Anatomy: Heart & Middle Mediastinum

Front 1

mediastinum, organization

Front 2

mediastinum is

Back 2

central compartment of thoracic cavity

Front 3

mediastinum, contents

Back 3

all thoracic vicera, except the lungs

Front 4

mediastinum, surrounded by

Back 4

pleural cavitites

Front 5

mediastinum estends from

Back 5

superior thoracic aperture to diaphragm

Front 6

mediastinum, in vivo is

Back 6

highly mobile

Front 7

mediastinum, effects of aging on

Back 7

connective tissue becomes more fibrous and rigid

Front 8

mediastinum, subdivisions

Back 8

superior and inferior parts

Front 9

mediastinum subdivided by

Back 9

thransverse thoracic plane

Front 10

transverse thoracic plane bisects

Back 10

sternal angle

Front 11

inferior mediastinum divided into

Back 11

three parts: anterior, middle, postierior

Front 12

location of contents in mediastinum, supine position

Front 13

aortic arch superior to

Back 13

transverse thoracic plane

Front 14

trachial bifurcation transected by

Back 14

transverse thoracic plane

Front 15

central tendon of diaphragm lies at

Back 15

level of xiphisternal junction (T9)

Front 16

location of contents in mediastinum, standing position

Front 17

aortic arch transected by

Back 17

transverse thoracic plane

Front 18

central tendon falls to

Back 18

mid level of xiphoid process (IV disc between T9 and T10)

Front 19

contents, superior mediastinum

Back 19

superior vena cava, brachiocephalic veins, arch of aorta, thoracic duct, trachea, esophagus, thyms, left recurrent laryngeal nerve

Front 20

contents, anterior mediastinum

Back 20

remnants of thymus, lymph nodes, fat & connective tissue

Front 21

contents, middle mediastinum

Back 21

pericardium, phrenic nerves, heart & cardiac plexus, roots of great vessels, arch of azygos vein, main bronchi & tracheobronchial lymph nodes

Front 22

contents, posterior mediastinum

Back 22

esophagus, thoracic aorta, azygos & hemiazygos veins, thoracic duct, vagus nerves, sympathetic trunks, splanchnic nerves

Front 23

middle mediastinum & contents

Front 24

location, left ventricle

Back 24

under 5th intercostal space

Front 25

know locations for auscultation, slide 10

Front 26

know how to ID structures, radiograph, slide 9

Front 27

heart surrounded by

Back 27

pericardial sac

Front 28

between pericardial sac and pleura there is

Back 28

a space

Front 29

structures that traverse the space between the pericardial sac and pleura

Back 29

pericardiacophrenic arteries and phrenic nerve

Front 30

two portions of pericardium

Back 30

outer fibrous and inner serous

Front 31

fibrous pericardium continuous with

Back 31

pretrachial layer of cervical fascia, tunica adventicia of great vessels, sternum, diaphragm, & structures in posterior mediastinum (loosely)

Front 32

inner serous layer invaginated by

Back 32

developing heart

Front 33

inner serous layer becomes

Back 33

visceral & parietal serous layer (a double layer)

Front 34

space between two layers of serous pericardium is

Back 34

pericardial cavity

Front 35

ID pericardial sinus, vessels and nerves, slide 13

Front 36

transverse sinus lies anterior to

Back 36

superior vena cava

Front 37

transverse sinus lies posterior to

Back 37

the aorta & pulmonary trunk

Front 38

location of transverse sinus important in

Back 38

heart surgery

Front 39

transverse pericardial sinus continuous from

Back 39

left to right sides of heart

Front 40

oblique pericardial sinus is a

Back 40

blind pouch

Front 41

pericardium, blood supply (main)

Back 41

pericardiophrenic a.

Front 42

pericardiophrenic a. is a branch of

Back 42

the internal thoracic a.

Front 43

pericardium, blood supply (minor)

Back 43

musculophrenic a., coronary a., branches of thoracic aorta

Front 44

musculophrenic a. is a terminal branch of

Back 44

internal thoracic a.

