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150 Cards in this Set

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mediastinum, organization
mediastinum is
central compartment of thoracic cavity
mediastinum, contents
all thoracic vicera, except the lungs
mediastinum, surrounded by
pleural cavitites
mediastinum estends from
superior thoracic aperture to diaphragm
mediastinum, in vivo is
highly mobile
mediastinum, effects of aging on
connective tissue becomes more fibrous and rigid
mediastinum, subdivisions
superior and inferior parts
mediastinum subdivided by
thransverse thoracic plane
transverse thoracic plane bisects
sternal angle
inferior mediastinum divided into
three parts: anterior, middle, postierior
location of contents in mediastinum, supine position
aortic arch superior to
transverse thoracic plane
trachial bifurcation transected by
transverse thoracic plane
central tendon of diaphragm lies at
level of xiphisternal junction (T9)
location of contents in mediastinum, standing position
aortic arch transected by
transverse thoracic plane
central tendon falls to
mid level of xiphoid process (IV disc between T9 and T10)
contents, superior mediastinum
superior vena cava, brachiocephalic veins, arch of aorta, thoracic duct, trachea, esophagus, thyms, left recurrent laryngeal nerve
contents, anterior mediastinum
remnants of thymus, lymph nodes, fat & connective tissue
contents, middle mediastinum
pericardium, phrenic nerves, heart & cardiac plexus, roots of great vessels, arch of azygos vein, main bronchi & tracheobronchial lymph nodes
contents, posterior mediastinum
esophagus, thoracic aorta, azygos & hemiazygos veins, thoracic duct, vagus nerves, sympathetic trunks, splanchnic nerves
middle mediastinum & contents
location, left ventricle
under 5th intercostal space
know locations for auscultation, slide 10
know how to ID structures, radiograph, slide 9
heart surrounded by
pericardial sac
between pericardial sac and pleura there is
a space
structures that traverse the space between the pericardial sac and pleura
pericardiacophrenic arteries and phrenic nerve
two portions of pericardium
outer fibrous and inner serous
fibrous pericardium continuous with
pretrachial layer of cervical fascia, tunica adventicia of great vessels, sternum, diaphragm, & structures in posterior mediastinum (loosely)
inner serous layer invaginated by
developing heart
inner serous layer becomes
visceral & parietal serous layer (a double layer)
space between two layers of serous pericardium is
pericardial cavity
ID pericardial sinus, vessels and nerves, slide 13
transverse sinus lies anterior to
superior vena cava
transverse sinus lies posterior to
the aorta & pulmonary trunk
location of transverse sinus important in
heart surgery
transverse pericardial sinus continuous from
left to right sides of heart
oblique pericardial sinus is a
blind pouch
pericardium, blood supply (main)
pericardiophrenic a.
pericardiophrenic a. is a branch of
the internal thoracic a.
pericardium, blood supply (minor)
musculophrenic a., coronary a., branches of thoracic aorta
musculophrenic a. is a terminal branch of
internal thoracic a.
coronary aa only supply _____ layer of pericardium
visceral layer of serous pericardium
venous drainage, pericardium
via pericardiocophrenic veins to brachiocephalic veins
pericardiophrenic veins also have tributaries to
azygos system
innervation of pericardium is via
phrenic nn (C3-C5)
phrenic nn to pericardium are
somatic (not visceral)
pain from pericardium referrs to
C3-C5 dermatomes
innervation of pericardium, minor
vagus n. (function unknown) & sympathetic trunks (vasomotor)
phrenic n passes anterior to
root of lung
vagus n passes posterior to
root of lung
pericardiacophrenic vessels & phrenic nn lie within
fibrous pericardium
cardiac muscle fibers arranged in
indistinct bundles that attach heavy fibrous connective tissue
fibrous skeleton of heart separates the
musculature of atria from ventricules
fibrous skeleton of heart, function
forms foundation to which the valves & myocardial fiber bundles are attached
4 fibrous rings of cardiac skeleton called
annuli fibrosi
annuli fibrosi are fused
to each other
superficial spiral bundles of the ventricles arise principally from
atrioventricular fibrous rings and from a vortex at apex
on the inside of the ventricles, fibers emerge from ventricles as
trabeculae carneae
trabeculae carneae aka
papillary muscles
deep spiral bundles attach to
fibrous rings
deep spiral buncles encircle one or both
ventricles
sternocostal surface of heart formed by
right ventricle & small part of right atrium
diapgragmatic surface of heart formed by
left ventricle & small part of right ventricle
base (posterior surface) of heart formed primarily by
left atrium & small part of right atrium
base (posterior surface) of heart lies anterior to
esophagus
anterior ulceration of esophagus can erode into
left atrium
right atrium, posterior wall, characteristic
smooth
right atrium, anterior portion, sturcture
pectinate muscle
fossa ovalis is
embryonic remnant of foramen ovale
memorize structures, slide 23
crista terminalis separates
smooth from rough walls of atrium
sulcus terminalis, location
exterior right atrium
sulcus terminalis is
a groove that marks the internal ridge of the crista terminalis
tricuspid valve aka
atrioventricular valve
tricuspid valve located
in right ventricle
3 papillary muscles
anterior, posterior, & septal
septomarginal trabecula
