Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
286 Cards in this Set
- Front
- Back
|
What is the name for the type of epithelium that is the innermost lining of blood vessels and heart chambers?
|
ENDOTHELIUM
|
|
|
Within an organ, the loose CT and/or fat and or dense CT form...
|
STROMA
|
|
|
Within an organ, what are the cells that give an organ its unique physiological function?
|
PARENCHYMA
|
|
|
What are most CT types derived from?
|
MESENCHYME
|
|
|
What is loose CT also known as?
|
AREOLAR TISSUE
|
|
|
What type of CT can accept or transmit stresses in single or multiple directions? (depending on subtype)
|
DENSE CONNECTIVE TISSUE
|
|
|
What type of cartilage forms synchondroses?
|
HYALINE CARTILEGE
|
|
|
Fibrocartilage resists what types of forces?
|
COMPRESSION FORCES & SHEARING FORCES
|
|
|
What type of cartilage is involved in symphasis joints?
|
FIBROCARTILAGE
|
|
|
A layer of epithelial cells with a subjacent layer of CT is a...
|
MEMBRANE
|
|
|
Name the mucous membranes of the body.
|
RESPIRATORY TRACT, GUT TUBE, URINARY TRACT, REPRODUCTIVE TRACT
|
|
|
Lines of cleavage are also known as...
|
LANGER'S LINES
|
|
|
Projections from the __________ into the ______________ makes dissection of these two layers difficult.
|
DSF, SSF
|
|
|
What is camper's fascia?
|
SSF located only in the anterior-lateral abdominal wall.
|
|
|
What is Scarpa's fascia?
|
DSF located only in the anterior-lateral abdominal wall.
|
|
|
What is epimysium?
|
Deep investing fascia covering skeletal mm.
|
|
|
What is myofascia?
|
Deep investing fascia covering skeletal mm.
|
|
|
Deep investing fascia may combine with...
|
PERIOSTEUM OR PERICHONDRIUM of a nearby bone or nearby cartilage (respectively)
|
|
|
What is an aponeurosis?
|
A broad, flat tendon that often connects two skeletal mm.
|
|
|
At what age do the sacral and coccygeal vertebra completely fuse?
|
30 y/o
|
|
|
At what age does a human develop its cervical curvature and why?
|
6 months, develops when the baby starts to lift its head.
|
|
|
At what age does a human develop its lumbar curvature and why?
|
1 year, develps when the baby assumes upright posture and begins to toddle.
|
|
|
Why do primary curvatures exist?
|
Due to differences in height between the anterior and posterior parts of vertebrae.
|
|
|
What is the intervertebral foramen formed by?
|
Superior vertebral notch of 1 vertebra, inferior vertebral notch of the vertebra just superior, and the posterolateral margin of the IVD.
|
|
|
Which vertebrae have transverse processes that articulate with a rib?
|
T1-T10
|
|
|
Why is cervical ROM greater than other regions ROM?
|
Due to the cervical IVDs relative thickness to the cervical vertebrae.
|
|
|
What does the ligamentum flavum do?
|
Vertically joins lamina of adjacent vertebrae. Slows VC flexion and aids in VC extension returning to neutral
|
|
|
The cervical VC is supplied vascularly by....
|
The vertebral artery (passes through transverse foramen of C6-C1) The vertebral vein passes through transverse foramen of C1-C7
|
|
|
The vertebral artery is a branch off of the...
|
Subclavian artery.
|
|
|
Vascular supply to the thoracic vertebra comes from...
|
The thoracic aorta-->posterior intercostal artery--->spinal branches
|
|
|
Vascular supply to the lumbar VC originates from...
|
The abdominal aorta--->lumbar arteries---->spinal branches
|
|
|
Vascular supply to the sacrum originates from...
|
The iliolumbar arteries---->m/l sacral arteries
|
|
|
What is responsible for venous drainage in the VC?
|
Internal & External vertebral venous plexes
|
|
|
What other cavities are contained within the thoracic cavity?
|
Pulmonary cavities and mediastinal cavity.
|
|
|
Which vessels reside in the costal groove of each rib?
|
Intercostal nerve and the posterior intercostal artery and vein
|
|
|
The first sternocostal joint is what type?
|
synchondrosis
|
|
|
Rib 10 may articulate with...
|
Only T10 or T10 and the T9-10 IVD
|
|
|
How could you identify rib 11 & 12 vs other ribs?
|
No neck, no tubercle, only one articulating surface at the head of the rib.
|
|
|
What direction does the SAP facet face in thoracic vertebra?