Front 45

coronary aa only supply _____ layer of pericardium

Back 45

visceral layer of serous pericardium

Front 46

venous drainage, pericardium

Back 46

via pericardiocophrenic veins to brachiocephalic veins

Front 47

pericardiophrenic veins also have tributaries to

Back 47

azygos system

Front 48

innervation of pericardium is via

Back 48

phrenic nn (C3-C5)

Front 49

phrenic nn to pericardium are

Back 49

somatic (not visceral)

Front 50

pain from pericardium referrs to

Back 50

C3-C5 dermatomes

Front 51

innervation of pericardium, minor

Back 51

vagus n. (function unknown) & sympathetic trunks (vasomotor)

Front 52

phrenic n passes anterior to

Back 52

root of lung

Front 53

vagus n passes posterior to

Back 53

root of lung

Front 54

pericardiacophrenic vessels & phrenic nn lie within

Back 54

fibrous pericardium

Front 55

cardiac muscle fibers arranged in

Back 55

indistinct bundles that attach heavy fibrous connective tissue

Front 56

fibrous skeleton of heart separates the

Back 56

musculature of atria from ventricules

Front 57

fibrous skeleton of heart, function

Back 57

forms foundation to which the valves & myocardial fiber bundles are attached

Front 58

4 fibrous rings of cardiac skeleton called

Back 58

annuli fibrosi

Front 59

annuli fibrosi are fused

Back 59

to each other

Front 60

superficial spiral bundles of the ventricles arise principally from

Back 60

atrioventricular fibrous rings and from a vortex at apex

Front 61

on the inside of the ventricles, fibers emerge from ventricles as

Back 61

trabeculae carneae

Front 62

trabeculae carneae aka

Back 62

papillary muscles

Front 63

deep spiral bundles attach to

Back 63

fibrous rings

Front 64

deep spiral buncles encircle one or both

Back 64

ventricles

Front 65

sternocostal surface of heart formed by

Back 65

right ventricle & small part of right atrium

Front 66

diapgragmatic surface of heart formed by

Back 66

left ventricle & small part of right ventricle

Front 67

base (posterior surface) of heart formed primarily by

Back 67

left atrium & small part of right atrium

Front 68

base (posterior surface) of heart lies anterior to

Back 68

esophagus

Front 69

anterior ulceration of esophagus can erode into

Back 69

left atrium

Front 70

right atrium, posterior wall, characteristic

Back 70

smooth

Front 71

right atrium, anterior portion, sturcture

Back 71

pectinate muscle

Front 72

fossa ovalis is

Back 72

embryonic remnant of foramen ovale

Front 73

memorize structures, slide 23

Front 74

crista terminalis separates

Back 74

smooth from rough walls of atrium

Front 75

sulcus terminalis, location

Back 75

exterior right atrium

Front 76

sulcus terminalis is

Back 76

a groove that marks the internal ridge of the crista terminalis

Front 77

tricuspid valve aka

Back 77

atrioventricular valve

Front 78

tricuspid valve located

Back 78

in right ventricle

Front 79

3 papillary muscles

Back 79

anterior, posterior, & septal

Front 80

septomarginal trabecula

Back 80

moderator band in right ventricle

Front 81

memorize sturctures, slides 24, 25, 26

Front 82

right ventricle, thickness

Back 82

one third of that of left ventricle

Front 83

left atrium forms

Back 83

base of heart

Front 84

left atrium, walls

Back 84

primarily smooth except for pectinate myscle in auricle

Front 85

left atrium, vessels

Back 85

two superior and two inferior pulmonary veins

Front 86

left atrium, depression

Back 86

located on medial wall for valve of foramen ovale

Front 87

left atrium, wall thickness

Back 87

thicker than right atrium

Front 88

left ventricle, valve

Back 88

bicuspid valve

Front 89

bicuspid valve aka

Back 89

mitral or atrioventricular valve

Front 90

left ventricle, papillary muscles

Back 90

two, anterior & posterior

Front 91

papillary muscles in left ventricles are larger than

Back 91

those in right ventricle

Front 92

trabeculae carneae are

Back 92

finer & more numerous than in right ventricle

Front 93

left ventricular wall is

Back 93

2-3 times as thick as right ventricle

Front 94

diastole, definition

Back 94

dilation of heart cavities, during which they fill with blood

Front 95

dilation of atria precedes

Back 95

dilation of ventricles

Front 96

visualize, slide 27

Front 97

visualize, slide 28

Front 98

systole, definition

Back 98

contraction of the heart, especially the ventricles, by which blood is driven through aorta & pulmonary artery to traverse systemic & pulmonary circulations respectively

Front 99

aortic valve, slide 29, visualize

Front 100

slide 30, visualize

Front 101

blood supply, innervation, & lymphatics

Front 102

right coronary artery located in

Back 102

atrioventricular groove

Front 103

right coronary a. gives rise to

Back 103

SA nodal & right marginal branches

Front 104

left coronary artery divides into

Back 104

circumflex & anterior interventricular branches

Front 105

circumflex a. lies in

Back 105

atrioventricular groove

Front 106

anterior interventricular branch lies in

Back 106

interventricular groove

Front 107

great and small cardiac veins drain

Back 107

the sternocostal surface of the heart along with the anterior cardiac veins

Front 108

structure that receives the posterior interventricular and/or middle cardiac vein on the diaphragmatic surface of the heart

