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Exam 2 > Thorax 4: Mediastinum and Heart > Flashcards

Thorax 4: Mediastinum and Heart Flashcards

1
Q

What are the different subdivisions of the mediastinum

A

Superior and inferior mediastinum

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2
Q

What divides the superior and inferior mediastinum

A

angle of louis: line from sternal angle to T4

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3
Q

The inferior mediastinum is divided further into what and how

A

based on coverings of the heart
anterior
middle
and poster

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4
Q

What are the boundaries of the superior mediastinum

A

thoracic inlet
sternum
vertebral bodies

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5
Q

What are the boundaries of the inferior mediastinum

A

diaphragm

sternum, pleural cavities, thoracic vertebral bodies

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6
Q

What type of space is the pericardial sac

A

potential space

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7
Q

What are the layers of the pericardial sac

A 
fibrous outer layer
serous pericardium (visceral and parietal)
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8
Q

Where will pericardiocentesis be performed

A

between parietal and visceral layer of the serous pericardium

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9
Q

What is the arterial and venous support of the pericardium

A

internal thoracic artery and aorta

Venous: brachiocephalic vein and azygos system

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10
Q

What is the innervation of pericardium

A

phrenic nerve

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11
Q

What vessels are associated with phrenic nerve

A

pericardiophrenic vessels

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12
Q

What are the two pericardial sinuses

A

Oblique and Transverse sinus

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13
Q

Where is the transverse sinus

A

space posterior to the ascending aorta and pulmonary trunk

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14
Q

What is important to note about the attachment of the pericardium on the heart

A

also covers the trunks of the great vessels

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15
Q

What is the apex of the heart

A

inferior, conical end. Tip of left ventricle

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16
Q

What is the innervation to the serous pericardium

A

Visceral: vagus
Parietal: phrenic

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17
Q

What is the anatomical base of the heart

A

posterior aspect composed of left atrium

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18
Q

What is the diaphragmatic surface of the heart

A

right and left ventricles that rest on diaphragm

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19
Q

What is the sternocostal surface of the heart

A

most anterior aspect composed of right ventricle

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20
Q

What is the right pulmonary surface of the heart

A

right atrium

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21
Q

What is the most anterior chamber of the heart

A

right ventricle

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22
Q

What is the most posterior chamber of the heart

A

left atrium

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23
Q

What composes the right side of the heart

A

right atrium

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24
Q

What composes the left side of the heart

A

left ventricle

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25
Q

Where is the coronary sulcus located

A

encircles the heart between atria and ventricles

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26
Q

Where is the inter ventricular sulcus found

A

between ventricles

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27
Q

What are the characteristic features of the right atrium

A

sinus venarum
pectinate muscles
fossa ovalis

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28
Q

What is the sinus venarum

A

smooth walls of right atrium

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29
Q

What is the fossa ovalis

A

remnant of foramen ovale

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30
Q

Where is the fossa ovalis located

A

right atrium on intertatrial septum

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31
Q

What are septomarginal trabeculae

A

extensions of cardiac muscle from inter ventricular septum to papillary muscles

32
Q

What is the function of septomarginal trabeculae

A

carry parts of conduction system of the heart

33
Q

What is the inflow tract of right ventricle

A

muscular

34
Q

What is the outflow tract of right ventricle

A

trunks arterioses is smooth

35
Q

What is the function of papillary muscles and chordae tendinae

A

papillary muscle connect to valves through chord tendinae which will pull the valves shut when contracted

36
Q

What are the different parts of the inter ventricular septum

A

membranous and muscular portion

37
Q

What portion of the inter ventricular septum do most presenting ISD occur

A

membranous portion

38
Q

What are the characteristic features of the right ventricle

A 
inflow outflow tracts
papillary muscles
moderator band
tricuspid valve
IV septum
39
Q

What type of blood will enter the right atrium

A

deoxygenated

40
Q

What are the associated veins that enter right atrium

A

IVC, SVC
coronary sinus
anterior coronary arteries
venus minimum

41
Q

What type of blood will be found in the left atrium

A

oxygenated

42
Q

What veins are associated with left atrium

A

pulmonary veins

43
Q

What is the muscle of the left atrium like

A

smooth except for auricle

44
Q

What are characteristics of left ventricle

A

inflow through mitral valve, smooth wall towards outflow to aorta, trabecualtions on bottom

45
Q

List the sequence of signals through the conduction system of the heart

A

SA node
AV node
Bundle of his (right and left branches through IV septum to each ventricle) which communicates with purkinje fibers

46
Q

Where is SA node located

A

where crista terminales and SVC meet

47
Q

Where is the AV node

A

junction of atria and ventricles

48
Q

Where is the bundle of His located

A

IV septum

49
Q

Where are purkinje fibers located

A

walls of ventricles (endocardium)

50
Q

How are valves of the heart anchored

A

through a DCT skeleton

51
Q

Where will the heart valves be ausculatated

A

aortic: right 2nd intercostal space parasternally
Pulmonary: left 2nd intercostal space parasternally
Tricuspid: left 5th intercostal space parasternally
Mitral: left 5th intercostal space midclavicular

52
Q

What are the main branches of the right coronary artery

A

marginal artery
posterior descending artery
SA nodal

53
Q

What are the main branches of the left coronary artery

A

circumflex
left anteriordescending artery
left marginal

54
Q

What determines dominance of the heart

A

what every coronary artery side the posterior descending artery comes off

55
Q

Which coronary artery is longer

A

right

56
Q

What are common variants of cardiac arteries

A

SA nodal can come off left

Posterior inerventricular can come off left circumflex coronary artery

57
Q

What is the arterial support to the conducting system of the heart

A

SA node: right coronary artery
AV node: small vessel as right coronary becomes posterior interventricular
Right and Left bundle: LAD

58
Q

What is the most common site of occlusion

A

LAD

59
Q

What is the second most common site of occlusion

A

right marginal

60
Q

What is the third most common site of occlusion

A

circumflex

61
Q

What is CABG and what is used

A

coronary artery bypass grafting usually uses greater saphenous vein from leg

62
Q

What is more common, right or left sided dominance of heart

A

right (75%)

63
Q

What artery runs with LAD

A

great cardiac vein

64
Q

What artery runs with right marginal

A

small cardiac vein

65
Q

What artery runs with PDA

A

middle cardiac vein

66
Q

What vein of the heart will drain directly into the right atrium

A

anterior cardiac veins

67
Q

What levels are the sympathetic innervation to the heart

A

T1-T4 (5)

68
Q

Where are the preganglionic GVE cell bodies that go to the heart found

A

IML of T1-T4

69
Q

Where are the postganglionic GVE cell bodies that go to the heart found

A

cervical sympathetic chain

70
Q

Where are the cell bodies that sense pain in the heart located

A

DRG of T1-T4

71
Q

What type of neurons are contained within the sympathetic cardiac nerve

A

postganglionic GVE

GVA

72
Q

Where is referred pain from the heart located to

A

left chest and down left arm (T1-T4 dermatomes), up neck too

73
Q

What causes referred pain

A

convergence at DRG of GVA and GSA, and pain referred to GSA territory

74
Q

Where is pericardiocentesis performed

A

under the xiphoid process and slightly to the left

75
Q

What layers are traversed in pericardiocentesis

A

skin, superficial fascia, fibrous pericardium, parietal layer of serous pericardium

Exam 2 (14 decks)

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