Cardiovascular Anatomy Quiz

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Questions and Answers

What is the term for the cul-de-sac formed by the zone of reflections around the veins?

Transverse pericardial sinus

Coronary sinus

Interventricular sulcus

Oblique pericardial sinus (correct)

Which artery lies posterior to the ascending aorta and pulmonary trunk?

Pulmonary trunk

Transverse pericardial sinus (correct)

Pericardiophrenic artery

Internal thoracic artery

Which structure encircles the heart and separates the atria from the ventricles?

Transverse pericardial sinus

Anterior interventricular sulcus

Coronary sulcus (correct)

Oblique pericardial sinus

What does the posterior interventricular sulcus contain?

Posterior interventricular artery Signup and view all the answers

Which nerve is NOT associated with the nervous supply to the pericardium?

Thoracic spinal nerve Signup and view all the answers

What type of fibres are present in Type 1 sympathetic trunks?

Postganglionic sympathetic fibres Signup and view all the answers

Which ganglia does the Greater Splanchnic Nerve originate from?

T5-T9 Signup and view all the answers

Where does the Left Vagus Nerve give off branches?

All of the above Signup and view all the answers

What is the function of the Left Recurrent Laryngeal Nerve?

Innervates muscles of the larynx Signup and view all the answers

Which structure does NOT have a direct attachment to the fibrous pericardium?

Apex of heart Signup and view all the answers

What is the role of the pericardial cavity?

Allows for uninhibited movement of the heart Signup and view all the answers

Which phrenic nerve descends along the left side of the pericardial sac?

Left phrenic nerve Signup and view all the answers

What type of pericardium consists of a thin double-layered sac?

Serous pericardium Signup and view all the answers

Which of the following best describes the inner layer of the serous pericardium?

Visceral layer adhering to the great vessels Signup and view all the answers

Which nerve lies posterior to the left brachiocephalic vein?

Left vagus nerve Signup and view all the answers

What condition may result from compression of the left recurrent laryngeal nerve due to a mass in the aortopulmonary window?

Left vocal cord paralysis Signup and view all the answers

What is a likely consequence when excess fluid accumulates in the pericardial cavity?

Cardiac tamponade Signup and view all the answers

Which anatomical anomaly is characterized by the aortic arch coursing to the right of the trachea?

Right-sided aortic arch Signup and view all the answers

What condition is described when there is an abnormally large amount of fluid in the pericardial cavity?

Pericardial effusion Signup and view all the answers

Which condition involves the left-to-right inversion of the body's organs?

Situs inversus Signup and view all the answers

Where does the ascending aorta originate?

At the aortic orifice at the base of the left ventricle Signup and view all the answers

What divides the inferior mediastinum into anterior, middle, and posterior sections?

Transverse plane at T4/T5 Signup and view all the answers

Which of the following arteries is the first branch of the arch of aorta?

Brachiocephalic Trunk Signup and view all the answers

Which structure is found posterior to the trachea in the superior mediastinum?

Oesophagus Signup and view all the answers

What structure does the ductus arteriosus connect during embryonic circulation?

Pulmonary trunk and arch of aorta Signup and view all the answers

What is the major lymphatic vessel in the body that enters the superior mediastinum?

Thoracic duct Signup and view all the answers

What is the relationship of the right pulmonary artery to the ascending aorta?

Posterior to ascending aorta Signup and view all the answers

Which of the following vessels passes over the left side of the aortic arch?

Left superior intercostal vein Signup and view all the answers

At what level does the arch of aorta end?

T4/T5 vertebral level Signup and view all the answers

What is the anterior boundary of the superior mediastinum?

Manubrium Signup and view all the answers

Which vein drains into the right atrium after passing through the pericardial sac?

Superior Vena Cava Signup and view all the answers

Which contents are located within the superior mediastinum?

Thymus and phrenic nerves Signup and view all the answers

What is the position of the left pulmonary artery in relation to the descending aorta?

Anterior and inferior Signup and view all the answers

The right and left brachiocephalic veins are located immediately posterior to which structure?

Thymus gland Signup and view all the answers

How is the inferior vena cava formed?

By the union of the right and left common iliac veins Signup and view all the answers

How is the superior mediastinum defined superiorly?

Superior border of T1 Signup and view all the answers

What is the primary function of the thymus gland located in the superior mediastinum?

Development of the immune system Signup and view all the answers

The transverse plane between which two landmarks separates the superior mediastinum from the inferior mediastinum?