|
posteriorly and laterally
|
|
|
What direction does the IAP facet face in thoracic vertebra?
|
anteriorly and medially
|
|
|
Which muscles attach distally to the jugular notch?
|
SCM, sternothyroid, sternohyoid.
|
|
|
What type of joint is the sternoclavicular joint?
|
synovial joint
|
|
|
What does the transverse thoracic plane pass through?
|
IVD between T4&T5 and the manubriosternal joint (sternal angle), 2nd costosternal joint, proximal segment of AA, bifurcation of trachea
|
|
|
What type of joint is a costovertebral joint?
|
synovial joint
|
|
|
What type of joint is a costotransverse joint?
|
synovial joint
|
|
|
What type of joint is an intervertebral joint?
|
symphasis
|
|
|
What type of "joint" is the costochondral junction?
|
synchondrosis
|
|
|
What type of joints are the sternocostal joints (2-7)
|
synovial joint
|
|
|
What type of joint is the manubriosternal joint?
|
symphasis
|
|
|
What type of joint provides NO to very little movement?
|
synchondrosis
|
|
|
The endothoracic fascia is also known as...
|
the subserosa to the costal parietal pleura
|
|
|
The posterior region of the thoracolumbar fascia separates...
|
the superficial muscles of the back from the intrinsic (deep) back muscles
|
|
|
The middle layer of the thoracolumbar fascia separates...
|
the deep back muscles and the quadratus lumborum
|
|
|
The anterior layer of the thoracolumbar fascia separates...
|
the quadratus lumborum from the retroperitoneal compartment
|
|
|
What does the suprapleural membrane reinforce?
|
the cupula
|
|
|
The superficial muscles of the back are innervated by what?
|
The ventral primary rami of the spinal nerves and the trapezius by CN XI
|
|
|
Splenius group functions:
|
B: neck extension
U: neck lateral flexion, ipsilateral rotation |
|
|
Erector spinae group functions:
|
B: VC extension
U: ipsilateral lateral flexion |
|
|
Semispinalis functions:
|
B: VC extension
U: contralateral rotation |
|
|
Multifidus function:
|
local VC stabilization, proprioception
|
|
|
At what vertebral level do the R and L crus emerge?
|
L1-L3
|
|
|
What does the caval foramen transmit? At what level?
|
IVC and some branches of the R. phrenic n. @ T8
|
|
|
What does the esophageal hiatus transmit? At what level?
|
Esophagus, esophageal blood vessels, anterior and posterior vagal trunks @ T10
|
|
|
What does the aortic hiatus transmit? At what level?
|
aorta, thoracic duct, cysterna chyli, azygous v (sometimes) and hemiazygous v (sometimes)@ T12
|
|
|
What structures pass through the diaphragm via anatomically variable paths (not via hiatus or foramen)?
|
L&R greater splanchnic nerves, L&R sympathetic chains (trunks), azygous v (sometimes), hemiazygous v (sometimes), R phrenic n., L phrenic n.
|
|
|
What is the origin of the posterior intercostal arteries?
|
superior intercostal artery for interspaces 1&2
thoracic aorta for interspaces 3-11 |
|
|
Where does the internal thoracic artery run? From where?
|
From the subclavian artery inferior along the costal cartilages.
|
|
|
What are the terminal branches of the internal thoracic arteries?
|
Musculophrenic artery & superior epigastric artery
|
|
|
What does the inferior phrenic artery supply?
|
Most of the diaphragm and the pericardial sac
|
|
|
What is the origin of the inferior phrenic artery?
|
It is the first pair of arteries off of the abdominal aorta
|
|
|
The C1 posterior primary ramus is also know as what?
|
Suboccipital nerve
|
|
|
The C2 posterior primary ramus is also known as what?
|
Greater occipital nerve
|
|
|
Intrinsic back muscles and the overlying skin/fascia are innervated by what?
|
Posterior primary rami of T1-L5
|
|
|
The recurrent meningeal branch stems from what?
|
Spinal nerve
|
|
|
The T1-T6 anterior primary rami are also known as what?
|
Intercostal nerves
|
|
|
The T7-T11 anterior primary rami are also known as what?
|
Thoracoabdominal nerves
|
|
|
The T12 anterior primary ramus is also known as what?
|
Subcostal nerve
|
|
|
Which are the typical intercostal nerve pairs?
|
T3-T6
|
|
|
From where do the phrenic nerves originate?
|
C3-5 anterior primary rami
|
|
|
Where do the R&L phrenic nerves pierce the diaphragm?
