CVS DR1: Mediastinum, Pericardium, Chambers of the heart Flashcards

1
Q

What cavities are enclosed in the thoracic walls?

A

2 pleural cavities and the mediastinum

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2
Q

How much of the thorax does the mediastinum contain?

Basic

A

Everything other than the lungs and their associated pleura

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3
Q

What are the sections of the thorax?

A

Superior

Inferior:

  • Anterior
  • Middle
  • Posterior
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4
Q

What kinda important organ is NOT contained in the superior mediastinum?

A

The Heart

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5
Q

What encloses the superior mediastinum, anteriorly and posteriorly?

A

Manubrium - Ant.

Vertebrae T1-T4 - Post.

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6
Q

Which plane separates superior and inferior mediastinum?

A

Transverse

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7
Q

What arteries are contained in the superior mediastinum?

A

Aortic arch

Brachiocephalic

Left Common Carotid

Left Subclavian

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8
Q

What veins are contained in the superior mediastinum?

A

Brachiocephalic

Superior vena cava

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9
Q

What major nerves pass through the superior mediastinum?

A

Vagus

Phrenic

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10
Q

What other organs and structures are present in the superior mediastinum?

A

Trachea & Oesophagus

Thoracic duct - lymphatics

Thymus gland

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11
Q

Describe the arrangement of the inferior pericardium, and it’s sections

A

Anterior section is the area between the sternum and the pericardium

Middle section is basically the pericardium

Posterior section is the area behind the pericardium

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12
Q

What is in the anterior mediastinum?

A

Thymus - behind the sternum

Lymph nodes

Fat

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13
Q

What is in the middle mediastinum?

A

Heart, pericardium

Great vessels

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14
Q

What is in the posterior mediastinum?

A

Oesophagus & vagus nerve

Azygos vein

Descending aorta

Sympathetic trunk

Thoracic duct

Splanchnic nerve

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15
Q

What are the 2 layers of the pericardium?

A

Fibrous & serous

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16
Q

Describe the serous pericardia

A

Innermost of the Fibrous & serous pericardia

Composed of 2 layers with fluid filled cavity separating them:

  • Parietal (outer) layer
  • Visceral (inner) layer = epicardium
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17
Q

Describe the fibrous pericardia

A

Outermost of the Fibrous & serous pericardia

Inner edge is in contact with parietal layer of serous pericardium

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18
Q

From the outermost layer of the pericardium:

List the layers moving inwards, until the innermost layer of the heart

A
  • Fibrous pericardium
  • Parietal layer of serous pericardium

Pericardial cavity

  • Visceral layer of serous pericardium = epicardium
  • Myocardium
  • Endocardium
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19
Q

What are the main features of the right atrium?

A

3 Openings for:

  • Inferior Vena cava
  • Superior vena cava
  • Coronary sinus

Interarterial septum

Fossa ovalis in Interarterial septum

Musculi pectinati & crista terminalis

Tricuspid valve

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20
Q

What features would you look for to identify the right ventricle?

A

Tricuspid valve:

  • 3 valve cusps
  • Chordae tendineae
  • Papillary muscles x3

Trabeculae carneae (contractile fleshy struts)

Moderator band (Septomarginal trabeculum)

1 Opening for pulmonary trunk

Interventricular septum

21
Q

What is the purpose of the Trabeculae carneae?

A

Most likely to prevent suction that would occur with a flat surface and thus impair the heart’s ability to pump efficiently. The papillary muscles themselves are just a specialised form of trabeculae carneae.

22
Q

What are the main features used to identify the left atrium?

A

4 Openings for:
l + r superior pulmonary veins
l + r inferior pulmonary veins

Bicuspid (mitral) valve

Smooth-walled, small chamber,
lying wholly postero-superiorly against
oesophagus.

Forms base of heart.

23
Q

What are the main identification features of the left ventricle?

A

Biscuspid (mitral valve):
2 valve cusps
Chordae tendineae
Papillary muscles x2

Trabeculae carneae

1 Opening for aorta

Interventricular septum

Wall 3x as thick as right ventricular wall.

