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150 Cards in this Set
- Front
- Back
- 3rd side (hint)
mediastinum, organization
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mediastinum is
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central compartment of thoracic cavity
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mediastinum, contents
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all thoracic vicera, except the lungs
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mediastinum, surrounded by
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pleural cavitites
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mediastinum estends from
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superior thoracic aperture to diaphragm
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mediastinum, in vivo is
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highly mobile
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mediastinum, effects of aging on
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connective tissue becomes more fibrous and rigid
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mediastinum, subdivisions
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superior and inferior parts
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mediastinum subdivided by
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thransverse thoracic plane
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transverse thoracic plane bisects
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sternal angle
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inferior mediastinum divided into
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three parts: anterior, middle, postierior
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location of contents in mediastinum, supine position
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aortic arch superior to
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transverse thoracic plane
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trachial bifurcation transected by
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transverse thoracic plane
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central tendon of diaphragm lies at
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level of xiphisternal junction (T9)
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location of contents in mediastinum, standing position
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aortic arch transected by
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transverse thoracic plane
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central tendon falls to
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mid level of xiphoid process (IV disc between T9 and T10)
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contents, superior mediastinum
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superior vena cava, brachiocephalic veins, arch of aorta, thoracic duct, trachea, esophagus, thyms, left recurrent laryngeal nerve
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contents, anterior mediastinum
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remnants of thymus, lymph nodes, fat & connective tissue
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contents, middle mediastinum
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pericardium, phrenic nerves, heart & cardiac plexus, roots of great vessels, arch of azygos vein, main bronchi & tracheobronchial lymph nodes
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contents, posterior mediastinum
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esophagus, thoracic aorta, azygos & hemiazygos veins, thoracic duct, vagus nerves, sympathetic trunks, splanchnic nerves
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middle mediastinum & contents
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location, left ventricle
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under 5th intercostal space
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know locations for auscultation, slide 10
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know how to ID structures, radiograph, slide 9
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heart surrounded by
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pericardial sac
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between pericardial sac and pleura there is
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a space
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structures that traverse the space between the pericardial sac and pleura
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pericardiacophrenic arteries and phrenic nerve
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two portions of pericardium
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outer fibrous and inner serous
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fibrous pericardium continuous with
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pretrachial layer of cervical fascia, tunica adventicia of great vessels, sternum, diaphragm, & structures in posterior mediastinum (loosely)
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inner serous layer invaginated by
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developing heart
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inner serous layer becomes
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visceral & parietal serous layer (a double layer)
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space between two layers of serous pericardium is
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pericardial cavity
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ID pericardial sinus, vessels and nerves, slide 13
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transverse sinus lies anterior to
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superior vena cava
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transverse sinus lies posterior to
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the aorta & pulmonary trunk
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location of transverse sinus important in
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heart surgery
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transverse pericardial sinus continuous from
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left to right sides of heart
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oblique pericardial sinus is a
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blind pouch
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pericardium, blood supply (main)
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pericardiophrenic a.
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pericardiophrenic a. is a branch of
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the internal thoracic a.
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pericardium, blood supply (minor)
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musculophrenic a., coronary a., branches of thoracic aorta
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musculophrenic a. is a terminal branch of
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internal thoracic a.
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coronary aa only supply _____ layer of pericardium
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visceral layer of serous pericardium
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venous drainage, pericardium
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via pericardiocophrenic veins to brachiocephalic veins
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pericardiophrenic veins also have tributaries to
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azygos system
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innervation of pericardium is via
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phrenic nn (C3-C5)
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phrenic nn to pericardium are
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somatic (not visceral)
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pain from pericardium referrs to
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C3-C5 dermatomes
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innervation of pericardium, minor
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vagus n. (function unknown) & sympathetic trunks (vasomotor)
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phrenic n passes anterior to
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root of lung
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vagus n passes posterior to
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root of lung
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pericardiacophrenic vessels & phrenic nn lie within
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fibrous pericardium
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cardiac muscle fibers arranged in
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indistinct bundles that attach heavy fibrous connective tissue
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fibrous skeleton of heart separates the
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musculature of atria from ventricules
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fibrous skeleton of heart, function
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forms foundation to which the valves & myocardial fiber bundles are attached
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4 fibrous rings of cardiac skeleton called
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annuli fibrosi
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annuli fibrosi are fused
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to each other
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superficial spiral bundles of the ventricles arise principally from
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atrioventricular fibrous rings and from a vortex at apex
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on the inside of the ventricles, fibers emerge from ventricles as
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trabeculae carneae
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trabeculae carneae aka
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papillary muscles
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deep spiral bundles attach to
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fibrous rings
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deep spiral buncles encircle one or both
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ventricles
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sternocostal surface of heart formed by
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right ventricle & small part of right atrium
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diapgragmatic surface of heart formed by
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left ventricle & small part of right ventricle
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base (posterior surface) of heart formed primarily by
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left atrium & small part of right atrium
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base (posterior surface) of heart lies anterior to
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esophagus
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anterior ulceration of esophagus can erode into
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left atrium
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right atrium, posterior wall, characteristic
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smooth
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right atrium, anterior portion, sturcture
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pectinate muscle
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fossa ovalis is
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embryonic remnant of foramen ovale
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memorize structures, slide 23
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crista terminalis separates
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smooth from rough walls of atrium
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sulcus terminalis, location
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exterior right atrium
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sulcus terminalis is
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a groove that marks the internal ridge of the crista terminalis
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tricuspid valve aka
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atrioventricular valve