|
R- through or near the caval foramen
L- near the apex of the heart |
|
|
The phrenic nerve contains GSEs to...?
|
Diaphragm skeletal muscle
|
|
|
The phrenic nerve contains GSAs from...?
|
proprioceptors of the diaphragm
pain receptors from: mediastinal parietal pleura, fibrous pericardium, parietal serous pericardium |
|
|
The phrenic nerve contains GVEs to...?
|
vascular smooth muscle within the diaphragm
|
|
|
A paralyzed hemidiaphragm does what during inspiration?
|
Ascends
|
|
|
A paralyzed hemidiaphragm does what during expiration?
|
Descends
|
|
|
Where is the preganglionic cell body of a GVE located?
|
In the lateral horn (intermediolateral cell column) of T1-L2/3 spinal cord segments
|
|
|
How many paravertebral ganglion are there?
|
31 pairs in utero
20-25 at birth due to fusion |
|
|
What is the ganglion impar?
|
Where the L&R sympathetic chains unite
|
|
|
Where are the white rami communicans found?
|
T1-L2 spinal cord segments only
|
|
|
Where do the splanchnic nerves emerge from?
|
T5 and below
|
|
|
What cranial nerves are part of the parasympathetic NS?
|
III- occulomotor, VII- facial, IX- glossopharngeal, X- vagus
|
|
|
What levels of gray matter are involved with the parasympathetic NS?
|
S2-4
|
|
|
What are the four locations of parasympathetic ganglia?
|
Intramural- within effector tissue walls
Terminal- in CT near effector tissue Enteric- terminal & intramural ganglia w/i wall of digestive tract Cranial- (details in H&N unit) |
|
|
What is the inferior border of the superior mediastinal cavity? The superior border?
|
Transverse Thoracic Plane, Superior Thoracic Aperture
|
|
|
If a patient was shot through the sternum at the T3 vertebral level, list the structures, in order, the bullet would pass through
|
Sternum, Thymus Gland, Great vv, Great aa, trachea, esophagus, thoracic duct, spine
|
|
|
If the thymus gland were enlarged, what might it impinge upon?
|
The great vessels
|
|
|
What is the function of the thymus gland? When is it functional?
|
Educates T-Lymphocytes in embryo through puberty
|
|
|
Where does the ascending aorta transition into the aortic arch?
|
TTP
|
|
|
What are the first branches off of the aorta?
|
L&R Coronary arteries
|
|
|
What spans between the bifurcation of the pulmonary arteries and the aortic arch? What was this structures significance in the fetus?
|
Ligamentum Arteriorsum, Prenatally it was the Ductus arteriosum which conveyed blood from the pulmonary trunk (RV) to the aorta
|
|
|
The descending aorta first travels posterior to what structure?
|
root of LEFT lung
|
|
|
The brachiocephalic trunk is posterior to the ___________ and anterior to the ___________.
|
Manubrium, trachea
|
|
|
What two vessels are formed from the brachiocephalic trunk?
|
R. Common Carotid a.
R. Subclavian a. |
|
|
What palpable structure lies directly anterior to the brachiocephalic trunk branch?
|
R Sternoclavicular joint
|
|
|
Describe the least common structural variant of the aortic arch
|
Aortic arch gives rise to a L and R brachiocephalic trunk each of which gives rise to a common carotid a. and a subclavian a.
|
|
|
Describe the aortic arch variation 27% of the population possess.
|
Aortic arch gives rise to a brachiocephalic trunk which branches into the R subclavian a, R common carotid a, and the L common carotid a. L subclavian a. branches from aortic arch.
|
|
|
Describe the spatial relationship of SVC to the trachea, to the ascending aorta.
|
Anterior-Right to trachea
Posterior-Right to ascending aorta |
|
|
What are the tributaries to the L & R brachiocephalic veins. What is the significance of the origin of the brachiocephalic veins?
|
Internal Jugular v and subclavian v bilaterally. The origin of the brachiocephalic veins is also known as the venous angle- where the R & L lymphatic ducts drain.
|
|
|
Which is longer- the R or L BCV?
|
L BCV
|
|
|
Which vein arches over the root of the R lung to join the SVC?
|
azygous v
|
|
|
What is the origin of the thoracic duct? How does this structure relate to the diaphragm?
|
Cysterna Chyli, located at or near the aortic hiatus
|
|
|
The R lymphatic duct drains lymph from...
|
The R side of the body superior to the diaphragm
|
|
|
What major structures are in the posterior mediastinal cavity?
