Anat Mst2

Front 1

Describe the structure of the pericardium. What structures does it cover?

Back 1

The Pericardium is a fibroserous membrane. The pericardium covers the heart and the great vessel roots

Front 2

What are the two layers of the pericardium and how are they arranged?

Back 2

Two layers of pericardium:

- Fibrous

- Serous

Front 3

What are two 'layers' does the serous pericardium form?
What is the name and function of the space between these layers which it forms? Is it a potential cavity?

Back 3

The serous pericardium comprises the parietal (outer) and visceral (inner) layers as one continous serous membrane. The cavity formed is the pericardial cavity (potential space), containing small amount of fluid to reduce friction.

Front 4

The apex of the heart lies on which space of the heart? Which chamber forms the apex?

Back 4

The apex of the heart is located on the left 5th intercostal space. It is formed by the left ventricle

Front 5

Where is the base of the heart located?

Back 5

On the posterior aspect of the heart.

Front 6

Each Atrium forms an "ear shaped" appendage/structure which projects to teh front of the heart. What is this called?

Back 6

The Auricles

Front 7

Label structures A and B on the anterior surface of the heart.

Back 7

A= Anterior atrioventricular sulcus
B= Anterior interventricular sulcus

(both continue onto posterior side of the heart)

Front 8

The VC feeds into the Right Atrium. Which areas of the body does the superior and inferior VC receive venous return from?

Back 8

Superior VC:

- All drainage from above, (thorax, head, etc)

Inferior VC:

- All drainage from below (abdomen, pelvis, lower limbs etc.)

Front 9

What is the function of the coronary sinus, and where is it located in the heart?

Back 9

The coronary sinus receives all venous return from the heart itself. It drains into the Right Atrium and it's located beside the IVC on the lower rear side.

Front 10

What is the Fossa Ovalis (oval fossa) and what is it remnant of?

Back 10

The fossa ovalis is a thin fibrous sheet between the two atria. It is remnant of the foramen ovale which allowed blood to pass from RA --> LA in fetal development

Front 11

Which valve lies between the RIGHT ATRIUM and the RIGHT VENTRICLE?

What structures attach to this valve?

Back 11

The Atrioventricular tricuspid valve

The chordae tendinae and papillary muscles

Front 12

Papillary muscles and chordae tendinae only attach to which types of valves? How do these structures assist the prevention of backflow and what direction do they contract towards?

Back 12

only attach to atrioventricular valves. Prevent backflow by forced closure due to pressure gradient in the ventricular contraction. They contract towards the valve.

Front 13

Label the structures A-D shown

Back 13

A= Tricuspid Valve

B= Papillary muscle

C= Chordae tendinae

D= Pulmonary valve

Front 14

The left ventricle is separated from the left atrium by which valve? In terms of the wall thickness, describe the left ventricular walls?

Back 14

Mitral/bicuspid Valve.
Highly muscular ridges

Front 15

The left atrium Contains an oval shaped impressino on its inner wall (adjacent to the right atrium) - what is the name of this structure?
Where does the left atrium pump blood to?

Back 15

Fossa ovalis
Pumps blood into the right ventricle

Front 16

The fibrous skeleton of the heart is comprised of what two paired components?
What are the 3 general functions of these two paired structures?

Back 16

Composed of two fibrous rings and two fibrous coronets. Together they provide:
- Attachment for cusps of the valves

- attachment for myocardium

- a form of electrical insulation --> separating the atrial muscles from the ventricular muscle

Front 17

The pulmonary and aortic valve lie where? What is there structure often referred to as?
Is the opening/closing of these passive or active?

Back 17

Pulmonary lies at the beginning of the pulmonary artery in the right ventricle (exit)

The aortic valve lies at the beginning of the aorta in the left ventricle (exit)

They are often referred to as 'semilunar' valves

The closure and opening of these is passive

Front 18

Where are the orifices of the coronary arteries found?

Back 18

Superior to the aortic valve.

Front 19

What is the sinoatrial (SA) node commonly called?
Where is it located and what is its function?

Back 19

The SA node is located at the junction of the: superior vena cava and the right atrium. It is often called the pacemaker of the heart.

Front 20

Where would you rind the atrioventricular (AV) node? What is its function?

Back 20

in the r-atrium, near the opening of the coronary sinuses and close to the cusps of the tricuspid valves.
the AV node distributes electrical signals to ventricles via AV bundles

Front 21

How is the heart innervated by nerve?
Indicate whether it is innervated by sympathetic or parasympathetic fibres.

Back 21

The heart is innervated by autonomic fibres from cardiac plexus (base of heart). Both parasymp and symp fibres.

Front 22

Where does the ascending aorta arise from?

Back 22

The left ventricle

Front 23

Where is the aortic arch located in relation to the body?. Describe the direction the vessel initially travels.

