Thorax Flashcards
What are the branches of the thoracic aorta?
-Right & left coronary artery
-Bracheocephalic - common carotid & subclavian
-Left common carotid
-Subclavian
Why is the ligament arteriosum associated with injury?
Tears of the aorta in rapid deceleration around the subclavian as the heart swings forward
Trace the path of the upper limb veins from the shoulder
Subclavian meets external jugular meets internal jugular becoming the brachiocephalic both join together to become the superior vena cava
What is the function of the phrenic nerve?
- Motor innervation to diaphragm
- Sensory innervation to peritoneum of the diaphragm
-Sensation to the pericardium, mediastinum
How is the left vagus different to the right?
Gives off recurrent laryngeal below ligamentum arteriosum
What does the right vagus wind around to give of the recurrent laryngeal branch?
Subclavian
What is the level of the thoracic plane?
Angle of Louis to T4
What structures are at the level of the thoracic plane?
- Tracheal bifurcation
- Azygos vein
- Pulmonary artery branches
- Beginning & end of arch of the aorta
- 2nd rib joins manubriosternum
When would you do a thoracotomy? Where does this normally happen?
Penetrating chest trauma with loss of output
Enter on the left side in the 5th space
Where do the coronary arteries arise from?
3 Aortic sinuses lie just above aortic valve
RIGHT = anterior sinus
LEFT = Left posterior sinus
What is the relevance of a bicuspid aortic valve?
Associated with altered coronary dominance and more prone to valvular disease
Where does the left coronary artery supply?
LA
LV
Interventricular septum
What are the branches of the left coronary artery?
- LAD
- Left circumflex
What is the route of the LAD?
Anterior inter ventricular sulcus
Around pulmonary trunk
Interventricular groove
Apex of the heart
What is the route of the left circumflex?
Descends in coronary sulcus on posterior of the heart
Where does the left circumflex supply?
Posterior LV
40% cases supplies LA node
What does the right coronary artery supply?
Both ventricles
Interventricular septum
Conducting system of the heart
What are the branches of the right coronary artery?
- Right marginal artery
- Posterior inter ventricular artery
- AV nodal artery
What is the route of the right coronary artery?
Passes between right atrial appendage & RV
Descends vertically on the front of the heart in the AV groove
Define coronary dominance
Major branch which supplies the AV node by the posterior descending artery
Which branches supply the AV node?
70% RCA
20% Circumflex
10% Co-dominance
What is the venous drainage of the heart?
LCA = Great cardiac vein
RCA = middle & small cardiac vein (drains directly into RA)
Where does the coronary sinus open into?
Right atrium
What is the average blood supply to the heart during the cardiac cycle?
300ml/min
Where do the lymphatics of the heart drain?
Tracheo-bronchia & mediastinal nodes