|
Thoracic aorta, azygous and hemiazygous v, thoracic duct, R&L sympathetic chains, R&L splanchnic nn, R&L thoracic cardiac visceral nn., esophagus
|
|
|
Does the thoracic aorta move more medial or lateral as it descends?
|
Medial
|
|
|
What are the first unpaired midline branches off of the aorta?
|
Esophageal branches, pericardial branches
|
|
|
What is the last pair of segmental branches to come off of the thoracic aorta?
|
Superior phrenic arteries
|
|
|
What does the AVS drain?
|
the back, thoracoabdominal wall, and mediastinal viscera
|
|
|
What is the significance of the AVS in IVC pathology?
|
Alternate route to RA via SVC if IVC is occluded
|
|
|
Name the main thoracic tributaries of the azygous v.
|
1-11 R post intercostal vv, R subcostal v, vertebral venous plexus of Baston, various esophageal and bronchial vv
|
|
|
What are the main thoracic tributaries to the hemiazygous v? accessory hemiazygous v?
|
9-11 L post intercostal vv, L subcostal v, inferior esophageal v. L 5-8 L posterior intercostal vv
|
|
|
At approximately what levels of the spine does the esophagus begin and end?
|
C6, T10
|
|
|
What types of nerve fibers is the esophagus controlled by?
|
orad 1/3- GSE
middle 1/3- GSE, GVE aborad 1/3- GVE |
|
|
Can the esophagus hold a suture? Why?
|
No- because there is no serosa
|
|
|
Where are the esophageal constrictions?
|
Pharynx, aortic arch, L primary bronchus, diaphragmatic
|
|
|
What direction and degree of rotation occurs in the esophagus during embryological development? What is the significance of this to the vagus nn?
|
90 degree clockwise rotation, causes R vagus to course posterior to the esophagus, L vagus to course anterior to the esophagus
|
|
|
From where do the sympathetic postganglionic GVEs innervating the esophagus originate?
|
T1-T10 L&R sympathetic chains
|
|
|
Where do the parasympathetic preganglionic GVEs originate?
|
Vagus nn
|
|
|
Where do the GSAs and GSEs of the esophagus run?
|
Vagus nn
|
|
|
What posterior horns convey pyrosis?
|
T8-T10
|
|
|
What is the foregut outgrowth that develops into the lungs?
|
Respiratory diverticulum
|
|
|
What embryonic structure develops into the pleural sacs?
|
pericardioperitoneal canals
|
|
|
The subserosa of the pleura is also known as....
|
Endothoracic fascia
|
|
|
Pulmonary cavity volume=
|
Lung volume + Pleural cavity volume
|
|
|
Does the pulmonary cavity volume change during pneumothorax?
|
NO, pleural cavity volume increases and lung volume decreases
|
|
|
Name the regions of parietal pleura
|
Mediastinal, costal, diaphragmatic, cervical
|
|
|
What reinforces the cervical parietal pleura? What is this an extension of?
|
Suprapleural membrane, endothoracic fascia
|
|
|
The cervical parietal pleura is also known as...
|
the cupula
|
|
|
What is the pulmonary ligament?
|
a double layer of pleural mesothelium inferior to the lung root
|
|
|
The sternal line of pleural reflection is the transition point between the _______ and ________
|
CPP MPP
|
|
|
The costal line of pleural reflection is the transition point between the _______ and the _______
|
CPP DPP
|
|
|
What occurs in the costodiaphragmatic recess during inspiration? expiration?
|
lung occupies most of CD recess, lung ascends and recedes from CD recess
|
|
|
What feature of the costodiaphragmatic recess can be visualized in XRay?
|
Costophrenic angles
|
|
|
Which is larger, the L or R costomediastinal recess? Why?
|
Left, due to cardiac notch of left lung
|
|
|
How far does the base of the lung move during quiet respiration? Forced respiration?
|
1.5 cm, 6-10 cm
|
|
|
Which is more inferior- the R or L lung apex? What is the clinical significance of this?
|
R. You want to insert venous catheters on the R (decreased chance of puncturing pleural sac and causing pneumothorax)
|
|
|
What is a hilum?
|
2-D area on medial lung surface
|
|
|
What plane is the hilum in?
|
parasagittal
|
|
|
What is posterior to the R lung root?
|
R vagus n, posterior pulmonary nerve plexus, ascending portion of azygous vein
|
|
|
What is anterior to the R lung root
|
R phrenic n, R pericardiophrenic vessels, anterior pulmonary nerve plexus
|
|
|
What is posterior to L lung root?
