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Anatomy > Thorax + Heart > Flashcards

Thorax + Heart Flashcards

1
Q

Discuss how the blood moves through the heart starting at the right atrium

A

(1. ) RA –> RV –> PA –> lungs

(2. ) lungs –> PV –> LA –> LV –> aorta –> rest of the body

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2
Q

What is the name of the valves that lie between the atrium and ventricles on the right?

A

Tricuspid valves

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3
Q

What structures form the left border and right border of the heart?

A 
Left = LV and left auricular appendage (+PA)
Right = SVC, IVC, R.auricle
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4
Q

What is the thoracic duct?

A

(1. ) Lymphatic vessel that drain inferior body + bowel (aside from the right upper limb, right breast, right lung and right side of the head and neck)
(2. ) Drained into the systemic circulation via junction between left subclavian and internal jugular vein
(3. ) Only route for fat absorption

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5
Q

What structure connects the umbilical vein to IVC?

A
  • ductus venosus allows for blood from umbillical vein into the IVC
  • Umbilical vein is carrying oxygenated blood from placenta to fetus.
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6
Q

What are the ductus arteriosus + foramen ovale?

A

(1. ) The ductus arteriosus connects the aorta to the pulmonary trunk.
(2. ) The foramen ovale connects the right atrium to the left atrium.

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7
Q

Where is the SAN found?

A

(1. ) Crista terminalis

(2. ) Ridge in right auricle.

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8
Q

What clinical significant about the right bronchus compared to the left?

A

Left bronchus is more horizontal in shape so foreign bodies are less likely to fall into it.

Instead, they will pass down the more vertical right bronchus

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9
Q

Describe the fetal circulation in the following:

(a. ) Ductus arteriosus
(b. ) Ductus venosus
(c. ) Fossa ovale
(d. ) Umbilical vein
(e. ) Umbilical arteries

A

(1. ) Ductus arteriosus connect PA to aorta so blood bypasses the lungs
(2. ) Ductus venosus connects umbilical vein to IVC so bypasses liver.
(3. ) Foramen ovale connects RA to LA.
(4. ) Umbilical vein connects umbilicus to the porta hepatis + IVC. This carries oxygenated blood from the placenta.
(5. ) Umbilical arteries (x2) carries deoxygenated blood to the placenta.

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10
Q

Describe the parts of the heart supplied by the coronary arteries

A

(1. ) RA = RCA
(2. ) RV = RCA, RMA, PDA, LADA
(3. ) LA = LCA, LCX
(4. ) LV = LCA, LCX, LADA, PDA
(5. ) Septum = LADA
(6. ) Apex = RMA

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11
Q

Describe the semi-lunar valves during systole and diastole

A

Systole
(1.) SLV are flushes against arterial wall as blood ejects out

Diastole

(2. ) Ventricle relax + blood falls back and pools into the SLV cusps so they force shut.
(3. ) The pool of blood feeds into the coronary artery.

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12
Q

Describe the internal structures and features inside the heart

A

(1. ) Texture of the walls:
- Smooth walls in the atrium
- Fossa ovale found in RA
- trabeculae structures found in the ventricles
- musculi pectini: ridges within inner wall of auricular appendages
- smooth cavity within the infundibulum

(2. ) Valves
- Chordae tendinae = prevents valve regurigation on ventricular contraction
- Papillary muscles
- MV = 2 cusps, SLV, TV = 3 cusps

(3. ) Other
- Moderator band found in RV, comprises of purkinje fibres.

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13
Q

Coronary Sinus: where is it found? where does it drain into?

A

(1. ) Left coronary sulcus = groove between LA + LV. LCX artery is also found here
(2. ) Coronary sinus drains the heart’s venous blood into the RA

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14
Q

What coronary artery supplies the SAN and AVN

A

(1. ) SAN = RCA (60%) or LCA (40%)
(2. ) AVN = RCA
(3. ) Disease in these arteries will cause electrical blockage

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15
Q

Describe coronary dominance

A

(1.) Coronary dominance is determined by which coronary a. the PAD arises from. PDA can arise from the following:

(2. ) RCA = right dominance (90%)
(3. ) LCX = left dominance (30%)
(4. ) Co-dominance = equal supply from L + R to PDA (20%)

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16
Q

Describe what would happen if there was poor blood supply to the papillary muscle

A

(1. ) Infarction and then rupture of dead papillary muscle
(2. ) Leads to failure of MV
(3. ) So blood will leak back into the LA (mitral valve disease)
(4. ) TOE used to provide images and measurements of MV function

17
Q

Describe the surface marking of the heart for auscultation.

