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Cardio Block2anatomy

What are the boundaries of the superior mediastinum? Superior boundary: superior thoracic; Inferior boundary: sternal angle plane; Anterior boundary: manubrium; Posterior boundary: T1-4 vertebrae
The superior mediastinum communicates with what space(s) above? Anterior Neck
The superior mediastinum communicates with what space(S) below? Anterior mediastinum and posterior mediastinum
List the strs w/in the superior mediastinum from deep to superficial. -Sympathetic chain (T1-4) -Esophagus -Trachea -Aortic arch and branches -Vagus nerve -Left recurrent laryngeal nerve -Cardiac-pulmonary plexus (around aortic arch) -Phrenic nerves (C3-5) -Brachiocephalic veins -Thoracic duct -Thymus
List the boundaries of the anterior mediastinum. Superior boundary: sternal angle plane; Inferior boundary: diaphram; Anterior boundary: sternum body; Posterior boundary: Pericardial sac
List the contents of the anterior mediastinum. Thymus and lymph nodes
What space(S) does the anterior mediastinum communicate with? Superior mediastinum
What structure limits the inferior space of the anterior mediastinum? Diaphram
The anterior mediastinum is located deep to what bony structure? Sternum
List the boundaries of the middle mediastinum. Superior: sternal angle plane; Inferior: diaphram; Anterior: anterior border of pericardial sac; Posterior: posterior border of pericardial sac
The middle mediastinum communicates with which spaces in the mediastinum NONE: enclosed in pericardial sac
List the 5 great vessels of the heart. Ascending aorta, pulmonary trunk, superior vena cava, inferior vena cava, pulmonary veins
List the 3 vessels that drain into the right atrium. Inferior, superior vena cava AND coronary sinus
What embryologic remnant remains in the interatrial septum? Fossa ovalis
Describe the structure of the interventricular septum. The upper part is fibrous b/c it is part of the cardiac skeleton of the heart. The remainder of the interventricular septum is thick and is formed of cardiac muscle.
Describe the structure of the tricuspid valve and compare it to the mitral valve. The tricuspid guards the right atrioventricular orifice and the mitral valve guards the left. Both are fibrous leaflets, tri=3, mitral=2. They both attach to chordae tendineae which attach to papillary muscles in the ventricle wall
Describe how the tricuspid and mitral valves open. Pressure changes, open during diastole close during systole.
What are the 4 vessels that drain blood into the left atrium? 4 pulm veins (R/L superior, R/L inferior)
Which chamber of the heart forms most of the anterior surface of the heart? Right ventricle
Which chamber of the heart forms the apex? Left ventricle
What intercostal space is the apex at? Deep to the left 5th intercostal space, lateral to the left sternal border, near the midclavicular line
Which chamber forms the base of the heart? Left atrium
What vertebral level is the base of the heart at? T5-8 when supine; T6-9 when standing
Where does the right coronary artery come from? Originates from the right cusp of the aortic valve.
Where does the right coronary artery course from origination? coronary sulcus
What are the right coronary artery's main branches? Right ventricular branch and Posterior descending artery (in the posterior interventricular sulcus)
Where does the left coronary artery come from? LEft cusp of the aortic valve
Where does the left coronary artery course from origination? coronary sulcus
What does the left coronary artery branch into? Divides into a circumflex artery that continues in the coronary sulcus to the base of the heart and a left anterior descending artery (LAD) that continues in the anterior interventricular sulcus to the apex of the heart.
What does it mean if a heart is described as right dominance and how is that different than left dominance? Which is more common? R coronary a. gives off post. interventricular a. in a R dominant heart. In a left dom. heart the circumflex a. gives off the posterior interventricular artery. R Dominance is most common (80%)
Does most of myocardial perfusion occur during diastole or systole? Diastole (both the subendocardial vessels and epicardial vessels are open, only the epicardial coronary vessels remain open during systole)
List the 3 main cardiac veins and how they drain the heart wall. Great, middle, small cardiac veins -->drain into coronary sinus located in the posterior coronary sulcus, and empty into the right atrium.
Where is the SA node? R atrium near opening of the superior vena cava
Where is the AV node? interarterial wall near the opening for the coronary sinus
Describe the closure of the pericardial sac. Superiorly: blends w/adventia on the superior vena cava, ascending aorta, and pulm a. Inferiorly: attaches to central tendon of diaphragm and blends w/adventia of the inferior vena cava. Posteriorly: blends w/ adventia of the 4 pulmonary veins
What is in the pericardial cavity? Thin layer of serous fluid produced by the visceral and parietal pericardium.
What is somatic sensory innervation of the pericardial sac? Phrenic nerves (C3-5)
List the structures w/in the posterior mediastinum from deep to superficial. Symp chain (T5-12) Thoracic aorta and branches Azygous venous system Esophagus Vagus Nerve Thoracic Duct
What is the course of the esophagus? Continuation of hypopharynx, begins at C6, courses btw cervical vertebrae and the trachea, in the posterior mediastinum it transverses the diaphragm through the esophageal hiatus (T10 level) to the stomach
What is the course of the trachea? Begins at C6 distal to larynx, superficial to esophagus while coursing, at sternal angle plane it bifurcates into R and L main bronchi, leaves the mediastinum and enters the pleural spaces.
What is the course of the thoracic duct? Begins below the diaphragm where it receives all lymph vessels from lower body, transverses the diaphragm into aortic hiatus (sandwiched btw thoracic aorta and esophagus), near sternal angle it bends left, deep to esophagus, and joins brachiocephalic vein
What is the course of the vagus nerves? Exit skull thru jugular foramen, posterior position in carotid sheaths on both sides of neck. Gives off several branches then enters the superior mediastinum, hugs aortic arch, gives off a left recurrent laryngeal nerve that passes under the aortic arch
What is the target of the left recurrent laryngeal nerve? larynx (nerve passes under the aortic arch and courses back up the neck lateral to the trachea to reach the larynx).
Created by: THerzogA



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