|
L vagus n, posterior pulmonary nerve plexus, descending aorta
|
|
|
What is anterior to the L lung root?
|
L phrenic n, pericardiophrenic vessels, anterior pulmonary nerve plexus
|
|
|
The oblique fissures are deep to what surface features?
|
T2 spinous process posteriorly to 7th rib anteriorly
|
|
|
The horizontal fissure is deep to what surface features?
|
R 4th rib posterior-laterally and 4RICS anteriorly
|
|
|
Epithelial inner lining of larynx and tracheobronchial tree and lung parynchyma are derived from what embryological layer?
|
Endoderm
|
|
|
Cartilaginous, CT, muscular structures of the lung are developed from what embryological layer?
|
Mesoderm
|
|
|
What is the name for the internal cartilaginous ridge at the TTP?
|
carina
|
|
|
The left primary bronchus is approximately ________ degrees from vertical
|
45
|
|
|
The left primary bronchus passes inferior to what structures?
|
aortic arch and L pulmonary artery
|
|
|
What are the branches of the left primary bronchus?
|
Superior lobar bronchus- gives lingular bronchus
Inferior lobar bronchus |
|
|
How many bronchopulomary segments are in the left lung? How are they distributed?
|
10
5 in superior lobe (2 lingular) 5 in inferior lobe |
|
|
What is a bronchopulmonary segment?
|
basic functional unit of the lung, pyramid-shaped tissues that roughly point toward the root
|
|
|
Each bronchopulmonary segment contains...
|
1 segmental (tertiary) bronchus,
1 pulmonary intrasegmental artery, pulmonary intersegmental veins, lymph vessels, GVEs that innervate bronchial smooth m. and mucus glands, GVAs |
|
|
The right main bronchus passes approximately ________ degrees from vertical
|
25
|
|
|
What are the lobar branches of the R bronchus?
|
Superior lobar bronchus
interlobar bronchus- branches to middle lobar bronchus & inferior lobar bronchus |
|
|
How are the bronchopulmonary segments distributed among the R lung lobes?
|
3 superior, 2 middle, 5 inferior
|
|
|
The pulmonary circuit contains __% of total blood at any single time
|
9%
|
|
|
Is the pulmonary valve anterior or posterior to the aortic valve?
|
Anterior
|
|
|
At what level does the pulmonary trunk bifurcate?
|
TTP
|
|
|
The pulmonary arteries branch into...
|
pulmonary intrasegmental arteries
|
|
|
What is the origin of the bronchial arteries? What do they supply other than the L&R bronchi?
|
R bronchial artery from (usually) 3rd R post intercostal artery
L bronchial artery from anterior aorta Also supply lung visceral pleura |
|
|
How many pulmonary veins are there?
|
4
2 superior (L&R) 2 inferior (L&R) |
|
|
What are the tributaries to the pulmonary veins?
|
pulmonary intersegmental vv.
|
|
|
What drains the PROXIMAL segments of the tracheobronchial tree? Where does that empty?
|
Bronchial veins, into the RA
|
|
|
Describe the lymphatic drainage of the right lung (and L lung inferior lobe)
|
lobar nodes-hilar nodes-carinal nodes-R.paratracheal nodes-R. bronchomediastinal trunk and/or R. deep cervical nodes-R. venous angle
|
|
|
Describe the lymphatic drainage of the L lung superior lobe
|
L superior lobar node-L hilar nodes-carinal nodes-L paratracheal nodes-L bronchomediastinal trunk and/or L deep cervical nodes-thoracic duct-L venous angle
|
|
|
What innervates the parietal pleura?
|
intercostal n/subcostal n--Cervical, Costal
phrenic n-- Mediastinal, Diaphragmatic |
|
|
Describe the route of parasympathetic innervation of the lungs
|
Medulla gives rise to R & L vagus nerves, fibers split off vagus nn and form cardiac visceral nn that convey preganglionic fibers through cardiac plexus and on to the pulmonary plexuses
|
|
|
Describe the sympathetic preganglionic GVE route of the lungs
|
Emerge from lateral T1-T5 horns, enter sympathetic trunk and ascend to synapse in cervical ganglia
|
|
|
Describe the sympathetic postganglionic GVE route to the lungs.
|
Emerge from cervical ganglia and form cardiac visceral nerves, pass through cardiac plexus into the R&L pulmonary plexuses
|
|
|
A GVA traveling antiparallel to a sympathetic GVE would convey information regarding...
