Ant302 Heart Middle Mediastinum

Front 1

whats the transverse thoracic plane?

Back 1

plane that passes through the manubriosternal joint horizontally - touches top of middle mediastinum.

Front 2

Is it In the supine or standing position that the aorta is transected by the transverse thoracic plane?

Back 2

standing. (the heart sags because of the weight).

Front 3

AP or PA xray? the heart is closer to the posterior or the anterior?

Back 3

the heart is closer to the posterior, therefore a PA xray would be more desirable.

Front 4

is the apex or the base at the superior end of the heart?

Back 4

base

Front 5

WHat are two function of the fibrous pericardium?

Back 5

prevents heart over-xpansion
also since its CT - it attaches nicely to vessels, ligaments, and other structures.

Front 6

why is the transverse pericardial sinus more important than the oblique pericardial sinus?

Back 6

surgeons can use this space to separate the difference sources of blood.

Front 7

the vagus nerve runs ____ to the root of the lung.

Back 7

posteriorly.

Front 8

the phrenic nerve passes _____ to the scalene muscle and the root of the lung.

Back 8

anteriorly

Front 9

The heart is attached to a _____ skeleton.

Back 9

fibrous

Front 10

the anterior view of the heart, the sternocostal view, contains mostly the ____ ventricle.

Back 10

Left

Front 11

the posterior view of the heart, the diaphragmatic surface (b/c the diaphragm slopes inferioposteriorly), contains mostly the ____ ventricle

Back 11

right.

Front 12

the inferior border of the superior mediastinum is at what level of the sternum and of the vertebrae?

Back 12

the manubriosternal joint, and t4 t5 IV disc.

Front 13

in infants and children the anterior mediastinum contains the inferior part of the ____.

Back 13

thymus.

Front 14

the pericardial sac lies at what vertebral level and rib level?

Back 14

2nd to 6th rib, T5 - T8

Front 15

the fibrous pericardium is continuous with the central tendon of the ____.

Back 15

diaphragm

Front 16

what attaches the pericardial sac to the sternum?

Back 16

sternopericardial ligaments

Front 17

the pericardial sac is fused with the ____ _____ of the great vessels entering and leaving the heart.

Back 17

tunica adventitia

Front 18

the visceral layer of the serous pericardium is also known as the ____ of the heart.

Back 18

epicardium

Front 19

What is the only thoracic viscera not contained within the mediastinum?

Back 19

lungs

Front 20

What is the superior limit to the mediastinum?

Back 20

the superior thoracic aperture, just superior to first ribs.

Front 21

in the supine position, The aortic arch is ____ to the transverse thoracic plane

Back 21

superior

Front 22

in the standing position, The aortic arch is _____ by transverse thoracic plane

Back 22

transected

Front 23

in supine position, tracheal bifurcation is transected by the ____ ____ ___ at the vertebral levels ____ and _____.

Back 23

transverse thoracic plane, T4, T5

Front 24

in supine position, Central tendon of diaphragm lies at level of ______ ______ at vertebral level ____.

Back 24

xiphisternal junction (T9)

Front 25

in the standing position, Central tendon may fall to mid level of _____ _____ at vertebral level _____.

Back 25

xiphoid process (disc Between T9-T10)

Front 26

what is the mediastinum surrounded by?

Back 26

pleural cavities

Front 27

why is the mediastinum less mobile with age?

Back 27

loose CT not as flexible, more fibrous and rigid.

Front 28

BIG question:
what is located in the middle mediastinum?

Back 28

TRAMPPP

Tracheobronchial lymph nodes
Roots of great vessels
Arch of azygos vein
Main bronchi
Plexus of heart & cardiac
Pericardium
Phrenic nerves

Front 29

Back 29

Front 30

The left ventricle is located under the ___ intercostal space.

Back 30

5th

Front 31

mitral valve is between left atrium and ____ ____.

Back 31

left ventricle

Front 32

What are the four distinct auscultation areas?

Back 32

A = aortic
P = pulmonary
T = tricuspid
M = mitral

Front 33

What is the auscultation area left laterally adjacent to thesternum in the 5th intercostal space?

Back 33

Tricuspid (ventricle)

Front 34

What is the auscultation area left laterally a finger length away from the sternum in the 5th intercostal space?

Back 34

Mitral valve.

Front 35

What is the auscultation area in the 2nd subcostal space on the right side adjacent to the sternum?

Back 35

Aortic

Front 36

What is the auscultation area in the 2nd subcostal space on the left side a finger's breadth away from the sternum?

Back 36

Pulmonary

Front 37

What nerves traverse the space between the pericardial sac and the pleura?

