Cardiovascular and Lymphatic System Quiz

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Questions and Answers

What is the primary function of the thoracic duct?

  • To convey lymph to the bloodstream (correct)
  • To produce lymphatic fluid
  • To transport oxygenated blood
  • To filter out toxins from the lymph

Which regions drain into the thoracic duct?

  • Both B and C are correct (correct)
  • Only the abdominal cavity
  • The right arm and thorax
  • The pelvic cavity and lower limbs

What is the cisterna chyli?

  • A lymphatic collection point for lower body lymph (correct)
  • An area that drains fluids from the brain
  • A major artery in the abdomen
  • A type of lymphatic vessel

Which lymphatic structures drain the right side of the head and neck?

<p>Right jugular lymph nodes (C)</p> Signup and view all the answers

What is another name for the thoracic duct?

<p>Van Horne's canal (D)</p> Signup and view all the answers

What is the primary function of the interatrial septum in the heart?

<p>Separates the right and left atria (A)</p> Signup and view all the answers

What characterizes the inferior vena cava (IVC)?

<p>It returns blood from the lower half of the body to the right atrium (D)</p> Signup and view all the answers

Which structure is responsible for marking the interventricular septum's position on the heart's surface?

<p>Anterior and posterior interventricular grooves (A)</p> Signup and view all the answers

What is true about the right atrioventricular orifice?

<p>It lies anterior to the opening of the IVC. (B)</p> Signup and view all the answers

What unique feature does the valve of the inferior vena cava exhibit?

<p>It is rudimentary and non-functioning in adults. (D)</p> Signup and view all the answers

Which part of the interventricular septum is thicker and muscular?

<p>Lower muscular part (B)</p> Signup and view all the answers

What is the function of the coronary sinus?

<p>Drains most blood from the heart wall (A)</p> Signup and view all the answers

What does the fossa ovalis represent?

<p>A remnant of fetal circulation at the interatrial septum (A)</p> Signup and view all the answers

What causes the bifid lower aspect of the lower trunk?

<p>Incomplete fusion of embryonic lymphatic trunks (D)</p> Signup and view all the answers

What is the most common variation in the termination of the thoracic duct?

<p>Left side termination (A)</p> Signup and view all the answers

Which lymph node is commonly associated with gastric cancer metastasis?

<p>Virchow's node (B)</p> Signup and view all the answers

What is the primary function of the pulmonic valve?

<p>To regulate blood flow into the pulmonary artery (A)</p> Signup and view all the answers

What percentage of cases report bilateral termination of the thoracic duct?

<p>1.5% (D)</p> Signup and view all the answers

Which feature is NOT characteristic of the left atrium?

<p>Has a distinctive crista terminalis (D)</p> Signup and view all the answers

What is the composition of the left atrioventricular valve?

<p>Two cusps - anterior and posterior (D)</p> Signup and view all the answers

Which site is the termination of the thoracic duct most commonly associated with?

<p>Subclavian vein (B)</p> Signup and view all the answers

What is known as Troiser’s Sign?

<p>Enlargement of the left supraclavicular node (A)</p> Signup and view all the answers

Which of the following statements about the right atrioventricular valve is true?

<p>It regulates blood flow from the right atrium to the right ventricle. (A)</p> Signup and view all the answers

In what percentage of cases might the thoracic duct terminate bilaterally?

<p>1.5% (B)</p> Signup and view all the answers

Where are the pulmonary veins located in relation to the left atrium?

<p>Open through the posterior wall (C)</p> Signup and view all the answers

Which embryonic structure contributes to the conus arteriosus?

<p>Bulbos chordis (B)</p> Signup and view all the answers

What condition is indicated by the presence of Virchow’s node?

<p>Gastric cancer metastasis (A)</p> Signup and view all the answers

What is the primary function of the sinoatrial (SA) node?

<p>Serves as the main impulse initiator of the heart (B)</p> Signup and view all the answers

What distinguishes the outflow portion of the right ventricle from the inflow portion?

<p>Leads to the pulmonary artery (C)</p> Signup and view all the answers

Where is the SA node specifically located?

<p>Superior posterolateral wall of the right atrium (C)</p> Signup and view all the answers

How many cusps does the aortic valve have?

<p>Three cusps (C)</p> Signup and view all the answers

What structure connects the atria and ventricles of the heart?

<p>Atrioventricular bundle (Bundle of His) (D)</p> Signup and view all the answers

Which artery provides the majority of the blood supply to the SA node?

<p>Right coronary artery (D)</p> Signup and view all the answers

What role does the atrioventricular (AV) node play in the heart's conduction system?

<p>Delays the electrical signal before it reaches the ventricles (A)</p> Signup and view all the answers

What anatomical feature is bordered by the junction between the right atrium and the venous sinus?

<p>Sulcus Terminalis (B)</p> Signup and view all the answers

Which layer of the heart hosts the specific layer of the SA node?

<p>Subepicardial layer (D)</p> Signup and view all the answers

What is the common name for the left anterior descending artery?

<p>Widow-Maker artery (D)</p> Signup and view all the answers

What is the primary function of the azygos vein?

<p>To drain blood from the thoracic wall (B)</p> Signup and view all the answers

Where does the right sympathetic trunk primarily lie?

<p>Behind the inferior vena cava (A)</p> Signup and view all the answers

Which thoracic vertebra level does the azygos vein join the hemiazygos vein?

