Thoracic Viscera Lab Flashcards
Heart location
lies between IC spaces 2 and 6; apex opposite last segment sternum and cr to sternal attachment diaphragm; distance apex to base usually 2/3 dorsoventral diameter of thorax
relationship of heart to ribs in thorax
medial
relationship of heart to lungs in thorax
ventro cd to cr lung lobe, ventro cr to cd lung lobe
relationship of heart to diaphragm in thorax
cr
relationship of heart to basal border of lung in thorax
cr
relationship of heart to cr vena cava in thorax
cd
PALT
Pulmonary valave- L side low 3rd IC space
Aortic valve- L side high 4th IC space just below horizontal line through shoulder jt
Left AV valve- L side low 5th IC space; caudodorsal to olecranon
Right AV valve (tricuspid)- R side low in 3rd or 4th IC space
cardiac notch
divides cr and cd lobes bilaterally; in theory cardiac notch provides access to heart that does not require piercing lungs so in theory go through L side bc L side larger and no accessory lobe
L cardiac notch
between 3rd and 6th ribs
R cardiac notch
between 3rd rib and 4th IC space
accessory lobe
On r lung, wraps around cd VC
course of the blood supply as it enters the heart, circulates to the lungs, and then is pumped to
the systemic circulation
Cr or Cd VC -> RA -> R AV valve -> RV -> pulomary artery -> lungs -> pulmonary vein -> LA -> L AV valve -> LV -> aorta -> brachiocephalic trunk
intervenous tubercle
prevents blood from cr and cd VC draining back into heart from crashing into each other and beocming turbulent
branches brachiocephalic trunk
L subclavian, bicarotid trunk, R subclavian arteries
branches of subclavian artery
costocervical trunk, deep cervical trunk, vertebral artery, superficial cervical artery, internal thoracic artery
Cd vena cava relationship to aorta
cd vc v to aorta
pleura
parietal and visceral
parietal pleura
costal- lines ribs
diaphragmatic pleura
mediastinal pleura
visceral pleura
touches lungs
pleural recess
where parietal pleura directly applied to each other; cupula pleura and costodiaphragmatic recess
cupula pleura
on both sides in cr mediastinum where costal pleura reflects back to become mediastinal pleura; in horse this extends cr to 1st rib on R side
costodiaphragmetic recess
cd to basal border of lung where costal and diaphragmatic pleura rest against one another
parts of medaistinum
cr (area in front of heart), middle (at level of heart), and caudal (cd to heart, portion v to esophagus pushed over to L by accessory lobe)
cr mediastinum on R side contains
cr vena cava costo cervical trunk deep cervical artery vertebral artery azygous vein phrenic nerve trachea vagus nerve thymus (in young patients) cr mediastinal LNs
cr mediastinum on L side contains
costocervical trunk deep cervical artery vertebral artery phrenic nerve vagus thymus (In young patients) cr mediastinal LNs aortic arch trachea esophagus
middle mediastinum contains
thoracic duct
phrenic nerve
Vagus nerve
Symp trunk
cd mediastinum contains
aorta esophagus cd vc d and v vagal trunks phrenic nerve azygous vein throacic duct
horse mediastinum
fenestrated so pneumothorax more likely to be bilateral in horse
phrenic nerve origin to ternimation
- phrenic nerve originates at C5, C6, C7 passes caudoventrally over cr vc, the heart, and then ventral to lung root with cd vc then to diaphragm (on R)
- phrenic nerve originates at c5,c6,c7 then passes caudoventrally over base of heart, then ventral to lung root with cd vc, then to diaphragm (on L)
Sympathetic NS gangia
cr cervical ganglion middle cervical ganglion cervicothroacic ganlgion symp trunk ganglion cd mesenteric ganglion pelivic ganglion
sympathetic ns nerves
sympathetic trunk, vertebral nerve; vago symp trunk splits into vagus and symp trunk as it approaches thorax from neck, symp trunk more dorsal of two; symp trunk T1-L4
Path of vagus
CN 10, exist skull via tympanioccipital fissure; vagus bifurcates into D and V branches at level T6 (R and L ventral branches unite at this level forming V vagal trunk (passes caudally ventral to esophagus); d branches unite farther caudally d to esophagus and form d vagal trunk; follows esophagus through diaphragm
vagal trunk accompany esophagus through diaphragm
through esophageal hiatus carries parasympathetic nerve supply to abdominal viscera
vagus lungs and esophagus
ventral branches vagus give rise to plexus on bifurcation of trachea which supplies lungs and esophagus
auricular surface heart
has auricle, is on L side
paraconal interventricular groove
on auricular side; contains L coronary artery and great cardiac vein
subsinusoidal interventricular groove
on atrial side; contains R coronary artery and middle cardiac vein
atrial side
R side
coronary groove
marks division between atria and ventricles; subsinusoidal and paraconal interventricular grooves pass from coronary groove to apex of heart; these mark position of interventricular septum
tracheobronchial LNs
bifurcation trachea cd to base of aortic arch at level of T6
Recurrent laryngeal nerve
branch of vagus
R recurrent laryngeal nerve leaves R vagus at level 1st rib and loops around branch of subclavian artery to run up neck
L recurrent laryngeal nerve arises farther caudally than R one (at base of aortic arch) it runs lateral to medial around arch of aorta (ligament arteriosum?) which makes it a longer course -> L laryngeal hemiplegia
lung lobes horse
L cr, L cd, R cr, R accessory, R cd
fossa ovalis
in intertribal septum; remnant of thin sheet that covered foramen vale during development; this is a depression in r atrium of heart
coronary sinus
short collecting trunk of large cardiac veins found in coronary and interventricular grooves
interventricular septum
wall separating ventricles
coronary arteries
structural blood supply to heart
