=thymus
121
State the contents of the anterior mediastinum.
Thymus, internal thoracic vessels, lymph nodes, fat
122
State the contents of the middle mediastinum.
Heart, ascending aorta, pulmonary trunk, superior/inferior vena cava, pulmonary veins, right/left phrenic nerves, cardiac plexus lymph nodes
123
State the contents of the posterior mediatinum.
Oesophagus, descending aorta, azygos veins, thoracic duct/lymph nodes, sympathetic trunk, thoracic splanchnic nerves
124
What is the name of the complete ring of cartilage around the oesophagus?
Cricoid cartilage, level with C6
125
What vein forms a direct connection between the SVC and the IVC?
The azygos vein
126
Where do the ascending lumbar veins drain?
The right ascending lumbar vein drains to the azygos vein. The left ascending lumbar vein drains to the hemiazygos vein.
127
Why is the azygos vein advantageous when other major veins are blocked?
The azygos vein is a collateral venous pathway, becoming a vital shunt if major pathways of venous return are obstructed.
128
Where does blood from posterior intercostal veins drain?
The azygos vein
129
What is the left venous angle?
The left venous angle is the junction where the left subclavian vein and left internal jugular vein meet to form the left brachiocephalic vein.
130
What are common sites of oesophageal constriction?
Cervical constriction at the cricopharyngeus at C6. Thoracic constriction at T4/5. Bronchial constriction of the LMB at the posterior mediastinum. Diaphragmatic constriction at the oesophageal hiatus at T10.
131
What are the vascular planes for the thoracic aorta?
Oesophageal and pericardial branches anteriorly, bronchial arteries arising laterally, intercostal and subcostal arteries posteriorly.
132
In what way do the superior phrenic arteries arise from the thoracic aorta?
The superior phrenic arteries arise from the inferior part of the thoracic aorta, they are paired parietal branches that have migrated anteriorly.
133
Label this diagram of the anterior heart.
1=brachiocephalic trunk
2=right brachiocephalic vein
3=SVC
4=ascending aorta
5=right superior pulmonary artery
6=right inferior pulmonary artery
7=right superior pulmonary vein
8=right inferior pulmonary vein
9=right auricle
10=right atrium
11=right ventricle
12=IVC
13=apex
14=left ventricle
15=coronary sulcus
16=left auricle
17=pulmonary trunk
18=left pulmonary veins
19=left pulmonary artery
20=left brachiocephalic vein
21=left subclavian artery
22=left common carotid artery
134
Label this diagram of the posteroinferior heart.
1=left common carotid artery
2=left subclavian artery
3=arch of aorta
4=left pulmonary artery
5=left superior pulmonary vein
6=left inferior pulmonary vein
7=left atrium
8=coronary sulcus
9=left ventricle
10=right ventricle
11=coronary sinus
12=IVC
13=right inferior pulmonary vein
14=right atrium
15=right superior pulmonary vein
16=right pulmonary artery
17=SVC
18=arch of azygos vein
19=right brachiocephalic vein
20=brachiocephalic trunk
135
What is dextrocardia?
In dextrocardia, the heart is positioned on the right side of the chest. Dextrocardia on its own does not usually cause
problems, but it may be a symptom of other conditions that affect the thoracic organs.
136
What are the 3 types of cardiovascular shadows that are cast on CXRs.
Transverse, as seen in the obese, pregnant and infantile. Oblique, as seen in the majority. Vertical, as seen in the narrow-chested.
137
What is a retro-oesophageal right subclavian artery?
A retro-oesophageal right subclavian artery (RERSA) is an anatomical variation where the right subclavian artery arises abnormally from the aortic arch instead of the brachiocephalic trunk.
138
State the parts of the diaphragm.
Peripheral muscular part and central diaphragmatic tendon
139
What is the innervation of the diaphragm proper?
Phrenic nerve (C3,4,5)
140
Through what does the IVC pierce the diaphragm?
The caval opening, at T8 in the central tendon, accompanied by branches of the right phrenic nerve and hepatic lymph vessels.
141
Localise the aortic hiatus.
At the T12 vertebra, between the crura
142
What is the crura?
The crura encircle the oesophagus to prevent regurgitation during deep inspiration.
143
State the arcuate ligaments.
Median ligament, medial ligaments, lateral ligaments
144
State the attachments of the median arcuate ligament.
Connects medial borders of medial ligaments and crosses over the anterior aorta. It unites the crura to form the aortic hiatus.
145
State the attachments of the medial arcuate ligament.
Body of L1 to the TP of L1
146
State the attachments of the lateral arcuate ligament.
TP of the L1 vertebra to the lower border of the 12th rib.
147
What is the arterial supply and venous drainage of the diaphragm? (table)
148
What is the arterial supply of the pericardium?
The pericardiacophrenic artery, a branch of ITA, running parallel to vein and phrenic nerve. With branches from the musculophrenic (ITA), bronchial, oesophageal, superior phrenic and coronary arteries.
149
What is the venous drainage of the pericardium?
The pericardiacophrenic veins which are tributaries of the brachiocephalic or ITV or azygos veins.
150
What is the nerve supply of the pericardium? Clinical implications?
Phrenic nerve (C3,4,5). Issues with the pericardium results in referred pain in the skin of the C3,4,5 dermatomes, of the ipsilateral supraclavicular region.
151
What is the only sensation of the heart proper?
Pain of the myocardium due to accumulation of metabolic products or ischemia.
152
What is tunica adventitia?
Tunica adventitia is the outermost layer of a blood vessel which is continuous with the surrounding tissue.
153
How does the fibrous pericardium prevent the heart from overfilling?
It does this because it is so unyielding and it is closely related to the great vessels that pierce in superiorly.
154
State the pericardial sinuses.
Transverse and oblique pericardial sinuses
155
Where is the transverse pericardial sinus?
At the junction of the aorta and pulmonary trunk
156
Where is the oblique pericardial sinus?
Behind the left atrium at the pulmonary veins and IVC
157
How is the transverse pericardial sinus used surgically?
A clamp is placed at the sinus around these large vessels to divert the flow of blood during cardiac surgery.
158
What comprises the skeleton of the heart?
Dense collagen forms 4 fibrous rings (annuli fibrosi), the right and left coronets and rings. They prevent over distension of valves. They're points of attachment for cusps and they provide electric insulation against chambers.
159
State the layers of the heart and pericardium from superficial to deep.
Fibrous pericardium, parietal pericardium, pericardial cavity, visceral pericardium, myocardium, endocardium
160
Label this diagram of an anterior view of the heart, detailing its arterial supply.
1=SA nodal branch
2=SA node
3=RCA
4=AV nodal branch of RCA
5=right marginal branch of RCA
6=posterior IV branch of RCA
7=lateral branch of anterior IV branch of LCA
8=left marginal artery
9=anterior IV branch of LCA
10=circumflex branch of LCA
11=LCA
161
Label this diagram of an posteroinferior view of the heart, detailing its arterial supply.
1=LCA
2=circumflex branch of LCA
3=anterior IV branch of LCA
4=right marginal branch of RCA
5=posterior IV branch of RCA
6=AV nodal branch of RCA
7=RCA
8=SA nodal branch of RCA