Sternal angle and T4/T5 intervertebral disc Signup and view all the answers

Study Notes

Mediastinum

The mediastinum is a broad central partition separating the two pleural cavities.
Boundaries: Anteriorly - Body of sternum, Posteriorly - Vertebral bodies of thoracic vertebrae, Inferiorly - Diaphragm, Superiorly - Thoracic aperture
The superior and inferior mediastinum are separated by a transverse plane between the sternal angle and the intervertebral disc at T4/T5.
The inferior mediastinum is further subdivided into anterior, middle, and posterior regions.

Superior Mediastinum

Centrally located in the thoracic cavity and contains the pericardium, heart, great vessels, and nerves.
Superior boundary: Oblique plane passing from jugular notch to superior border of T1; Inferior boundary: Transverse plane between sternal angle and intervertebral disc at T4/T5
Lateral boundary: Pleural cavities on either side
Anterior boundary: Posterior surface of the manubrium; Posterior boundary: Body of the first four thoracic vertebrae

Superior Mediastinum Contents

Thymus: Most anterior component, immediately posterior to the manubrium, asymmetrical, bilobed structure involved in early immune system development
Left and Right Brachiocephalic Veins: Immediately posterior to the thymus
Left Superior Intercostal Vein: Passes over the left side of the aortic arch, situated lateral to the vagus nerve and medial to the phrenic nerve
Trachea and Oesophagus: Trachea is midline and palpable in the jugular notch, Oesophagus posterior to the trachea, immediately anterior to the vertebral bodies
Thoracic Duct: Major lymphatic vessel in the body that enters the superior mediastinum inferiorly and continues upwards

Anterior Mediastinum

Superior boundary: Transverse plane between the sternal angle and intervertebral disc at T4/T5; Inferior boundary: Diaphragm
Lateral boundary: Pleural cavities on either side; Anterior boundary: Body of the sternum; Posterior boundary: Pericardial sac
Type 1 Sympathetic Trunk: Branches from upper 5 ganglia, has postganglionic sympathetic fibers, contains visceral afferent fibers, supply thoracic viscera.
Type 2 Sympathetic Trunk: Branches from lower 7 ganglia, has preganglionic sympathetic fibers, contains visceral afferent fibers, supply abdominal and pelvic viscera.

Sympathetic Trunks

Greater Splanchnic Nerve: Descends across vertebral bodies medially, ends in the coeliac ganglion, some fibers go straight to the medulla of the adrenal gland
Lesser Splanchnic Nerve: Ends in the aorticorenal ganglion
Least Splanchnic Nerve: Ends in the renal plexus

Vagus and Phrenic Nerves in the Mediastinum

Right Vagus Nerve

Lies between the brachiocephalic trunk and right brachiocephalic vein
Descends posteriorly towards the trachea and crosses the lateral surface of the trachea, passing posterior to the oesophagus
Gives branches to the cardiac plexus, pulmonary plexus, and oesophageal plexus

Left Vagus Nerve

Lies posterior to the left brachiocephalic vein, between the left common carotid and left subclavian arteries
Lies deep to the parietal pleura, crosses the left side of the arch of the aorta, passing posterior to the root of the left lung
Gives branches to the cardiac plexus, pulmonary plexus, and oesophageal plexus

Left Recurrent Laryngeal Nerve

Branch of the left vagus nerve
Arises at the inferior margin of the arch of the aorta and lies lateral to the ligamentum arteriosum
Passes inferior to the arch of the aorta, entering the groove between the trachea and oesophagus

Right Phrenic Nerve

Enters the mediastinum lateral to the vagus nerve
Lies posterolateral to the right brachiocephalic vein and continues along the right side of the SVC
Descends along the right side of the pericardial sac within the fibrous pericardium, anterior to the root of the right lung
Passes through the diaphragm at the caval opening

Left Phrenic Nerve

Enters the mediastinum lateral to the left vagus nerve
Lies posterolateral to the left brachiocephalic vein
Passes superficially to the left vagus nerve and left superior intercostal vein
Follows the left side of the pericardial sac and lies anterior to the root of the left lung
Pierces the diaphragm near the apex of the heart

