Thorax

Question 1

What are the branches of the thoracic aorta?

Answer 1

-Right & left coronary artery
-Bracheocephalic - common carotid & subclavian
-Left common carotid
-Subclavian

Question 2

Why is the ligament arteriosum associated with injury?

Answer 2

Tears of the aorta in rapid deceleration around the subclavian as the heart swings forward

Question 3

Trace the path of the upper limb veins from the shoulder

Answer 3

Subclavian meets external jugular meets internal jugular becoming the brachiocephalic both join together to become the superior vena cava

Question 4

What is the function of the phrenic nerve?

Answer 4

• Motor innervation to diaphragm
• Sensory innervation to peritoneum of the diaphragm
  -Sensation to the pericardium, mediastinum

Question 5

How is the left vagus different to the right?

Answer 5

Gives off recurrent laryngeal below ligamentum arteriosum

Question 6

What does the right vagus wind around to give of the recurrent laryngeal branch?

Answer 6

Subclavian

Question 7

What is the level of the thoracic plane?

Answer 7

Angle of Louis to T4

Question 8

What structures are at the level of the thoracic plane?

Answer 8

• Tracheal bifurcation
• Azygos vein
• Pulmonary artery branches
• Beginning & end of arch of the aorta
• 2nd rib joins manubriosternum

Question 9

When would you do a thoracotomy? Where does this normally happen?

Answer 9

Penetrating chest trauma with loss of output
Enter on the left side in the 5th space

Question 10

Where do the coronary arteries arise from?

Answer 10

3 Aortic sinuses lie just above aortic valve
RIGHT = anterior sinus
LEFT = Left posterior sinus

Question 11

What is the relevance of a bicuspid aortic valve?

Answer 11

Associated with altered coronary dominance and more prone to valvular disease

Question 12

Where does the left coronary artery supply?

Answer 12

LA
LV
Interventricular septum

Question 13

What are the branches of the left coronary artery?

Answer 13

• LAD
• Left circumflex

Question 14

What is the route of the LAD?

Answer 14

Anterior inter ventricular sulcus
Around pulmonary trunk
Interventricular groove
Apex of the heart

Question 15

What is the route of the left circumflex?

Answer 15

Descends in coronary sulcus on posterior of the heart

Question 16

Where does the left circumflex supply?

Answer 16

Posterior LV
40% cases supplies LA node

Question 17

What does the right coronary artery supply?

Answer 17

Both ventricles
Interventricular septum
Conducting system of the heart

Question 18

What are the branches of the right coronary artery?

Answer 18

• Right marginal artery
• Posterior inter ventricular artery
• AV nodal artery

Question 19

What is the route of the right coronary artery?

Answer 19

Passes between right atrial appendage & RV
Descends vertically on the front of the heart in the AV groove

Question 20

Define coronary dominance

Answer 20

Major branch which supplies the AV node by the posterior descending artery

Question 21

Which branches supply the AV node?

Answer 21

70% RCA
20% Circumflex
10% Co-dominance

Question 22

What is the venous drainage of the heart?

Answer 22

LCA = Great cardiac vein
RCA = middle & small cardiac vein (drains directly into RA)

Question 23

Where does the coronary sinus open into?

Answer 23

Right atrium

Question 24

What is the average blood supply to the heart during the cardiac cycle?

Answer 24

300ml/min

Question 25

Where do the lymphatics of the heart drain?

Answer 25

Tracheo-bronchia & mediastinal nodes