|
pain, stretch (distention), ischemia, irritation
|
|
|
A GVA traveling antiparallel to a parasympathetic GVE would convey information regarding...
|
nausea, hunger (vagus), fullness, stretch (pelvic splanchnics), blood pressure, blood gas levels
|
|
|
What fuses to form the internal terminal crest?
|
sinus venosus and primordial atrium
|
|
|
What septum forms the valve of the foramen ovale?
|
primum
|
|
|
Is the septum secundum on the R or L of the septum primum?
|
Right
|
|
|
The primordial atrium develops from what portion of the heart tube?
|
Caudal
|
|
|
The primordial atrium becomes what postnatally?
|
Right auricle
|
|
|
When does the primordial ventricle become R&L ventricles?
|
week 7
|
|
|
The fusion of the membranous and muscular interventricular septum finalizes the continuity of what?
|
RV with pulmonary trunk and LV with ascending aorta
|
|
|
What direction does the heart tube twist normally?
|
CCW
|
|
|
What is the condition called in which the heart tube twists CW?
|
Dextrocardia
|
|
|
Is a left to right shunt acyanotic or cyanotic?
|
Acyanotic
|
|
|
What happens when a neonate takes its first breath?
|
Air expands in lungs, decreased pulmonary vascular resistance, increase pulmonary blood flow, decreased BP in RA, RV and pulmonary trunk
|
|
|
What happens when a neonate is separated from the placenta?
|
cut umbilical cord, lose low vascular resistance placenta, increased overall neonate system vascular resistance, increased BP in aorta, LV, LA
|
|
|
Each ventricle pumps ___L/min to its respective circulation
|
5
|
|
|
The umbilical arteries are supplied by what?
|
internal iliac arteries from the common iliac arteries from the descending aorta
|
|
|
The umbilical vein branches into...
|
a hepatic bypass via ductus venosus or through hepatic portal vein
|
|
|
The foramen oval becomes the _____ ________ postnatally
|
fossa ovalis
|
|
|
The ductus arteriosus becomes the __________ __________ postnatally
|
ligamentum arteriosus
|
|
|
The ductus venosus becomes the _______ __________ postnatally
|
ligamentum venosum
|
|
|
The umbilical vein becomes the ___ _______ of the liver near early adulthood
|
round ligament
|
|
|
The umbilical arteries become ________ ________ _________ postnatally
|
medial umbilical ligaments
|
|
|
A persistent patent ductus arteriosus is acyanotic/cyanotic?
|
acyanotic
|
|
|
A persistent patent foramen ovale is acyanotic/cyanotic?
|
acyanotic
|
|
|
Ventricular septal defects are typically acyanotic/cyanotic?
|
acyanotic
|
|
|
What is the most common type of heart dysmorphia?
|
Ventricular septal defects
|
|
|
What is a tetralogy of fallot?
|
4 simultaneous congenital heart defects: stenosis of infundibulum, VSD, dextroposition of aorta, RV hypertrophy due to patent DA
|
|
|
What is the function of the pericardium?
|
cardiac seat belt: protects heart, prevents heart from sudden overdilation due to overfilling, stabilizes vigorously beating heart
|
|
|
What outer layer of the great vessels is the fibrous pericardium attached to?
|
Tunica Adventitia
|
|
|
What is a cardiac tamponade?
|
When pericardial cavity fills with blood or serous fluid compressing the heart and thus decreasing cardiac output
|
|
|
The transverse pericardial sinus runs between....
|
the pulmonary trunk and ascending aorta leaving the ventricles anteriorly and the SVC and pulmonary veins entering their atria posteriorly
|
|
|
The oblique pericardial sinus is bounded by...
|
the left atrium anteriorly, the pericardial reflections surrounding the pulmonary veins and IVC laterally, and the anterior surface of the esophagus posteriorly
|
|
|
What supplies the fibrous and parietal pericardium? What are these a branch of?
|
R/L pericardiacophrenic aa, Internal thoracic aa.
|
|
|
What does the heart drain to?
|
Pericardiacophrenic vv are tributaries to either the brachiocephalic vv or internal thoracic vv
|
|
|
What do the GSAs in the phrenic nerves convey? To where?
|
pain/stretch sensory info from: mediastinal parietal pleura, parietal pericardium, fibrous pericardium back to the C3-C5 posterior horns
|
|
|
Where can you find the apex of the heart (surface feature)?
|
4th-5th LICS and MCL
|
|
|
The anatomical base of the heart is...
|
LA some RA
|
|
|
What does the anatomic base of the heart face?