Forms apex of heart

24
Q

Describe the vertebral level of the heart

A

T5-8

Middle 4 vertebrae^

(when in recumbent position)

25
Q

Where is the apex of the heart?

A

5th Left intercostal space

In the midclavicular line

26
Q

What forms the base of the heart?

A

Left atrium

This lies wholly posterior, and against the oesophagus

27
Q

What forms the right border of the heart?

A

Superior Vena cava & right atrium

28
Q

What forms the left border of the heart?

A

Aortic arch and left ventricle

29
Q

The surface anatomy ‘area’ of the heart is a weird box thing

What forms each corner and where is it located on the surface?

A

Apex (bottom left) - 5th IC space in Midclavic. line

Upper left - End of 2nd left rib, in line with Sternal angle

Upper right - Intercostal cart of 3rd rib

Bottom right - IC cartilage of 6th right rib, in line with bottom of body of sternum

30
Q

What are the main arteries located in the chest wall and trunk?

A

Descending aorta

Internal thoracic artery:
- This gives off branches of Anterior intercostal arteries

31
Q

What are the main veins of the chest wall and trunk?

A

Inferior vena cava

Azygos vein

Internal thoracic vein:
- Receives anterior thoracic veins

32
Q

What lymph vessel would you look for in the chest wall and trunk?

Where is this located?

A

Thoracic duct

Runs just behind the Aorta

33
Q

What is the endocardium composed of?

A

Simple squamous epithelium sitting on basement membrane

Sits on connective tissue

34
Q

What is the mycocardium made of?

A

Many layers of cardiac muscle (myocytes)

35
Q

What is the Epicardium (visceral serous) made of?

A

Simple squamous epithelium sitting on BM with connective tissue

May have fatty layer separating it from the myocardium

36
Q

What is cardiac tamponade?

A

When excess fluid accumulates in the pericardial cavity (many reasons why this can happen)

Increased pressure exerted by fluid onto the heart reduces the filling of the heart

Can lead to cardiac failure if severe enough

37
Q

Describe the nervous innervation of the VISCERAL pericardium

A

Autonomic innervation from:

  • T1-T4 nerves
  • Vagus nerve via cardiac plexus (same as heart wall itself)
38
Q

Describe the nervous innervation of the Parietal and fibrous layers of the pericardium

A

Innervated mainly by the Phrenic nerve

39
Q

Which layers of the pericardium can detect pain?

A

Parietal layer of serous & the Fibrous layer

They’re innervated by phrenic whereas the visceral serous layer only receives autonomic innervation

40
Q

What nerves link to the cardiac plexus?

A

Vagus nerve (branches of)

Nerves from Sympathetic trunk:

  • Middle cervical ganglion
  • Stellate ganglion
  • T2
  • T3
  • T4
41
Q

What chamber of the heart contains the fossa ovalis?

What is it?

A

Contained in the right atrium

Remnant of the foramen ovale which closes after birth

Was basically a passage from the right to left atria to avoid the pulmonary circulation which the foetus did not need when in the womb

42
Q

The right atrium has an ‘auricle’

What is this?

A

Flappy bit at the top of the atrium

43
Q

What separates the two atria?

A

Interatrial septum

44
Q

What is the name of the bumpy, pure stringy muscle section on the walls of the atria?

A

Musculi pectinati

45
Q

What is the name given to the large ridge/bump thing that is found at the end of the musculi pectinati?

A

Crista terminalis

crista sort of means ridge

46
Q

What is the correlation between the number of cusps in a valve, and the number of papillary muscles in the ventricle

A

For each cusp, there is one papillary muscle attached to it

47
Q

The moderator band (septomarginal trabeculum) is found in the right ventricle.

What is it’s function?

A

It carries the right bundle branch from the AV node to the papillary muscles in the RV

This means contraction of papillary muscles is coordinated with heart contraction, meaning the valve doesn’t invert

48
Q

What is the difference between Musculi pectinati and trabecullae carnae?

A

They have the same appearance, columned, stringy walls of muscle

However, the Musculi P are only in the atria and the Trabecullae C are only in the ventricles

49
Q

What valve separates the left ventricle and left atrium?

A

Mitral valve

bicuspid