Back 108

coronary sinus

Front 109

receives small cardiac vein at its right end

Back 109

coronary sinus

Front 110

innervation of heart supplied by both

Back 110

sympathetic and parasympathetic fibers

Front 111

cardiac plexus located on

Back 111

anterior surface of trachia at bifurcation and on anterior surface of aortic arch

Front 112

sympathetic innervation of heart consists of

Back 112

postganglionic fibers from cervical or upper thoracic ganglion

Hint 112

None

Front 113

route of sympathetic nn to heart

Back 113

preganglionic fibers frokm upper 4 or 5 thoracic segments --> sympathetic chain --> synapse in cervical or upper thoracic ganglion --> postganglionic fibers enter cardiac plexus

Front 114

sympathetic nerves are

Back 114

adrenergic (norepinephrine)

Front 115

sympathetic innervation of heart cuases

Back 115

increased heart rate and increased force of contraction

Front 116

visceral affernts from sympathetics carry

Back 116

pain back to spinal levels in which they originated

Front 117

parasympathetic innervation of heart consists of

Back 117

vagus nerve

Front 118

parasympathetic nerves are

Back 118

cholinergic (acetylcholine)

Front 119

parasympathetic innervation of heart causes

Back 119

heart rate to slow, force of contraction to decrease, and constriction of blood vessels

Front 120

SA node, location

Back 120

junction of superior vena cava and superior end of crista terminalis

Front 121

SA node aka

Back 121

pacemaker of heart

Front 122

SA node initiates and regulates impulse of

Back 122

70 beats per minute

Front 123

fibers that supply SA node

Back 123

sympathetic and parasympathetic fibers via the cardiac plexus

Front 124

AV node located

Back 124

in posteroinferior region of interarterial septum near orifice of coronary sinus

Front 125

AV node receives impulses from

Back 125

the SA node

Front 126

AV node sends impulses to

Back 126

ventricles via atrioventricular bundle

Front 127

atrtioventricular bundle separates into

Back 127

right and left bundles to respective ventricles

Front 128

atrioventricular bundle bifurcation located at

Back 128

junction of membranous & muscular parts of septum

Front 129

lymphatics of heart form

Back 129

networks adjacent to endocardium and epicardium

Front 130

efferent lymphatic vessels of heart drain along

Back 130

coronary aa

Front 131

eferent lymphatic vessels of heart empty into

Back 131

lymph nodes associated with the lower end of the trachea (tracheobronchial nodes)

Front 132

clinical considerations

Front 133

pericardiocentesis

Back 133

process of removing fluid from pericardial sac via needle aspiration

Front 134

pericarditis caused by

Back 134

certain inflammatory diseases that produce a pericardial effusion (fluid) in the pericardial sac

Front 135

pericarditis causes

Back 135

chest pain

Front 136

pericarditis results in

Back 136

compression of heart and ineffective pumping because fibrous pericardium does not expand

Front 137

fluid in pericardium aka

Back 137

cardiac tamponade

Front 138

cardiac tamponade, result

Back 138

can be lethal if fluid is not removed from pericardial sac

Front 139

dopplar flow used to

Back 139

check for stenosis of arteries

Front 140

atherosclerotic thickening of intimal layer of internal carotid a will

Back 140

obstruct blood flow as a result of stenosis (narrowing)

Front 141

partial occlusion of carotid a may result in

Back 141

sudden dizziness & disorientation that disappears in 24 hours; may also cause a minor stroke

Front 142

stenosis occurs in the

Back 142

internal carotid a just superior to its origin

Front 143

internal carotid a located proximal to

Back 143

glossopharyngeal, vagus, accessory, hypoglossal, & superior laryngeal nn

Front 144

arteriosclerosis is

Back 144

hardening of the arteries

Front 145

types of arteriosclerosis

Back 145

atherosclerosis, Monckeberg's atherosclerosis, and arteriolosclerosis (small vessels)

Front 146

atherosclerosis is a common form of

Back 146

arteriosclerosis

Front 147

atherosclerosis is associated with

Back 147

buildup of fat (cholesterol) in arterial walls

Front 148

in atherosclerosis, calcium deposits foorm

Back 148

atheromatous plawues that can result in formation of thrombi

Front 149

transverse pericardial sinus is location where

Back 149

once pericardial sac is opened, one can place a clampe or ligature around great vessels during coronary bypass, heart transplant, etc.

Front 150

great vessels anterior to transverse pericardial sinus

Back 150

ascending aorta & pulmonary trunk