Case 2

Question 1

what is the mediastinum?

Answer 1

the region in the thorax minus the lungs and pleura

Question 2

what can the mediastinum be split into?

Answer 2

superior and inferior
inferior is split into anterior middle and posterior

Question 3

the heart and pericardium are found in which region of the mediasternum?

Answer 3

middle

Question 4

where does the superior vena cava bring blood from?

Answer 4

the head and neck

Question 5

what is the vena cava split into?

Answer 5

superior and inferior

Question 6

where do the veins drain into the heart?

Answer 6

right atrium

Question 7

where after the right atrium does the blood pass through?

Answer 7

the tricuspid valve

Question 8

where does oxygenated blood enter the heart?

Answer 8

pulmonary vein

Question 9

which valve allows oxygenated blood through the left atrium to left ventricle?

Answer 9

mitral valve

Question 10

name the greater vessels

Answer 10

brachiocephalic trunk
left common carotid artery
left subclavian artery

Question 11

what covers the heart?

Answer 11

pericardium (fibrous)

Question 12

what are the layers of the pericardium and their functions

Answer 12

fibrous - tough, loose fitting, inelastic
serous - has a parietal and visceral layer

Question 13

what lies between the two layers of serous pericardium?

Answer 13

pericardial fluid

Question 14

name the surface anatomy of the heart

Answer 14

right 3rd and 6th costal cartilage
left 2nd costal cartilage and 5th intercostal space (apex beat mid clavicular line)

Question 15

describe the location of the heart

Answer 15

located behind the mediastinum
behind the sternum
between 2nd and 6th ribs
between T5 and T8

Question 16

name the auscultatory sites

Answer 16

aortic valve - right 2nd intercostal space
pulmonary valve - left 2nd intercostal space
tricuspid valve - left 4th+5th intercostal spaces
mitral valve - apex beat

Question 17

what is the purpose of coronary arteries purposes?

Answer 17

supply the heart primarily

Question 18

name the coronary arteries

Answer 18

left and right coronary arteries
left and right aortic sinuses

Question 19

how can you distinguish which is the aorta or pulmonary artery?

Answer 19

coronary arteries arise from aorta

Question 20

what does the left coronary artery also supply (other than left side if heart)?

Answer 20

the apex of the heart

Question 21

name the branches of the left coronary artery

Answer 21

circumflex branch (winds around the heart) –> marginal branch
left anterior descending artery (LAD) is a major branch–> diagonal branch
SA (nodal branch)

Question 22

what does circumflex mean?

Answer 22

winding or wrapping

Question 23

name the branches of the right coronary arteries

Answer 23

right coronary artery - marginal branch, sinoatrial branch, posterior descending branch/ posterior interventricular artery

Question 24

where does the posterior descending artery/ posterior interventricular artery run?

Answer 24

in between the ventricles

Question 25

where does the SA (nodal) branch supply?

Answer 25

SA node and these branches are highly variable

Question 26

what is coronary artery dominance?

Answer 26

determined by posterior descending artery (right) majority but some can be left coronary artery dominant

Question 27

why is coronary artery dominance important to know?

Answer 27

to known which areas of the heart are most at risk of a heart attack

Question 28

what is the right CA marginal branch and posterior descending branch accompanied by?

Answer 28

small cardiac vein (marg) middle cardiac vein (posterior desc)

Question 29

how do veins run on the heart? what is the pattern?

Answer 29

they run with the arteries

Question 30

what runs alongside the left CA the left anterior descending artery ?

Answer 30

great cardiac vein

Question 31

what is an important note to make in terms of the draining of the cardiac veins?

Answer 31

they all drain into the coronary sinus which opens into the right atrium there is no artery opening in the right atrium (think about it and it will make sense)

Question 32

learn the territories if the coronary arteries

Question 33

name the atrioventricular valves

Answer 33

tricuspid and mitral

Question 34

name the semilunar valves

Answer 34

pulmonary and aortic

Question 35

identify the internal structure of the right atrium

Answer 35

venous return opening for superior and inferior vena cava, coronary sinus and impression of fossa ovalis

Question 36

name the features of the wall of the right atrium

Answer 36

pectinate muscle and crista terminalis

Question 37

what is crista terminalis and how does this relate to the pectinate muscles?

Answer 37

crista terminalis is a thick band of muscle which which has small fibres which come off it called pectinate muscles

Question 38

how do you identify the right atrium

Answer 38

it is the only chamber which contains the crista terminalis and pectinate muscles

Question 39

what does the right atrium also contain for heart beat related purposes?

Answer 39

SAN and AVN

Question 40

what is the anatomical position of the SAN?

Answer 40

small bump inferior to superior vena cava

Question 41

what is the anatomical position of the AVN?

Answer 41

by the tricuspid valve

Question 42

do the features of the right and left ventricles remain the same?

Answer 42

yes

Question 43

name the features of the ventricles

Answer 43

papillary muscle chordae tendineae trabeculae carneae

Question 44

what is the floor of the ventricle called?

Answer 44

trabeculae carneae

Question 45

where does the papillary muscle attach?

Answer 45

to the trabeculae carneae

Question 46

what is the function of the papillary muscle?

Answer 46

for additional strength and to stabilise the valve

Question 47

name the regions of the left atrium?

Answer 47

opening for the pulmonary veins you can see depression for fossa ovalis

Question 48

what texture does the left atrium have?

Answer 48

it is a smooth chamber

Question 48

how do you distinguish the right and left ventricle?

Answer 48

the thickness of the muscle wall (left has more hypertrophy)