moderator band in right ventricle
memorize sturctures, slides 24, 25, 26
right ventricle, thickness
one third of that of left ventricle
left atrium forms
base of heart
left atrium, walls
primarily smooth except for pectinate myscle in auricle
left atrium, vessels
two superior and two inferior pulmonary veins
left atrium, depression
located on medial wall for valve of foramen ovale
left atrium, wall thickness
thicker than right atrium
left ventricle, valve
bicuspid valve
bicuspid valve aka
mitral or atrioventricular valve
left ventricle, papillary muscles
two, anterior & posterior
papillary muscles in left ventricles are larger than
those in right ventricle
trabeculae carneae are
finer & more numerous than in right ventricle
left ventricular wall is
2-3 times as thick as right ventricle
diastole, definition
dilation of heart cavities, during which they fill with blood
dilation of atria precedes
dilation of ventricles
visualize, slide 27
visualize, slide 28
systole, definition
contraction of the heart, especially the ventricles, by which blood is driven through aorta & pulmonary artery to traverse systemic & pulmonary circulations respectively
aortic valve, slide 29, visualize
slide 30, visualize
blood supply, innervation, & lymphatics
right coronary artery located in
atrioventricular groove
right coronary a. gives rise to
SA nodal & right marginal branches
left coronary artery divides into
circumflex & anterior interventricular branches
circumflex a. lies in
atrioventricular groove
anterior interventricular branch lies in
interventricular groove
great and small cardiac veins drain
the sternocostal surface of the heart along with the anterior cardiac veins
structure that receives the posterior interventricular and/or middle cardiac vein on the diaphragmatic surface of the heart
coronary sinus
receives small cardiac vein at its right end
coronary sinus
innervation of heart supplied by both
sympathetic and parasympathetic fibers
cardiac plexus located on
anterior surface of trachia at bifurcation and on anterior surface of aortic arch
sympathetic innervation of heart consists of
postganglionic fibers from cervical or upper thoracic ganglion
None
route of sympathetic nn to heart
preganglionic fibers frokm upper 4 or 5 thoracic segments --> sympathetic chain --> synapse in cervical or upper thoracic ganglion --> postganglionic fibers enter cardiac plexus
sympathetic nerves are
adrenergic (norepinephrine)
sympathetic innervation of heart cuases
increased heart rate and increased force of contraction
visceral affernts from sympathetics carry
pain back to spinal levels in which they originated
parasympathetic innervation of heart consists of
vagus nerve
parasympathetic nerves are
cholinergic (acetylcholine)
parasympathetic innervation of heart causes
heart rate to slow, force of contraction to decrease, and constriction of blood vessels
SA node, location
junction of superior vena cava and superior end of crista terminalis
SA node aka
pacemaker of heart
SA node initiates and regulates impulse of
70 beats per minute
fibers that supply SA node
sympathetic and parasympathetic fibers via the cardiac plexus
AV node located
in posteroinferior region of interarterial septum near orifice of coronary sinus
AV node receives impulses from
the SA node
AV node sends impulses to
ventricles via atrioventricular bundle
atrtioventricular bundle separates into
right and left bundles to respective ventricles
atrioventricular bundle bifurcation located at
junction of membranous & muscular parts of septum
lymphatics of heart form
networks adjacent to endocardium and epicardium
efferent lymphatic vessels of heart drain along
coronary aa
eferent lymphatic vessels of heart empty into
lymph nodes associated with the lower end of the trachea (tracheobronchial nodes)
clinical considerations
pericardiocentesis
process of removing fluid from pericardial sac via needle aspiration
pericarditis caused by
certain inflammatory diseases that produce a pericardial effusion (fluid) in the pericardial sac
pericarditis causes
chest pain
pericarditis results in
compression of heart and ineffective pumping because fibrous pericardium does not expand
fluid in pericardium aka
cardiac tamponade
cardiac tamponade, result
can be lethal if fluid is not removed from pericardial sac
dopplar flow used to
check for stenosis of arteries
atherosclerotic thickening of intimal layer of internal carotid a will
obstruct blood flow as a result of stenosis (narrowing)
partial occlusion of carotid a may result in
sudden dizziness & disorientation that disappears in 24 hours; may also cause a minor stroke
stenosis occurs in the
internal carotid a just superior to its origin
internal carotid a located proximal to
glossopharyngeal, vagus, accessory, hypoglossal, & superior laryngeal nn
arteriosclerosis is
hardening of the arteries
types of arteriosclerosis
atherosclerosis, Monckeberg's atherosclerosis, and arteriolosclerosis (small vessels)
atherosclerosis is a common form of
arteriosclerosis
atherosclerosis is associated with
buildup of fat (cholesterol) in arterial walls
in atherosclerosis, calcium deposits foorm
atheromatous plawues that can result in formation of thrombi
transverse pericardial sinus is location where
once pericardial sac is opened, one can place a clampe or ligature around great vessels during coronary bypass, heart transplant, etc.
great vessels anterior to transverse pericardial sinus
ascending aorta & pulmonary trunk