|
T6-T9 vertebra with oblique sinus, esophagus and descending aorta intervening
|
|
|
What is the clinical base of the heart?
|
surface projection of superior heart border onto anterior thoracic wall (2LICS to 2RICS)
|
|
|
What can you find in the anterior interventricular sulcus?
|
Anterior interventricular a, great cardiac v, fat
|
|
|
What is the corresponding internal feature to the terminal groove?
|
Terminal crest
|
|
|
What can you find in the coronary groove?
|
coronary sinus, circumflex coronary a, R coronary a.
|
|
|
What can you find in the posterior interventricular sulcus?
|
posterior interventricular a and middle cardiac v.
|
|
|
The diaphragmatic surface is...
|
mostly LV, some RV
|
|
|
The left pulmonary surface is...
|
mostly LV
|
|
|
The sternocostal pulmonary surface is...
|
mostly RV, slight contribution from RA and LV
|
|
|
The right pulmonary surface is...
|
mostly RA
|
|
|
The inferior border is..
|
mostly RV slight LV
|
|
|
The left border is...
|
mostly LV some left auricle of LA
|
|
|
The right border is...
|
RA and terminal segments of SVC and IVC
|
|
|
Where do you auscultate for the aortic valve?
|
sternal border of 2RICS
|
|
|
Where do you auscultate for the pulmonary valve?
|
sternal border of 2LICS
|
|
|
Where do you auscultate for the tricuspid valve?
|
sternal border of 4or5LICS
|
|
|
Where do you auscultate for the mitral valve?
|
9cm L of midline 5LICS
|
|
|
The visceral pericardium is also known as...
|
epicardium
|
|
|
What parasympathetic structures can you find within myocardium? Where?
|
distal para pre GVEs, para ganglion, para post GVEs. In or near autorhythmic cell regions
|
|
|
What sympathetic structures can you find within the myocardium? Where?
|
distal sym post GVEs, sensors and initial segments of GVAs that accompany GVEs
|
|
|
What is included within the endocardium?
|
Subendocardial layer and endothelium
|
|
|
What layer of the heart contains the distal cardiac conduction system fibers? What are these called?
|
Subendocardial layer, Purkinje fibers
|
|
|
What is included in the fibrous skeleton of the heart?
|
fibrous rings around valve orifices
R&L fibrous trigones connecting the fibrous rings membranous part of the IVS membranous part of the interatrial septum |
|
|
What valve does not have a fibrous ring?
|
Pulmonary valve
|
|
|
What are the cusps of the R AV valve?
|
A P S
|
|
|
The semilunar cusps of the pulmonary valve are derived from...
|
the embryological truncus arteriosus
|
|
|
What happens in the pulmonary valve during ventricular diastole?
|
Sinuses fill with recently ejected blood, expands sinuses, approximates 3 cusps, closes semilunar valve
|
|
|
What percentage of patients have an incomplete fusion of the fossa ovalis valve?
|
20-25%
|
|
|
Name the cusps of the left atrioventricular valve
|
Anterior, Posterior
|
|
|
What is the aortic vestibule?
|
The smooth tapering transition from LV into aorta
|
|
|
The aortic semilunar valve is derived from what embryological structure?
|
Truncus arteriosus
|
|
|
Name the cusps of the aortic semilunar valve?
|
P R L sinuses
|
|
|
What structures connect the R&L coronary arteries and the R&L aortic sinus?
|
ostia
|
|
|
The pressure in the coronary arteries is highest during ventricular systole/diastole?
|
Diastole
|
|
|
What is included in the central blood volume?
|
all blood contained in: SVC+thoracic IVC+RA+RV+entire pulmonary circuit+LA
|
|
|
What is included in the peripheral blood volume?
|
all blood contained in: LV+entire systemic circulation except SVC and thoracic IVC
|
|
|
Describe dominance in regards to the arterial supply of the heart
|
67% of the population is R dominant, in which the posterior interventricular artery is a branch of the R coronary artery. 15% are left dominant and 18% are codominant
|
|
|
The proximal branch of the R coronary artery that travels posterior between the great vessels is...
|
sinuatrial nodal a
|
|
|
A second proximal branch may emerge from the R coronary artery and travel ant/inf, what branch is this?
|
Conus arteriorsus branch
|
|
|
What does the R Marginal artery supply?
|
RV
|
|
|
On what surface of the heart can you find the AV nodal artery?
|
posterior/inferior
|
|
|
What does the posterior interventricular artery supply?
