Anatomy_ heart and middle med.txt

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Anatomy_ heart and middle med.txt
2011-01-08 22:21:53

Heart and middle mediadstinum
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  1. What is located in the middle mediastinum?
    • pericardium
    • heart
    • ascending aorta
    • pulmonary trunk
    • SVC
    • arch of the azogus
    • main bronchi
  2. What ribs does the pericardium lie behind
    2nd to 6th coastal cartilage
  3. What vertebral levels does the pericardium lie?
  4. Attachments of the fibrous pericardium
    • fused with the tunica adventitia of the great vessels
    • posterior surface of the sternum by the sternopericardial ligaments
    • fused with the central tendon of the diaphragm
  5. What does the fibrous pericardium protect the heart from?
  6. The pericardial cavity
    • between the parietal and visceral layers of the serous pericardium
    • allows for frictionless movement of the heart
  7. What forms the epicardium
    visceral pericardium
  8. Two sinuses in the middle mediastinum
    • transverse
    • oblique
  9. Arterial supply of the pericardium
    • mainly the pericardiacophrenic artery, a branch of the internal thoracic
    • small contributions from the musculophrenic artery, the terminal branch of the internal thoracic
    • coronary arteries supply the visceral layer
    • small branches off the aorta; bronchial, esophageal and phrenic
  10. venous drainage of the pericardium
    • pericardiacophrenic vein
    • azygus
  11. Nerve supply of the pericardium
    • phrenic nerve, C5-C8; sensory, pain refereed to the shoulder
    • vegas nerve
    • sympothetic trunk
  12. Surgical importance of the transverse sinus
    cardiac surgery, separates the inflow from the outflow
  13. What is paricarditis
    • Inflammation of the pericardium
    • causes chest pain
    • can cause pericardial friction rub
  14. What is pericardial effusion?
    • passage of fluid from the pericardial capillaries into the pericardial sinus
    • caused by inflammation
    • can compress the heart
  15. Cardiac tamponade
    fluid enters the fibrous pericardium and since the pericardium is not elastic the fluid compresses the heart and decreases filling
  16. drainage of fluid from the pericardial cavity
    • pericardiocentesis
    • 5th or 6th intercostal space near the sternum
  17. level of the aortic arch
    • standing; T4/T5
    • supine; T2/T3
  18. The apex of the heart
    • directed anteriorly and to the left, formed by the inferior part of the left ventricle
    • posterior to the 5th intercostal space, 9cm from the median plane
    • hear the sound of mitral valve closure
  19. The base of the heart
    • the hearts posterior aspect
    • mainly left atrium with a little right atrium
    • faces posteriorly toward the vertebrae, T6-T9, separated by the esophagus and aorta
    • superior to the bifurcation of pulmonary trunk and inferior to the coronary groove
    • receives the pulmonary veins and both vena cave
  20. the four surfaces of the heart
    • anterior; right ventricle
    • diaphragmatic (inferior); left ventricle and some of the right. associated with the central tendon
    • Left pulmonary; LV
    • Right pulmonary surface; right atrium
  21. Four borders of the heart
    • right; right atrium
    • left; LV and some left atrial appendage (auricle)
    • Inferior; right ventricle
    • superior; right and left atria,
  22. The right auricle represents?
    the primordial atrium
  23. Smooth part of the right atrium
    the sinus venarum
  24. The coronary sinus is a derivative?
    of the embryonic venous sinus
  25. Structure that separates the right atrium from the auricle
    • sulcus terminals externally
    • crista terminalis internally
  26. Musclular part of the right atrium
    pectinate muscle
  27. level of the opening of the SVC
    3rd costal cartilage
  28. level of the IVC opening
    5th costal cartilage
  29. Outflow of the right ventricle
    conus arteriosus (infundibulum)
  30. Muscular elevations of the RV
  31. what separates the muscular inflow of the RV from the smooth outflow?
    the supraventricular crest
  32. three leaflets of the tricuspid valve
    • anterior
    • posterior
    • septal
  33. Two parts of the intervetricular septum
    • membranous part
    • muscular part
  34. What carries the conduction form the IV septum to the papillary muscles
    • the moderator band (septomarginal trabecula)
    • to the anterior papillary muscle
  35. level of the pulmonary valve
    3rd costal cartilage
  36. function of pulmonary sinus
    to allow blood to get behind pulmonary valve leaflets so they do not stick to the walls
  37. The interior of the left atrium
    • large smooth wall and a small pectinate muscle
    • four pulmonary veins
    • thicker wall then right atrium
  38. The smooth wall of the left atrium is formed by?
    • absorption of parts of the embryonic pulmonary veins
    • the rough wall is the primordial left atrium
  39. Outflow tract of the LV
    aortic vestibule
  40. level of the mitral valve
    fourth costal cartilage
  41. Level of the aortic valve
    3rd costal cartilage
  42. Most prevalent congenital heart defect
  43. Most frequent valve abnormality
    • aortic stenosis
    • results in LV hypertrophy
  44. surface anatomy of the heart
    • superior border; line from the inferior 2nd left costal cartilage to the superior part of the right 3rd costal cartilage
    • right border; 3-6 costal cartilage
    • inferior border;
    • left
  45. Areas of auscultation for the heart?
    • aortic valve; second intercostal space to the right of the sternum
    • pulmonary valve ; second intercostal space to the left of the sternum
    • tricuspid valve; fifth intercostal space on left sternal border
    • mitral valve; apex of the heart, fit intercostal space
  46. The RCA supplies
    • right atrium
    • most of the right ventricle
    • part of LV, diaphragmatic surface
    • posterior IV septum
    • SA node, 60%
    • AV node, 80%
  47. LCA supplies
    • the left atrium
    • LV
    • anterior IV septum
  48. lymphatic drainage of the heart
    • lymph vessels of the heart pass to the subepicardial lymph plexus
    • this vessels runs posterior and superior from the heart to the inferior tracheobronchial lymph nodes
  49. location of the SA node
    • anteriolateral wall
    • just deep to the epicardium at the junction of the SVC and the right atrium
    • the superior end of the sulcus terminals
  50. location of the AV node
    • posteroinferior of the intertribal septum
    • near the opening of the coronary sinus
  51. Autonomic innervation of the heart?
    • superficial and deep cardiac plexuses
    • located anterior to the bifurcation of the trachea and posterior to the ascending aorta
  52. Sympathetic innervation of the heart
    • T1-T5
    • postsynaptic cell bodies in the cervical and superior thoracic paravertibral ganglia
    • SA and AV node
    • indirectly diolates coronary vessels
  53. Parasympathetic to the heart
    • vagus nerve
    • SA and AV node
  54. three most common spots of coronary occlusion
    • LAD
    • RCA
    • Cx
  55. Dominance
    • Rt- 65%
    • Lt- 15%
    • CO-18%