Superficial Anatomy of the Heart

Pericardium

Fibro-serous sac surrounding the heart and root of great vessels
Fibrous Pericardium: Tough connective tissue outer layer, cone-shaped bag, apex is continuous with the adventitia of great vessels, base is attached to the central tendon of the diaphragm, anterior attachment to the sternum via sternopericardial ligaments
Serous Pericardium: Thin, consists of two parts: Parietal and Visceral layers, between the two layers is the pericardial cavity filled with fluid, allows for relatively uninhibited movement of the heart, Parietal layer lines the fibrous pericardium, Visceral layer is adherent to the heart
Reflections of Serous Pericardium: Superiorly - Surrounds the aorta and pulmonary trunk, Posteriorly - Surrounding veins
Oblique Pericardial Sinus: J-shaped cul-de-sac formed by reflections around the veins
Transverse Pericardial Sinus: Passage between the two sites of reflections, lies posterior to the ascending aorta and pulmonary trunk, anterior to the superior vena cava, superior to the left atrium

Vessels and Nerves

Arterial: Internal thoracic artery, pericardiophrenic, musculophrenic, and inferior phrenic arteries, thoracic aorta.
Venous: Azygos system of veins, superior phrenic vein, internal thoracic vein.
Nervous: Vagus and Phrenic nerves, Sympathetic trunks.

External Sulci

Coronary Sulcus

Encircles the heart and separates the atria from the ventricles.
Contains the right coronary artery, small cardiac vein, coronary sinus, and circumflex branch of the left coronary artery.

Interventricular Sulci

Anterior Interventricular Sulcus: On the anterior surface of the heart, contains the anterior interventricular artery and great cardiac vein
Posterior Interventricular Sulcus: On the diaphragmatic surface of the heart, contains the posterior interventricular artery and middle cardiac vein

Great Vessels

Pulmonary Trunk

Contained within the pericardial sac, covered by the visceral layer of the serous pericardium, associated with the ascending aorta in the same sheath.
Arises from the conus arteriosus of the right ventricle at the opening of the pulmonary trunk and ascends moving posteriorly.
Initially anterior and then to the left of the aorta.
At the intervertebral disc between T5/T6 the pulmonary trunk divides into the right pulmonary artery and left pulmonary artery.

Aorta

Ascending Aorta: Originates at the aortic orifice at the base of the left ventricle, level of the lower edge of the 3rd costal cartilage, continues to the level of the 2nd costal cartilage where it enters the superior mediastinum to become the arch of the aorta.
Arch of Aorta: Begins as the ascending aorta emerges from the pericardial sac, courses superiorly, posteriorly, and to the left, ends at the T4/T5 vertebral level, and extends as high as the manubrium of the sternum.

Branches of the Arch of the Aorta

Brachiocephalic Trunk: The most anterior branch, divides into the right common carotid artery and right subclavian artery at the level of the sternoclavicular joint.
Left Common Carotid Artery: Ascends on the left of the trachea and supplies the left side of the head and neck.
Left Subclavian Artery: Ascends on the left of the trachea and supplies the left upper limb.

Ligamentum Arteriosum

Important in embryonic circulation, connecting the pulmonary trunk and arch of the aorta, allowing blood to bypass the lungs during development.
Closes soon after birth and forms the ligamentum arteriosum.

Superior Vena Cava

The lower half is encased in the pericardial sac.
Passes through the fibrous pericardium at the 2nd costal cartilage.
Begins by the union of the right and left brachiocephalic veins and drains into the right atrium.
Receives the azygos vein immediately before entering the pericardial sac.

Inferior Vena Cava

Enters the fibrous pericardium at T8.
Formed at L5 by the union of the right and left common iliac veins.
Ascends anterior to the vertebral column, on the right side of the abdominal aorta.

Aortopulmonary Window

The left recurrent laryngeal nerve passes between the pulmonary artery and aorta.
Any mass in this region may compress the nerve which leads to left vocal cord paralysis and hoarseness of voice.

Pericardial Effusion

Normally, only a tiny amount of fluid exists in the pericardial cavity.
Excess fluid within the pericardial sac compresses the heart, resulting in cardiac tamponade.
This leads to biventricular failure.
Fluid is removed with a needle to relieve symptoms.

Aortic Arch Anomalies

A right-sided aortic arch occurs when the vessel courses to the right of the trachea and passes over the right main bronchus.
This is sometimes associated with dextocardia (right-sided heart) and situs inversus (left-to-right inversion of the body's organs).

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Description

Test your knowledge on the anatomy of the cardiovascular system with this quiz. Answer questions related to the structure and function of the heart, its surrounding components, and key arteries. Challenge yourself and enhance your understanding of cardiovascular anatomy!