|
R&L ventricles and posterior 1/3 of IVS
|
|
|
The L coronary artery exits the L aortic sinus and immediately branches into the...
|
circumflex a. and the anterior interventricular artery
|
|
|
What does the anterior interventricular artery supply?
|
RV, LV, apex, and anterior 2/3 of IVS
|
|
|
Where does the L Marginal artery course? What does it supply?
|
along L heart border, LV
|
|
|
What does the circumflex artery supply?
|
LA & LV
|
|
|
What is the distribution territory of the RCA in a R. dominant heart?
|
RA, most of RV, diaphragmatic surface of LV, posterior 1/3 of IVS, SA node in 60%, AV node in 80%
|
|
|
What is the distribution territory of the RCA in a R. dominant heart?
|
RA, most of RV, diaphragmatic surface of LV, posterior 1/3 of IVS, SA node in 60%, AV node in 80%
|
|
|
What is the distribution territory of the LCA in a R. dominant heart?
|
LA, most of LV, some of RV, anterior 2/3 of IVS (including AV bundle), SA node in 40%
|
|
|
What is the distribution territory of the LCA in a R. dominant heart?
|
LA, most of LV, some of RV, anterior 2/3 of IVS (including AV bundle), SA node in 40%
|
|
|
The coronary sinus lies in the anterior/posterior coronary sulcus?
|
Posterior
|
|
|
The coronary sinus lies in the anterior/posterior coronary sulcus?
|
Posterior
|
|
|
What is the course of the great cardiac vein?
|
begins at apex and courses superior through anterior interventricular sulcus to the coronary sulcus (coronary sinus)
|
|
|
What is the course of the great cardiac vein?
|
begins at apex and courses superior through anterior interventricular sulcus to the coronary sulcus (coronary sinus)
|
|
|
List the tributaries entering the coronary sinus beginning at the anterior IVS
|
GCV, L Marginal V, Posterior V, middle V, small V, entry into coronary sinus
|
|
|
List the tributaries entering the coronary sinus beginning at the anterior IVS
|
GCV, L Marginal V, Posterior V, middle V, small V, entry into coronary sinus
|
|
|
List the primary CCS components in chronological order they reach threshold potential
|
Sinuatrial node, atrioventricular node, atrioventricular bundle, R&L bundle branches, Purkinje branches
|
|
|
List the primary CCS components in chronological order they reach threshold potential
|
Sinuatrial node, atrioventricular node, atrioventricular bundle, R&L bundle branches, Purkinje branches
|
|
|
What allows for quick propagation of action potentials through the myocardium?
|
Gap Junctions
|
|
|
What allows for quick propagation of action potentials through the myocardium?
|
Gap Junctions
|
|
|
What is the only electrical conduit across the high-resistance fibrous skeleton of the heart and also through the membranous IVS?
|
AV Bundle (Bundle of His)
|
|
|
What is the only electrical conduit across the high-resistance fibrous skeleton of the heart and also through the membranous IVS?
|
AV Bundle (Bundle of His)
|
|
|
Cervical cardiac visceral nerves and thoracic cardiac visceral nerves convey which types of nerve fibers?
|
preganglionic parasympathetic GVEs, postganglionic sympathetic GVEs and accompanying GVAs
|
|
|
Cervical cardiac visceral nerves and thoracic cardiac visceral nerves convey which types of nerve fibers?
|
preganglionic parasympathetic GVEs, postganglionic sympathetic GVEs and accompanying GVAs
|
|
|
What is the function of the cardiac nerve plexus?
|
Conveys pre para GVEs, post sym GVEs and accompanying GVAs of the cardiac visceral and thoracic visceral nerves across the great vessels of the heart
|
|
|
What is the function of the cardiac nerve plexus?
|
Conveys pre para GVEs, post sym GVEs and accompanying GVAs of the cardiac visceral and thoracic visceral nerves across the great vessels of the heart
|
|
|
What are the extensions of the cardiac plexuses?
|
Coronary Plexus and L&R pulmonary plexuses
|
|
|
If there is pain due to coronary vessel ischemia, what GVA route does it take?
|
visceral pain from heart to the T1-T4/5 spinal cord segments antiparallel to the sympathetic GVE pathways
|
|
|
If there is referred pain to the dermatomes and sclerotomes what GVA route does it take?
|
travel up the Vagus nerves and terminate in the medulla. antiparallel to the parasympathetic GVE pathways
|
|
|
If a patient is experiencing angina pectoris, what GVE fibers are the GVA fibers opposing?
|
sympathetic GVE pathways
|
