| the sternal angle (the thoracic plane) | where is the divide between the superior and inferior mediastinum? |
| the anterior, middle and posterior mediastinum | What is the inferior mediastinum further subdivided into? |
| T1-4 | Which vertebrae form the prosterior border of the superior mediastinum? |
| superior (this organ is only present until puberty) | where is the thymus located in the mediastinum? |
| fibrous pericardium, parietal layer of serous pericardium, pericardial cavity, epicardium (viceral layer of the serous pericardium), myocardium, endocardium | Name the layers of the pericardium (outside in) |
| cardiac muscle | what is the myocardium composed of? |
| endocardium (simple epithelium), myocardium, epicardium (simple epithelium) | what are the structures of the heart wall |
| accumulation of excess fluid in the pericardial cavity which causes increased pressure on the heart wall and impedes the normal filling of the heart (if very severe can lead to cardiac failure) | what is cardiac tamponade? |
| autonomic innervation via T1-4 nerves and vagus via the cardiac plexus (same as the heart wall) | what is the visceral pericardium innovated by? |
| mainly the phrenic nerve (parietal can feel pain) | what is the parietal and fibrous pericardium innovated by? |
| thin walls and receive blood (increased capacity) | What role does the auricles of the heart play in adults? |
| left ventricle | what chambers of the heart form the apex? |
| left atrium | what chamber of the heart forms the base? |
| opening for coronary sinus, interarterial septum, fossa ovalis, musculi pectinati, crista terminalis, left auricle | name the structures found in the open right atrium? |
| bypass the lungs in the foetus and move blood directly from the right to left atrium of the heart | what was the function of the foramen ovale (the now sealed fossa ovalis) |
| pulmonary trunk, pulminary valve (semilunar),moderator band, papillary muscle, trabeculae carnea, chordinae tendoneae, tricuspid valve | name the structures found in the right ventricle |
| connects interventricular septum with anterior wall of RV, carries part of the right bundle branch of the AV bundle of the conducting system to the anterior papillary muscle | what is the function of the moderator band? |
| left is 3x thicker as higher force required to pump blood through the systemic circulation | why is the left ventricle wall thicker than the right? |
| 3 (attached to the three cusps) | how many papillary muscles are found in the right ventricle? |
| superior and inferior pulmonary veins, foramen ovale | structures of the left atrium |
| bicuspid valve | which valve connects the LA to the LV? |
| aortic valve, pulmonary valve, mitral (bicuspid) valve, papillary muscles | name the structures of the left ventricle |
| 2 | how many papillary muscles are found in the left ventricle? |
| attaches to the cusps of the atrioventricular valves, contracts on systole to prevent inversion or prolapse of these valves | what is the function of the papillary muscle? |
| to hold the atrioventricular valves in place while the heart is pumping blood | what is the function of the chordae tendineae? |
| atrioventricular sulcus and interventricular sulcus | name the two sulci (grooves) in the heart |
| right coronary artery, left anterior descending artery, circumflex artery, left coronary artery, posterior descending artery (right) | name the five coronary arteries |
| ascending aorta (aortic sinus) | from which part of the aorta do the coronary arteries arise? |
| circumflex and right coronary arteries | which pair of coronary arteries anastomose in the coronary (atrioventricular) sulcus? |
| right posterior and left anterior descending arteries | which pair of coronary arteries anastomose in the interventricular sulcus? |
| coronary sinus, small cardiac vein, great cardiac vein, middle cardiac vein, obliquie vein of left atrium, anterior cardiac veins | name the cardiac veins |
| directly into the right atrium | where does the anterior cardiac vein drain into? |
| interventricular septum and anterior walls of both ventricles | what does the anterior descending artery supply? |
| left atrium and posterior walls of left ventricle | what does the circumflex artery supply? |
| lateral side of the heart (including right atrium) | what does the marginal artery supply? |