A
  • Mitral valve + Apex: 5th ICS in midclavicular line.
  • Tricuspid valve: 4th/5th ICS at left sternal edge.
  • Pulmonary valve: 2nd ICS at left sternal edge.
  • Aortic valve: 2nd ICS at right sternal edge.
18
Q

Describe the branches off the aortic arch

A

(1. ) Brachiocephalic Trunk -> R.Subclavian A + R.CCA
(2. ) L.CCA
(3. ) L.Subclavian A -> Vertebral, internal thoracic, thyrocervical, costocervical

19
Q

Describe SVC and their tributaries

A

(1. ) Right side of thorax
- drains into intercostal v
- drains into azygous vein
- drains into SVC

(2. ) Left side of thorax
- drains into intercostal v
- drains into hemizygous vein
- drains into azygous then SVC

20
Q

Hiatus and foramina in diaphragms

A
  • Diaphragm attaches to all the inferior border of the ribs
  • Crus attach to L2, 3, 4
  • T8 = IVC
  • T10 = Oesophagus
  • T12 = Aorta
21
Q

What are the accessory muscles for inspiration and expiration?

A

Accessory muscles of expiration

  • Acts to depress the ribs
  • Rectus abdominis, internal oblique, transversus abdominis, and external oblique.

Accessory muscles of inspiration
- sternocleidomastoid, scalenes, pectoralis major and minor, latissimus dorsi, serratus anterior and serratus posterior superior.

22
Q

What structures (7) are found within the hilum of the lungs?

A
  • Main bronchus
  • PA
  • PV
  • Bronchial A.
  • Lymphatic vessels
  • Vagus branch
  • Sympathetic nerves
23
Q

Describe the lobes and fissures in the lungs

A

Right lobe

  • three lobes: superior, middle, inferior lobes
  • horizontal + oblique fissure

Left lobe

  • two lobes: superior, inferior
  • oblique fissure
24
Q

What is the pleura innervated by?

A

(1. ) Visceral pleura = pulmonary plexus of CNX (PNS) and SNS fibres - these detect stretch
(2. ) Parietal pleura = T1-T12 (dermatomes) - these detect pressure, pain, temp.

Note: phrenic nerve supplies mediastinal pleura

25
Q

What lines the lungs?

A

(1. ) Pleural is double layered serous mb
(2. ) Parietal pleura lines the thoracic cage
(3. ) Visceral pleura lines the lungs and fissures
(4. ) There is space between both pleuras which contains serous fluid.
- This lubricates + alongs for lungs to move
- Creates surface tension which ensures the thorax expands as the lungs do too.

26
Q

What is IC recession?

A
  • partial blockage in airways so air can’t flow freely
  • this causes reduced air pressure inside chest
  • so during inspiration ICM are sucked inside
27
Q

What is a collapsed lung (pneumothorax)?

A

(1. ) Air enters the cavity, ST is lost

(2. ) Sx = chest pain, SoB, asymmetric chest expansion

28
Q

What are pleural recesses?

A
  • These are areas where fluid can collect e.g. pulmonary oedema
  • Usually collects where there is opposing surfaces of parietal pleura touch such as at the costodiaphragmatic.
  • CXR would show costophrenic angle blunting
29
Q

What muscles are involved in quiet and forced inspiration

A

Quiet/normal inspiration

  • Diaphragm: contracts + flattens
  • External ICM: elevates ribs + inc thoracic vol

Forced/Active inspiration

  • Accessory muscles acts to elevate the ribs
  • Pec major and minor
  • Sternocleidomastoid
  • latissimus dorsi
  • serratus anterior
30
Q

What muscles are involved in quiet and forced expiration

A

Quiet/normal expiration
- internal ICM: depress ribs

Forced expiration: ABDO MUSCLES

  • Accessory muscles acts to depress the ribs
  • Rectus abdominis, internal oblique, transversus abdominis, and external oblique.
31
Q

Name structure responsible for the apex beat normally palpated in the left 5th intercostal space and midclavicular line

A

Left ventricle

32
Q

Name the structure that maintains the systemic diastolic blood pressure by preventing backflow of blood into the heart during diastole

A

Aortic valves

Anatomy (8 decks)

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