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tricuspid valve located
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in right ventricle
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3 papillary muscles
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anterior, posterior, & septal
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septomarginal trabecula
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moderator band in right ventricle
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memorize sturctures, slides 24, 25, 26
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right ventricle, thickness
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one third of that of left ventricle
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left atrium forms
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base of heart
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left atrium, walls
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primarily smooth except for pectinate myscle in auricle
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left atrium, vessels
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two superior and two inferior pulmonary veins
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left atrium, depression
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located on medial wall for valve of foramen ovale
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left atrium, wall thickness
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thicker than right atrium
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left ventricle, valve
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bicuspid valve
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bicuspid valve aka
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mitral or atrioventricular valve
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left ventricle, papillary muscles
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two, anterior & posterior
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papillary muscles in left ventricles are larger than
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those in right ventricle
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trabeculae carneae are
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finer & more numerous than in right ventricle
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left ventricular wall is
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2-3 times as thick as right ventricle
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diastole, definition
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dilation of heart cavities, during which they fill with blood
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dilation of atria precedes
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dilation of ventricles
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visualize, slide 27
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visualize, slide 28
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systole, definition
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contraction of the heart, especially the ventricles, by which blood is driven through aorta & pulmonary artery to traverse systemic & pulmonary circulations respectively
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aortic valve, slide 29, visualize
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slide 30, visualize
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blood supply, innervation, & lymphatics
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right coronary artery located in
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atrioventricular groove
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right coronary a. gives rise to
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SA nodal & right marginal branches
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left coronary artery divides into
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circumflex & anterior interventricular branches
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circumflex a. lies in
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atrioventricular groove
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anterior interventricular branch lies in
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interventricular groove
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great and small cardiac veins drain
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the sternocostal surface of the heart along with the anterior cardiac veins
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structure that receives the posterior interventricular and/or middle cardiac vein on the diaphragmatic surface of the heart
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coronary sinus
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receives small cardiac vein at its right end
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coronary sinus
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innervation of heart supplied by both
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sympathetic and parasympathetic fibers
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cardiac plexus located on
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anterior surface of trachia at bifurcation and on anterior surface of aortic arch
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sympathetic innervation of heart consists of
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postganglionic fibers from cervical or upper thoracic ganglion
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None
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route of sympathetic nn to heart
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preganglionic fibers frokm upper 4 or 5 thoracic segments --> sympathetic chain --> synapse in cervical or upper thoracic ganglion --> postganglionic fibers enter cardiac plexus
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sympathetic nerves are
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adrenergic (norepinephrine)
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sympathetic innervation of heart cuases
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increased heart rate and increased force of contraction
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visceral affernts from sympathetics carry
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pain back to spinal levels in which they originated
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parasympathetic innervation of heart consists of
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vagus nerve
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parasympathetic nerves are
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cholinergic (acetylcholine)
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parasympathetic innervation of heart causes
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heart rate to slow, force of contraction to decrease, and constriction of blood vessels
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SA node, location
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junction of superior vena cava and superior end of crista terminalis
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SA node aka
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pacemaker of heart
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SA node initiates and regulates impulse of
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70 beats per minute
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fibers that supply SA node
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sympathetic and parasympathetic fibers via the cardiac plexus
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AV node located
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in posteroinferior region of interarterial septum near orifice of coronary sinus
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AV node receives impulses from
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the SA node
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AV node sends impulses to
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ventricles via atrioventricular bundle
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atrtioventricular bundle separates into
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right and left bundles to respective ventricles
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atrioventricular bundle bifurcation located at
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junction of membranous & muscular parts of septum
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lymphatics of heart form
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networks adjacent to endocardium and epicardium
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efferent lymphatic vessels of heart drain along
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coronary aa
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eferent lymphatic vessels of heart empty into
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lymph nodes associated with the lower end of the trachea (tracheobronchial nodes)
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clinical considerations
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pericardiocentesis
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process of removing fluid from pericardial sac via needle aspiration
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pericarditis caused by
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certain inflammatory diseases that produce a pericardial effusion (fluid) in the pericardial sac
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pericarditis causes
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chest pain
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pericarditis results in
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compression of heart and ineffective pumping because fibrous pericardium does not expand
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fluid in pericardium aka
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cardiac tamponade
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cardiac tamponade, result
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can be lethal if fluid is not removed from pericardial sac
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dopplar flow used to
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check for stenosis of arteries
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atherosclerotic thickening of intimal layer of internal carotid a will
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obstruct blood flow as a result of stenosis (narrowing)
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partial occlusion of carotid a may result in
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sudden dizziness & disorientation that disappears in 24 hours; may also cause a minor stroke
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stenosis occurs in the
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internal carotid a just superior to its origin
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internal carotid a located proximal to
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glossopharyngeal, vagus, accessory, hypoglossal, & superior laryngeal nn
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arteriosclerosis is
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hardening of the arteries
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types of arteriosclerosis
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atherosclerosis, Monckeberg's atherosclerosis, and arteriolosclerosis (small vessels)
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atherosclerosis is a common form of
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arteriosclerosis
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atherosclerosis is associated with
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buildup of fat (cholesterol) in arterial walls
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in atherosclerosis, calcium deposits foorm
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atheromatous plawues that can result in formation of thrombi
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transverse pericardial sinus is location where
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once pericardial sac is opened, one can place a clampe or ligature around great vessels during coronary bypass, heart transplant, etc.
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great vessels anterior to transverse pericardial sinus
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ascending aorta & pulmonary trunk
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