by mtoom

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What is the moderator band?
A muscular band of heart tissue found in the right ventricle, from the base of the anterior papillary muscle to the ventricular septum.
What is another name for the moderator band?
Septomarginal trabecula
Why is the moderator band important?
Because it carries part of the right bundle branch of the AV bundle of the conduction system of the heart to the anterior papillary muscle, facilitating conduction.
What are the valves of the right ventricle?
The tricuspid (right atrioventricular) valve and the pulmonary valve.
Describe blood flow through the right ventricle?
From right atrium, comes in through the tricuspid valve from the right atrium, goes through the pulmonary valve, to the pulmonary arch, and to the lungs.
What are the valves of the left ventricle?
The mitral (left atrioventricular) valve and the aortic valve.
Describe blood flow path through left ventricle.
From the left atrium, passes through the mitral (left atrioventricular) valve into the left ventricle, then through the aortic valve into the aortic arch.
Where does blood for the coronary arteries come from?
Right coronary artery fed by the right cusp (i.e. right aortic sinus) of the aortic valve. Left coronary artery fed by the left cusp (i.e. left aortic sinus) of the aortic valve.
Where does the right coronary artery run?
From its point of origin, through the coronary sulcus to the posterior aspect of the heart.
What are the 2 main branches of the right coronary artery and where do they run?
1. The right marginal artery runs towards the apex on the anterior surface of the heart.
2. On the posterior surface of the heart, the right coronary artery branches into the posterior interventricular artery which runs through the posterior interventricular sulcus towards the apex. It anastomoses with the circumflex and LAD arteries.
What is the coronary sulcus?
It separates the atria from the ventricles and is also known as the atrioventricular groove.
Where are the papillary muscles and what do they do?
The papillary muscles are located in the ventricles of the heart. They attach to the chordae tendinae, which attach to the atrioventricular valves.
What is the function of the chordae tendinae?
To prevent inversion of the atrioventricular valves by anchoring the valves to the papillary muscles of the heart.
What is the transverse pericardial sinus?
It is the sinus between:
a) aorta and the pulmonary trunk
b) vena cava
What is the importance of the anastomosis between the portal and systemic venous systems in the lower esophagus?
In cirrhosis, not all portal venous blood flow can be recovered from the hepatic veins. This blood instead enters collateral channels draining into systemic circulation. One area where this happens is the portosystemic anastomosis between the left gastric vein and the azygos vein. This can cause esophageal varices which are susceptible to trauma and, once damaged, may bleed profusely, constituting a medical emergency.
What is the thoracic duct?
The thoracid duct is the principal channel through which lymph from most of the body is returned to the venous system.
What is the cisterna chyli? Where is it located? What does it drain?
The cisterna chyli is a sacular dilation of lymph trunks. It is located on L1/L2 on the anterior surface of vertebral bodies. It drains the abdominal viscera, pelvis and lower limbs.
Where does the thoracic duct flow?
From the cisterna chyli (if it exists) up the anterior surface of the spine, between the thoracic aorta and the azygous vein, flowing into the left brachiocephalic vein around its point of bifurcation.
What is the course of the left recurrent laryngeal nerve?
It branches off of the left vagus nerve, loops around the arch of the aorta, between the aorta and the pulmonary artery, and ascends to terminate in the larynx.
What is the course of the right recurrent laryngeal nerve?
It branches off of the right vagus nerve, loops under the right subclavian artery (just above the apex of right lung) and ascends to the larynx.
What can persistent hoarseness of the voice indicate?
Something pressing on recurrent laryngeal nerve. For example:
1. A mass in the aorto-pulmonary window, where the left recurrent laryngeal nerve runs.
2. A mass in the right apex of the lung.
What is the ductus arteriosus?
A blood vessel connecting the pulmonary artery to the aortic arch. It allows most of the blood from the right ventricle to bypass the fetus's fluid-filled non-functioning lungs.
What is the ligamentum arteriosum?
It is the ligament connecting the aortic arch to the pulmonary trunk.
What is the fossa ovalis?
The fossa ovalis is a depression in the right atrium, resulting from the foramen ovale.
What is the foramen ovale?
A hole between atria of the heart that allowed blood to flow through during fetal development as fetus has non-functional lungs.
What is the path of the left phrenic nerve?
Passes along left side of heart, pierces diaphragm on its own.
What is the path of the right phrenic nerve?
Passes between brachiocephalic artery and subclavian vein, over right atrium, through diaphragm with the vena cava (at TVIII).
At what vertebral level does the esophagus go through the diaphragm?
At what vertebral level does the thoracic aorta go through the diaphragm?
What is the clinical importance of the cervical origin of the phrenic nerves?
  • Pain from structures served by the phrenic nerve can be referred to somatic regions served C3-C5. (e.g. an abscess beneath the right diaphragm might cause a patient to feel pain in the right shoulder).
  • Irritation of the phrenic nerve (or tissues supplied by it) leads to the hiccough reflex. A hiccough is a spasmodic contraction of the diaphragm, which pulls air against the closed folds of the larynx.
At what vertebral level does the inferior vena cava go through the diaphragm?
At what vertebral level does the thoracic duct go through the diaphragm?
What is a pneumonic for the levels at which 3 major structures pass through the diaphragm?
"I ate ten eggs at twelve"
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