Back 23

Located at level of manubrial-sternal junction. Arches superiorly, posteriorly and to the left.

Front 24

Does the aortic arch travel over or under the bifurication of the trachea?
which lung does the aortic arch leave an impression on?

Back 24

Travels over the trachea.

Leaves impression on left lung

Front 25

At what vertebral level (roughly) does the descending aorta align medially?

Back 25

roughly at T12 (abdominal aorta)

Front 26

Where are the coronary arteries found?
What does the right coronary artery supply?
What does the left coronary artery supply?

Back 26

Located: superior to aortic valve

RCA: supplies R-atria + R-ventricle

LCA: supplies L-atria + L-ventricle

Front 27

What is branch is structure 'A' of the aortic arch?

Back 27

Brachiocephalic trunk (branches into subclavian + common carotid)

Front 28

What is branch is structure 'B' of the aortic arch?

Back 28

Right subclavian artery

Front 29

What is branch is structure 'C' of the aortic arch?

Back 29

Right carotid artery

Front 30

What is branch is structure 'D' of the aortic arch?

Back 30

Left common carotid artery

Front 31

What is branch is structure 'E' of the aortic arch?

Back 31

Left subclavian artery

Front 32

What is structure 'F'? what is it remnant of?

Back 32

Ligamentum arteriosum. Remnant of the ductus arteriosis in fetal circulation

Front 33

What are some areas supplied by the parietal branches of the descending aorta?

Back 33

Parietal:

- intercostal = walls

- pericardial = pericardium

- phrenic = diaphram

Front 34

What are some areas supplied by the visceral branches of the descending aorta?

Back 34

Visceral:

- Bronchial = airways, bronchial trees

- Esophageal = esophagus

Front 35

In the image depicting the 'great veins' what are structures 'A'? What feature regarding its position affects the venous return rate?

Back 35

A = brachiocephalic veins

It slightly to the right meaning that the right side drains slightly faster (less distance to travel)

Front 36

In the image depicting the 'great veins' what are structures 'B'? which arteries to the travel alongside and where do they return venous flow from?

Back 36

B = internal jugular veins

accompany the common carotid arteries

return venous flow from the head and neck

Front 37

In the image depicting the 'great veins' what is structures 'C'? (should be labelled for both sides)
which artery does it accompany?

Back 37

C= subclavian veins

accompanies the subclavian arteries

Front 38

Do the coronary veins accompany the coronary arteries? What structure do they drain into and where is this located?

Back 38

Yes the coronary veins accompany the coronary arteries. They drain into the coronary sinus which is located next to the IVC

Front 39

Where does the azygous vein receive it's blood return from?

What structure does it arch over?

Back 39

The azygous vein receives all venous return from :

- thoracic wall and pericardium

- lungs, trachea, bronchi and esophagus.
(all thoracic areas except heart!)

it arches over the root of the right lung

Front 40

Which lung does the azygous vein leave an impresion on? (azygous groove?)

Back 40

the right lung

Front 41

What artery supplies the AV and SA node? are they functional end arteries?

Back 41

Coronary arteries. Yes the coronary arteries are functional end arteries

Front 42

Where do the right coronary arteries lie? (assume classic distribution)
does it form an anastamose?

Back 42

Lies in the atrio-ventricular groove. Follows groove onto posterior side where it anastamoses with the left coronary artery.

Front 43

What two branches does the left coronary artery branch into?

where do each of these structures lie on the heart and where do they anastamose?

Back 43

Divides into:

Circumflex branch:
runs in atrioventricular groove (anteriorly+posteriorly) and anastamoses with right coronary artery
Anterior interventricular branch: runs along interventricular groove on anterior side. When it turns posterior it continues and anastamoses with right coronary groove

Front 44

If you were to suddenly block part of the coronary artery, would the anastamoses be able to compensate for obstruciton of flow?
What if the obstruction were a gradual build up over time (e.g. plaque)?

Back 44

Sudden block = not be able to compensate --> death
gradual blockage = slow reduction of flow to the area, the channel can compensate sending blood through anastamoses.

Front 45

The thoracic cavity is divided in to 3 major compartments which are?

Back 45

- Right pulmonary cavity (right lung site)

- Medianastium (compartment between two lungs)

- left pulmonary cavity (left lung site).

Front 46

Describe the structure of the pleura

Back 46

Pleura = continuous serous membrane that covers each lung and the wall of the pleural cavity.

Front 47

What 2 sections can the pleura be divided into and what structures do they cover?

Back 47

Can be divided into:

Parietal pleura: covers wall of pleural cavity

visceral pleura: covers surface of each lung

Front 48

What four sections can the parietal pleura be divided into? What do they relate to/surround?