| posterior right ventricle walls | what does the posterior descending artery supply? |
| T4 | at what vertebrae level does the aortic arch begin and terminate? |
| L4 | at what vertebrae does the abdominal aorta bifurcate into common iliacs? |
| L5 | at what level does the bifurcation of the common iliac arteries occur? |
| brachiocephalic (branches into right subclavian and right carotid), left common carotid and left subclavian | name the three branches of the aortic arch |
| small veins which drain directly into each chamber of the heart | what are the venea cordis minimae? |
| posterior intercostal arteries (only ones which are visible in wet specimen) and bronchial/oesophageal/pericardial arteries | name the branches of the descending thoracic aorta |
| subclavian artery (the ITA runs next to the sternum and branches into the anterior intercostal arteries, these branches also supply the fibrous pericardium, parietal pleura and diaphragm) | which artery gives origin to the internal thoracic artery? |
| arise at vertebral level L5 and become the femoral aa | external iliac arteries |
| arise at vertebral level L5 and supply pelvic viscera | internal iliac arteries |
| head, neck and upper limbs | where does the superior vena cava drain blood from? |
| abdominal and pelivic cavites and lower limbs | where does the inferior vena cava drain blood from? |
| drains anterior intercostal veins to the L + R brachiocephalic veins | what does the internal thoracic (mammary) vein drain? |
| lies anterior and to the right of the the aorta, L + R brachiocephalic veins and azygous vein | where does the superior vena cava lie and what drains into it? |
| L+R common iliac veins | what drains into the inferior vena cava? |
| azygos vein- runs right side of aorta and hemiazygos veinous system- left side of aorta (these drain the posterior intercostal veins) into the superior vena cava | what is the azygos venous system comprised of? |
| T8/9 | at what vertebrae level does the hemiazygos drain into the azygos vein? |
| subclavian, axillary, brachial then radial and ulnar | What are the main arteries in the arm ( top to bottom) |
| the lateral border of the first rib | at which bony point does the subclavian artery become the axillary artery? |
| cubital fosa | in which area of the upper limb does the brachial artery branch into the radial and ulnar aa. |
| radial | which artery is more superficial, radial or ulnar? |
| femoral, popliteal, dorsalis pedis, posterior tibial arteries | where can you find a pulse in the lower limbs? |
| iliac, deep femoral, superficial femoral, politeal, anterior and posterior tibial | name the major arteries in the lower limb? |
| lateral border of the politeal muscle | where does the popliteal artery branch into the anterior and posterior tibial aa. |
| continuation of the anterior tibial artery on the dorsum of the foot | what is the dorsalis pedis? |
| medial malleolus | the posterior tibial a. enters the sole of the foot inferior to which malleolus of the ankle? |
| named according to their corresponding arteries and they lie next to them i.e femoral, politeal, posterior tibial veins | how are the deep veins named? |
| carotid a, abex beat, brachial a, abdominal a ,radial a, femoral a, popliteal a, posterior tibia a, dorsalis pedis a | what are the main pulses of the body (head down) |
| the great and small saphenous veins | name the two superficial veins of the lower limbs? |
| femoral vein | which vein does the great saphenous v. drain into? |
| the popliteal vein | which vein does the small saphenous vein drain into? |
| the leaflets of the valves no longer properly meet leading to valvular incompetence allowing the backflow of blood (most common in superficial veins of legs) | what causes varicose veins |
| medial end of the left subclavian vein | where does the thoracic duct drain into? |
| medial end of the right subclavian vein | where does the right lymphatic duct drain into? |
| vertebral level L1 as the cisterna chyli (it crosses the body from left to right T4 so it can drain into the L subclavian v) | where does the thoracic duct commence? |
| parasternal nodes | along the internal thoracic artery and recieve lymph from medial part of breast, intercostal spaces, costal pleura, diaphragm |
