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34 Cards in this Set
- Front
- Back
- 3rd side (hint)
where do the internal thoracic arteries run?
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along the sternum; anastomose with intercostal arteries
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Superior and inferior regions of the mediastinum at the level of the sternal angle
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What is contained in the mediastinum?
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mediastinum = the space between the pleural cavities in the chest; it contains the heart, great vessels, esophagus, airways, nerves and thoracic duct
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Azygos System/Vein
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Connects superior vena cava with inferior vena cava; receives blood from intercostals and subcostals
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Relationship of the azygos system and esophagus
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Receives blood from esophageal plexi, which anastomse with branches of hepatic portal system
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Left Posterior Mediastinum; note ligamentum arteriosum = remnant of fetal ductus arteriosus which enusres a single circulatory system before birth
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right posterior mediastinum; noite azygos vein, arch of azygos where it connects to superior vena cava
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Thoracic Duc tin posterior mediastinum; note that the TD receives lymph from all but the upper right quadrant of the body (which is drained via the right lymphatic duct); crosses from right to left to empty into veins at the left venous angle
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Transverse Sinus; since you can separate the pulmonary trunk and aorta from venous inflow you can connect a heart lung machine here
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Note how pericardial sac is fused to central tendon of the diaphragm
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AlOH
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antacid, constipation
1. alkalinizes stomach, delays gastric emptying, chelates -->↓ absorption of tetracycline, isoniazid, ketoconazole, fluroquinolones 2. alkalinizes urine which changes urinary excretion of drugs ↑ acidic drug excretion (salicylates) ↓ basic drug excretion (quinidine) Toxicity: hypokalemia, hypophosphatemia, proximal muscle weakness, osteodystrophy, seizures |
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What is the function of the connective tissue of A-V boundary?
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Fibrous skeleton associated with the valves and atrioventricular septum; provides mechanical support and electrical insulation of the atria from the ventricles
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Normal Heart Orientation
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Base of heart is where the veins and arteries enter/leave
Left ventricle is dorsolateral to right ventricle |
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二
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èr
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two
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Which heart valves are not tethered by cordae tendineae?
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Pulmonic and aortic semilunar valves
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What structure may be damaged when a surgeon closes a ventricular septal defect?
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AV Bundle
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Where are the coronary arteries located?
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Aortic Sinus;
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Which coronary artery supplies the interventricular septum (which includes most of the AV bundle branches)
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Left coronary Artery
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Which coronary branch supplies the SA node?
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right coronary artery
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What is the most common site of occlusion?
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Anterior Interventricular Branch
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where are cell bodies for the first order neurons of the sympathetic nervous system?
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Interomediolateral Nulceus
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Long preganglionic parasympathetic axons (vagus nerve) with short postganglionic neurons located in the wall of the structure innervated
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Conducting System of the Heart
If denervated, the heart will spontaneously contract at approximately 30 bpm |
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Bundle of His
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Begins at AV node; bifurcates passing along the interventricular septum to reach the myocardium
blockage here = heart block, which can happen during a procedure to repair a defect in the intraventricular septum |
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How does epinephrine affect adrenergic postganglionic sympathetic axons?
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Potentiates the action of NE via B2R
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How do you account for the reffered pain of MI?
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T1-T5 dermatones affected; usually goes down left side bc left ventricles commonly affected (larger oxygen demand due to thick walls from pumping against systemic pressure)
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Levine's Sign; pressing on sternum; afferent traffic for pressure diminishes competes w/ pain traffic for conscious perception; diminishes pain in T1-T5(t6)
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Note the three layers of the pericardium; (outer fibrous, parietal, visceral)
There is pericardial space between the parietal and visceral layers |
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Effusive Constrictive Pericarditis
Exertional fatigue, dyspnea, abnormallly distended neck veins, dependent edema, and hepatic engorgement are almost universally present. Ascites is found in 15-50% of patients. |
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Why might you get left shoulder pain in effusive constrictive pericarditis?
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Fibrous and parietal layers of the serous pericardium are innervated by the phrenic nerves
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Where will pain from the ascending aorta radiate?
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Anterior thoracic wall since it's an anterior structure
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Where will pain from the descending aorta radiate?
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Posterior chest wall; descending aorta is a posterior structure
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Grave prognostic sign of aortic dissection
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Interscapular pain that moves over time
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Relative to the mediastinum, where is the arch of the aorta?
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Superior mediastinum (T4 and above)
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