Unit 4 - Wk 1 Anatomy

Front 1

where do the internal thoracic arteries run?

Back 1

along the sternum; anastomose with intercostal arteries

Front 2

Back 2

Superior and inferior regions of the mediastinum at the level of the sternal angle

Front 3

What is contained in the mediastinum?

Back 3

mediastinum = the space between the pleural cavities in the chest; it contains the heart, great vessels, esophagus, airways, nerves and thoracic duct

Front 4

Azygos System/Vein

Back 4

Connects superior vena cava with inferior vena cava; receives blood from intercostals and subcostals

Front 5

Relationship of the azygos system and esophagus

Back 5

Receives blood from esophageal plexi, which anastomse with branches of hepatic portal system

Front 6

Back 6

Left Posterior Mediastinum; note ligamentum arteriosum = remnant of fetal ductus arteriosus which enusres a single circulatory system before birth

Front 7

Back 7

right posterior mediastinum; noite azygos vein, arch of azygos where it connects to superior vena cava

Front 8

Back 8

Thoracic Duc tin posterior mediastinum; note that the TD receives lymph from all but the upper right quadrant of the body (which is drained via the right lymphatic duct); crosses from right to left to empty into veins at the left venous angle

Front 9

Back 9

Transverse Sinus; since you can separate the pulmonary trunk and aorta from venous inflow you can connect a heart lung machine here

Front 10

Back 10

Note how pericardial sac is fused to central tendon of the diaphragm

Front 11

AlOH

Back 11

antacid, constipation
1. alkalinizes stomach, delays gastric emptying, chelates -->↓ absorption of tetracycline, isoniazid, ketoconazole, fluroquinolones
2. alkalinizes urine which changes urinary excretion of drugs
↑ acidic drug excretion (salicylates)
↓ basic drug excretion (quinidine)

Toxicity: hypokalemia, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures

Front 12

What is the function of the connective tissue of A-V boundary?

Back 12

Fibrous skeleton associated with the valves and atrioventricular septum; provides mechanical support and electrical insulation of the atria from the ventricles

Front 13

Normal Heart Orientation

Back 13

Base of heart is where the veins and arteries enter/leave

Left ventricle is dorsolateral to right ventricle

Front 14

二

Back 14

èr

Hint 14

two

Front 15

Which heart valves are not tethered by cordae tendineae?

Back 15

Pulmonic and aortic semilunar valves

Front 16

What structure may be damaged when a surgeon closes a ventricular septal defect?

Back 16

AV Bundle

Front 17

Where are the coronary arteries located?

Back 17

Aortic Sinus;

Front 18

Which coronary artery supplies the interventricular septum (which includes most of the AV bundle branches)

Back 18

Left coronary Artery

Front 19

Which coronary branch supplies the SA node?

Back 19

right coronary artery

Front 20

What is the most common site of occlusion?

Back 20

Anterior Interventricular Branch

Front 21

where are cell bodies for the first order neurons of the sympathetic nervous system?

Back 21

Interomediolateral Nulceus

Front 22

Back 22

Long preganglionic parasympathetic axons (vagus nerve) with short postganglionic neurons located in the wall of the structure innervated

Front 23

Back 23

Conducting System of the Heart

If denervated, the heart will spontaneously contract at approximately 30 bpm

Front 24

Bundle of His

Back 24

Begins at AV node; bifurcates passing along the interventricular septum to reach the myocardium

blockage here = heart block, which can happen during a procedure to repair a defect in the intraventricular septum

Front 25

How does epinephrine affect adrenergic postganglionic sympathetic axons?

Back 25

Potentiates the action of NE via B2R

Front 26

How do you account for the reffered pain of MI?

Back 26

T1-T5 dermatones affected; usually goes down left side bc left ventricles commonly affected (larger oxygen demand due to thick walls from pumping against systemic pressure)

Front 27

Back 27

Levine's Sign; pressing on sternum; afferent traffic for pressure diminishes competes w/ pain traffic for conscious perception; diminishes pain in T1-T5(t6)

Front 28

Back 28

Note the three layers of the pericardium; (outer fibrous, parietal, visceral)
There is pericardial space between the parietal and visceral layers

Front 29

Back 29

Effusive Constrictive Pericarditis

Exertional fatigue, dyspnea, abnormallly distended neck
veins, dependent edema, and hepatic
engorgement are almost universally
present. Ascites is found in 15-50% of
patients.

Front 30

Why might you get left shoulder pain in effusive constrictive pericarditis?

Back 30

Fibrous and parietal layers of the serous pericardium are innervated by the phrenic nerves

Front 31

Where will pain from the ascending aorta radiate?

Back 31

Anterior thoracic wall since it's an anterior structure

Front 32

Where will pain from the descending aorta radiate?

Back 32

Posterior chest wall; descending aorta is a posterior structure

Front 33

Grave prognostic sign of aortic dissection

Back 33

Interscapular pain that moves over time

Front 34

Relative to the mediastinum, where is the arch of the aorta?

Back 34

Superior mediastinum (T4 and above)