| phrenic nodes | thoracic surface of diaphragm and recieve lymph from pericardium, diaphragm, liver and drain into parasternal nodes |
| intercostal nodes | found at the vertebral end of the intercostal spaces |
| where does lymph from the heart drain? | right inferior tracheobronchial nodes and mediastinal (bronchopulmonary and paratracheal) nodes |
| what nerves innovate the heart? | vagus nerves (parasympathetic)and T1-4 (sympathetic) are routed to the heat in the cardiopulmonary plexus which is situated at the bifurcation of the trachea |
| what carries pain fibres from heart to spinal cord? | T1-4 spinal nerves |
| what do motor fibres in the heart wall do? | innervate and influence the SA node and the AV node of modified cardiac cells (purkinje cells) |
| What are Purkinje cells? | modified cardiac cells that spontaneously generate electrical signals, the branches of these cells are known as Purkinje fibres |
| name the different structures of electrical signals in the heart | SA node, internodal pathways, AV node, bundle of His, right bundle branch/left bundle branch, purkinje fibres |
| where does the heart lie in the recumbent position? | infront of the oesophagus and vertebrae T5-8 |
| surface anatomy of the borers of the heart | right, left, superior, inferior, apex |
| where does the sinu-atrial node lie? | near the opening for the SVC in the right atrium |
| where does the atrioventricular node lie? | inferior part of the interatrial septum |
| where does the bundle of His lie? | within each side of the interventricular septum |
| why can angina be felt in the anterior chest wall and the left arm? | the brain cannot sometimes identify the direct location of where pain is coming from. In angina (ischaemic pain of the heart), the pain is transmitted via nerve fibres to vertebrae levels T1-4, when these nerves converge there can be some confusion of the origin of the pain and thus the dermatomes of T1-4 can be affected (left arm, jaw, chest wall ect) |
| what is referred pain? | pain perceived at a location other than the site of the painful stimulus/ origin |
| where is the apex beat? | 5th intercostal space on the midclavicular line (where the apex of the heart is found) |
| what heart chamber makes up the right border? | RA |
| what heart chamber makes up the left border? | LV |
| what heart chambers make up the inferior border? | LV and RV |
| what heart chambers make up the superior border of the heart? | RA, LA and great vessels |
| what chambers make up the anterior/sternocostal surface? | RA (1/4), RV (1/2), LV (1/4) |
| what vertebral level is the sternomanubrial and xiphisternal planes? | T4 and T8/9 |
| upon which structure does the inferior border of the heart lie? | the diaphragm |
| name the three layers of the blood vessels? | tunica adventitia (connective tissue), tunica media (muscle layer), tunica intima (innermost epithelium) |
| what is the difference between veins and arteries? | arteries= smaller diameter, thicker walls, thick media, thin adventitia
veins= thin media, thick adventitia |
| what are the three types of artery? | elastic, muscular, arterioles |
| composition of elastic artery | tunica intima- no inner elastic lamina and can't tell difference between tunic intima
tunica media- presence of concentric fenestrated sheets of elastin, only a few smooth muscle fibres (these secrete elastin)
tunica adventitia- no OEL, thin layer of tunica adventitia
function- stretch during systole, during diastole there is decreased pressure, arteries recoil causing constant pressure on the blood |
| composition of muscular artery | tunica intima- presence of internal elastic lamina
tunica media- visible smooth muscle, absence of elastic
tunica adventitia- presence of vasa vasorum, broder layer, OEL
function- controls distribution of blood |
| composition of arterioles | -smaller muscular arteries gradually change into arterioles
-no IEL
-only 1-2 layers of smooth muscle in T. media
-no T. adventitia
-rich sympathetic nerve innovation, control blood flow to capillary beds and control blood pressure (systemic) |
| what type of artery is the aorta and pulmonary trunk? | elastic and conducting |
| what type of artery is the radial and femoral arteries? | muscular and distributing |
| what tissue predominates in the tunica media of arterioles? | smooth muscle |