Back 48

1. cervical pleura - lines cervical extension of pleural cavity

2. costal pleura - related to ribs and intercostal space

3. mediastinal pleura - covers mediastinum

4. diaphragmatic pleura - covers the diaphragm

Front 49

What is the purpose of the pleural cavity?

Does it contain fluid?
Is it a potential space?
where does it lie between?

Back 49

Purpose: creates frictionless environment

Fluid: yes, few mls of serous fluid

It is only a potential space between visceral and pleural cavity

Front 50

What are the two key characteristics of the pulmonary ligament, and what structure does it form? Does it lie superior or inferior to the lung root?

Back 50

1. Double-folded pleura

2. Represents a continuity between the parietal and visceral pleura

- Forms the pleural sleeve

- Lies inferior to the lung root

Front 51

What type of nerve innervation do each of the visceral and parietal pleurae receive?

Back 51

Visceral pleura receive autonomic nerve innervation

Parietal pleura receive somatic nerve innervation.

Front 52

What is the clinical significance of penetration of the pleural cavity?

Back 52

The pleural cavity is supplied by somatic nerves, and hence is extremely painful during needle-penetration procedures.

Front 53

What two sections enclose the trachea and what are they comprised of?

Back 53

Tracheal ring (cartilage)

- horseshoe shape

Trachealis muscles (smooth muscle)

- encloses posterior surface

Front 54

At what vertebral level does the bronchial tree begin and at what level does the bronchus divide into the right and left bronchus?

Back 54

C6
&
T4/5

Front 55

When comparing the right main bronchus to the left main bronchus, which is larger and more medial? Consequently, which is more prone to obstruction?

Back 55

The right main bronchus is:
- More medial and

- Wider

and hence is more likely to be obstructed than the left main bronchus

Front 56

What do the main bronchus subdivide into? what does this further subdivide into?

Back 56

Main bronchus --> lobar bronchi --> segmental bronchi

Front 57

What are the 3 characteristics of the individual bronchopulmnoary segments?

Back 57

1. Each supplied by independently segmented bronchus

2. Each have independent blood supply

3. Surgically resectable

Front 58

What is structure '1' of the right lung? (anterior view)

Back 58

Apex of the lung

Front 59

What is structure '2' of the right lung? (anterior view)

Back 59

Superior lobe

Front 60

What is structure '3' of the right lung? (anterior view)

Back 60

Costal surface

Front 61

What is structure '4' of the right lung? (anterior view)

Back 61

Middle lobe

Front 62

What is structure '5' of the right lung? (anterior view)

Back 62

Inferior Lobe

Front 63

What is structure '6' of the right lung? (anterior view)

Back 63

Base or diaphragmatic surface

Front 64

What is structure 1 of the right lung? (medial view)

Back 64

Anterior border

Front 65

What is structure 2 of the right lung? (medial view)

Back 65

Mediastinal part (could also be groove for azygous vein)

Front 66

What is surface 3 of the right lung? (medial view)

Back 66

Medial surface

Front 67

What are the 4 key difference between the left and right lung?
super spooky Hints:

1. fissures?
2. grooves?

3. main bronchi?

4. size/length?

Back 67

1. Left lung only has oblique fissure (superior and inferior lobes)
Right lung has additional horizontal fissure which further divides superior into superior and middle lobes.

2. Groove on left lung is due to aortic arch

Groove on right lung due to azygous vein

3. Right main brochus has already started to divide at the hilum, whereas the left main bronchus has not yet split.

4. right lung is bigger and heavier, however it is shorter. The left lung also has the cardiac notch, (where the heart sits.

Front 68

On the left lung shown below, what is labelled? what forms this indent?

Back 68

Cardiac notch. (impression left by heart.)

Front 69

Which arteries and veins are responsible for oxygenation in the lungs?

Back 69

Pulmonary arteries and veins

Front 70

Which arteries and veins are responsible for vascular supply of the lungs?

Back 70

The bronchial arteries and veins

Front 71

Within the structures of the hilum of each lung, what positions do the pulmonary arteries lie?

Back 71

In the inferior and anterior most positions

Front 72

When comparing the position of the pulmonary vein in both the right and left lung what is the key difference?

Back 72

in the Left lung, the pulmonary artery always sits in the most superior position. (right lung is more central and lower.

Front 73

Describe the 4 stages of lymph drainage (pathway) of the lungs

Back 73

1. superficial and deep lymphatics

2. Bronchopulmonary (hilar nodes)

3. Tracheobronchial nodes

4. Bronchomediastinal lymph trunks (right or left)

Front 74

Where do the lungs and visceral pleurae receive nerve innervation from?
Is this supplied by sympathetic or parasympathetic nerves?

Back 74

Lungs and visceral pleurae receive nerve innervation from the pulmonary plexus

Supplied by both parasymp. and symp.