Back 37

Pericadiacophrenic arteries and the phrenic nerve traverses this space

Front 38

Back 38

Front 39

The pericardium has (for our purposes) what two main layers?

Back 39

outer fibrous and inner serous layers.

Front 40

The inner serous layer is invaginated by the developing heart & becomes a double layer forming a ___ & ___ ____ layer.

Back 40

visceral and
parietal serous layer

Front 41

what is the space between the two layers of serous pericardium?

Back 41

pericardial cavity

Front 42

Why is the transverse sinus more important clinically than the oblique sinus?

Back 42

you can separate the inflow of the heart from the outflow of the heart.

Front 43

what does the transverse sinus separate?

Back 43

the inflow and outflow of the heart -
INFLOW
- IVC, SVC, headed for lungs and deoxy.
- RPV x2 and LPV x2, just left the lungs and headed for body.
OUTFLOW
- Aorta - filled with oxy and headed to body,
- Pulmonary trunk (aka pulmonary artery) with deoxygenated blood headed for lungs

Front 44

Back 44

Front 45

TRUE /FALSE - the pericardium and the heart share the same blood and nerve supply.

Back 45

FALSE! They are very different.

Front 46

the ericardiacophrenic artery is a branch of what artery?

Back 46

internal thoracic a.

Front 47

the main blood supply of the pericardium is what artery?

Back 47

pericardiacophrenic a., a branch of the internal thoracic a.

Front 48

venous drainage of the pericardium is from what veins, and where do they feed?

Back 48

Venous drainage is mainly via pericardiacophrenic veins to the brachiocephalic veins

Front 49

is the phrenic nerve (C3-C5) visceral or somatic?

Back 49

somatic

Front 50

since the phrenic nerve is somatic, pain felt in the pericardium often does what?

Back 50

it is referred to the C3-C5 dermatomes. (neck shoulder and lateral arm)

Front 51

Heart pain will have its own set of nerves that it affects. but what else might be affected and have a different set of nerves with referred pain?

Back 51

heart pain is usually accompanied with pericardium pain, as this sack typically will be compressed or hurt if the heart is having problems.

Front 52

Relate shoulder neck and lateral arm pain to the heart.

Back 52

These dermatomes can have referred pain from the phrenic nerve, which additionally innervates the pericardium. If the heart is hurting as in a heart attack or something similar, this will also have an effect on the pericardum and cause problems for the C3-C5 dermatomes, as the phrenic nerve is not visceral but is somatic.

Front 53

Pericardiocentesis, is removal of excess fluid from the pericardial cavity. Where is the needle inserted?

Back 53

Left 5th or 6th intercostal space near the sternum.

Front 54

Back 54

Front 55

does the phrenic or the vagus nerve pass anterior to the root of the lung?

Back 55

phrenic

Front 56

what are the muscles of the heart attached to?

Back 56

a fibrous skeleton

Front 57

The four fibrous rings of the heart, annuli fibrosi, hold the valves in place and are ___ together.

Back 57

fused.

Front 58

Back 58

Front 59

What are the biggest things you see when youre looking at the heart from the sternocostal surface?

Back 59

Its the anterior view so Formed mostly by right ventricle & small part of right atrium

Front 60

Back 60

Front 61

Back 61

Front 63

Back 63

Front 64

The base (posterior) surface of the heart contains mostly what structure?

Back 64

the left atrium (small part of right atrium)

Front 65

the base of the heart lies anterior to what structure?

Back 65

the esophagus

Front 66

and anterior ulceration of the esophagus could erode into what structure of the heart?

Back 66

left atrium

Front 67

the superior vena cava opens into the right atrium at what costal level?

Back 67

right 3rd costal cartilage

Front 68

the inferior vena cava opens into the right atrium at what costa level?

Back 68

right fifth costal cartilage

Front 69

what is on the external surface of the right atrium just over the crista terminalis?

Back 69

the sulcus terminalis

Front 70

Back 70

Front 71

the coronary sinus receives blood from what?

Back 71

the coronary veins

Front 72

Back 72

Front 73

Back 73

Front 74

What is a non-support related function of the septomarginal trabeculae?

Back 74

this moderator band is a curved muscular bundle that runs from the intermuscular septum to the anterior papillary muscle. This trabeculae carries right bundle branches of the AV bundle of the conducting system of the hear,t to the anterior papillary muscle. this allows the valves to open slightly before the rest of the ventricle contracts (preventing prolapsed valves)

Front 75

which papillary muscle does the septomarginal trabeculae attach to?

Back 75

anterior papillary m.