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74 Cards in this Set
- Front
- Back
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Parts of mediastinum |
Superior and inferior |
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Parts of inferior mediastinum |
Anterior, middle, and posterior |
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Division of superior and inferior mediastinum |
Transverse thoracic plane
Guide to location of arch of aorta and bifurcation of trachea |
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Position of bifurcation of trachea and arch of aorta in relation to transverse thoracic plane |
Supine: arch of aorta is superior, bifurcation is transected by
Standing: arch is transected, bifurcation is inferior |
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Structures in superior mediastinum |
Arch of aorta, roots of its major branches (brachiocephalic, left common carotid, left subclavian), brachiocephalic veins, superior vena cava, vagus and phrenic nerves, trachea, esophagus, thoracic duct, thymus gland |
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Where does the trachea divide? |
Sternal angle |
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Vagus and phrenic nerve relation to root of lung |
Vagus: posterior
Phrenic: anterior |
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Recurrent laryngeal nerve |
Hooks under arch of aorta lateral to ligamentum arteriosum (remnant of ductus arteriosum) |
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Structures in medial mediastinum |
Pericardium, heart, ascending aorta, pulmonary trunk, superior vena cava, inferior vena cava, and bronchi at root of lungs |
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Structures in posterior mediastinum |
Descending thoracic aorta, thoracic duct, azygos and hemiazygos vein, esophagus, thoracic sympathetic trunk, and posterior mediastinal lymph nodes
"Duck between two geese" |
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What does the azygos vein drain? |
Back, thoarcoabdominal walls, and mediastinal viscera
Collateral pathway for venous drainage from inferior vena cava to superior vena cava
Receives blood from hemiazygos and accessory azygos veins |
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What does the thoracic duct drain? |
Entire body below diaphragm, left side of body above diaphragm |
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Branches of descending thoracic aorta |
Bronchial arteries (supply lower trachea and bronchial tree), posterior intercostal arteries (supply intercostal muscles), vertebral column and spinal cord, deep back muscles, skin overlying intercostal spaces, superior phrenic arteries (supply diaphragm) |
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Movement of descending thoracic aorta |
Beings of left anterior to trachea, moves midline and posteriorly against vertebral column |
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Esophagus movement |
Begins on right median line against vertebral column, moves left and anteriorly as it descends |
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Where does thoracic aorta and esophagus pass through diaphragm? |
Aorta: Aortic hiatus at T12
Esophagus: T10 |
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Where is the heart? |
3rd-5th ribs on left of thorax
Apex points left |
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3 surfaces of heart |
Anterior (sternocostal): right ventricle
Inferior (diaphragmatic): left ventricle
Left (pulmonary): left ventricle |
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Right border of heart |
Right atrium b/w superior and inferior vena cava |
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Inferior border of heart |
Mostly right ventricle, some left ventricle |
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Left border of heart |
Mostly left ventricle |
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Superior border of heart |
Left and right atria |
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Fibrous skeleton of heart |
Insulates electrical activity
Ensures conduction from AV node to AV bundle, allows for a pause b/w atrial and ventricular contraction |
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Muscles of right vs left ventricle |
Left is 2-3 times thicker
Pump same amount of blood but left is against more resistance |
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Where does the right atrium receive blood from? |
SVC, IVC, and coronary sinus |
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Fossa ovalis |
In right atrium
Depression in interarterial wall, remnant of fetal foramen ovale |
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Sinus venarum |
Smooth, thin walled posterior region of right atria
Receives venous blood (openings from SVC, IVC, and coronary sinus) |
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Pectinate muscle |
Right atrium
Muscular anterior region |
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Sulcus terminalis |
Right atrium
External demarcation point b/w sinus venarum and pectinate muscle |
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Crista terminalis |
Internal demarcation point b/w sinus venarum and pectinate muscle |
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Coronary sinus |
B/w openings of IVC and antrioventricular orifice |
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SA node (sinuatrial node) |
Just deep to epicardium at junction of SVC and right atrium (superior end of sulcus terminalis) |
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AV node (atrioventricular) |
Posterioinferior region of interarterial septum near opening of coronary sinus |
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Right auricle |
Embryonic development
Increases capacity of right atrium during increased venous return |
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AV orifice |
Right ventricle
Closed by tricuspid valve (anterior, posterior, and septal cusps) |
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Papillar muscle |
Contracts slightly ahead of ventricle (prevents prolapse) |
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Moderator band |
Connects interventricular septum to anterior papillary muscle (permits early conduction)
Contains part of right bundle branch |
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Membranous portion of interventricular septum |
Most common ventricular septal defect area |
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Left atrium receives blood from |
4 valveless pulmonary veins |
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Left AV orifice |
Mitral valve closes
4th costal space
Most frequently diseased |
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When is blood flow to coronary arteries max? |
Diastole (behind semi-lunar valves) |
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Mitral auscultation point |
Apex (left 5th intercostal mid-clavicular) |
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Tricuspid auscultation point |
Left 4th intercostal, lateral to sternum |
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Pulmonic auscultation point |
Left 2nd intercostal, lateral to sternal angle |
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Aortic auscultation point |
Right 2nd intercostal, lateral to sternal angle |
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Branches of ascending aorta |
Right and left coronary ateries |
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Where does right coronary artery travel through? |
Coronary sulcus |
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Branches of r. coronary |
SA nodal, right marginal, PDA, posterolateral branches |
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Branches of PDA |
AV nodal |
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What does the r. coronary artery supply? |
Right atrium, most of RV, diaphrgamatic surface of LV, posterior 1/3 of IV septum, SA node 60% of time, AV node 80% of time, 67% of time posterior interventricular artery (right dominant) |
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Where does left coronary artery travel through? |
Coronary sinus also |
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Branches of left coronary artery |
Anterior interventricular (LAD) and circumflex artery |
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Branch of LAD |
Lateral diagonal branches |
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Branch of circumflex |
Obtuse marginal |
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What does left coronary artery supply? |
Left atrium, most of LV, part of RV, 2/3 of interventricular septum, and AV bundle branch |
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What does LAD supply? |
Both ventricles and interventricular septum |
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What does circumflex artery supply? |
Posterior LV |
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What does obtuse marginal supply? |
Lateral wall of LV |
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How does conduction get from SA node to LA? |
3 pathways:
1. Anterior (Bachmann's bundle)
2. Middle
3. Posterior |
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How does conduction get from LA to AV node? |
Internodal pathways
Pause of 0.1sec at AV node to allow for ventricular filling |
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After AV node where does conduction go? |
AV bundle (His) |
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Branches of AV bundle |
R and L bundle branches (where bundle branch blocks occur)
One side bundle branch block=hemiblock |
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Branches of L bundle |
Thin anterior fascicle
Thick posterior fascicle |
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From bundle branches where does conduction go? |
Purkinje fibers |
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From purkinje fibers to? |
Ventricular cardiac muscle |
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Pericardium |
Covering of heart |
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Fibrous pericardium |
Outermost layer
Attached to diaphragm and fused with outer layer (tunica adventitia)
Fused to parietal serous layer |
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3 layers of heart wall |
Epicardium, myocardium, endocardium |
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Fetal circulation |
Umbilical veins to ductus venosus to IVC to right atrium to foramen ovale to left atrium to left ventricle to aorta to body |
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Foramen ovale becomes |
Fossa ovalis |
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Ductus arteriosum becomes |
Ligamentum arteriosum (due to lack of prostaglandins) |
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Ductus venosus becomes |
Ligamentum venosus (2-3 months) |
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Umbilical veins... |
Remain patent, become ligamentum teres |
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Umbilical arteries become |
Medial umbilical ligaments |