<p>7th Thoracic Vertebra (C)</p> Signup and view all the answers

What anatomical structure does the left brachiocephalic vein cross?

<p>The jugular notch (D)</p> Signup and view all the answers

What is collected by the lymphatic system below the neck?

<p>Lymph from virtually all parts of the body below the neck (B)</p> Signup and view all the answers

What potential clinical risk is associated with the left brachiocephalic vein?

<p>Bleeding if exposed during surgical procedures (D)</p> Signup and view all the answers

What happens to the hemiazygos and accessory hemiazygos veins in some variations?

<p>They join as one trunk (A)</p> Signup and view all the answers

What is a primary role of the thoracic lymphatics?

<p>To dictate the spread of tumors (C)</p> Signup and view all the answers

Flashcards

Conus arteriosus

The outflow portion of the right ventricle leading to the pulmonary artery.

Pulmonary Artery

The vessel that carries deoxygenated blood from the right ventricle to the lungs.

Left Atrium

Receives oxygenated blood from pulmonary veins and pumps it into the left ventricle.

Pulmonary Veins

Carry oxygenated blood from the lungs to the left atrium.

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Pulmonary Valve

Valve that controls blood flow from the right ventricle to the pulmonary artery.

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Mitral Valve

Valve between the left atrium and left ventricle.

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Tricuspid Valve

Valve between the right atrium and right ventricle.

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Aortic Valve

Valve that controls blood flow from the left ventricle to the aorta.

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IVC (Inferior Vena Cava)

Carries blood from the lower body to the right atrium.

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Right Atrium

Receives deoxygenated blood from the body (incl. IVC).

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Interatrial Septum

Partition separating the right and left atria.

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Coronary Sinus

Drains blood from the heart muscle.

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Right Atrioventricular Orifice

Opening for blood flow from the right atrium to the right ventricle.

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Inter-ventricular Septum

Partition separating the right and left ventricles.

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Fossa Ovalis

Fetal remnant; a depression in the atrial septum.

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Thoracic Duct

The largest lymphatic vessel in the body, it collects lymph from the lower limbs, pelvic cavity, abdominal cavity, left side of the thorax, left side of the head and neck, and left arm. It then empties this lymph into the bloodstream.

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Cisterna Chyli

An elongated lymph sac located below the diaphragm, near the first two lumbar vertebrae and on the right side of the aorta. It receives lymph from the intestines, lumbar region, and lower thorax. It eventually merges with the thoracic duct.

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Right Lymphatic Duct

Drains lymph from the right side of the head and neck, upper limb, and thorax. It is formed by the confluence of the right jugular, subclavian, and broncho-mediastinal lymph trunks.

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What does the thoracic duct drain?

The thoracic duct drains lymph from the following areas:

  • Lower Limbs
  • Pelvic Cavity
  • Abdominal Cavity
  • Left Side of Thorax
  • Left Side of Head and Neck
  • Left Arm
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What structures drain into the cisterna chyli?

The following structures drain into the cisterna chyli:

  • Intestinal Trunk
  • Right and Left Lumbar Trunks
  • Small lymph vessels from the lower thorax
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What is the Hemiazygos Vein's location?

The Hemiazygos vein lies to the left of the vertebrae and descends to join the Azygous vein at the level of the 7th Thoracic Vertebra.

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What forms the Hemiazygos Vein?

It's formed from the veins of the 4th to 8th intercostal spaces (ICS) and occasionally by the left bronchial veins.

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How does the Hemiazygos Vein drain?

The Hemiazygos vein often joins the Hemiazygos accessory veins and their shared trunk drains into the Azygous vein.

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What is the significance of the Hemiazygos Vein in tumor spread?

It plays a crucial role in the spread of tumors because it collects lymphatic drainage from various body parts below the neck and upper limbs.

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What is the location of the right sympathetic trunk?

It lies behind the right border of the inferior vena cava.

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What is the location of the left sympathetic trunk?

It lies close to the left border of the aorta.

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What is the Azygous vein?

It is a major vein that collects blood from the chest, back, and abdomen.

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What is the Brachiocephalic vein?

It's a major vessel in the root of the neck that drains into the Azygous vein.

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SA Node

The primary pacemaker of the heart, initiating and regulating heartbeats. It's located in the superior posterolateral wall of the right atrium, near the opening of the superior vena cava.

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AV Node

The AV node receives the electrical signal from the SA node and delays it slightly before sending it to the ventricles. It's located at the base of the right atrium.

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Bundle of His

The bundle of His carries the electrical signal from the AV node to the ventricles. It's the sole connection between the atria and ventricles for the electrical impulse.

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Sulcus Terminalis

A groove marking the junction between the right atrium and the sinus venosus. This is a landmark for the location of the SA node.

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Tendon of Todaro

A structure that forms the inferior boundary of the right atrioventricular orifice, also a landmark for the AV node.

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Right Coronary Artery (RCA)

Supplies blood primarily to the SA node, providing about 60% of its blood flow.

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Left Coronary Artery (LCA)

Supplies blood to the SA node, providing about 40% of its blood flow.

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Fibrous Skeleton of the Heart

This is a fibrous connective tissue structure that provides support and anchors the heart valves. The Bundle of His pierces this structure.

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What happens when embryonic lymphatic trunks fail to fuse?

It leads to a bifid lower aspect of the lower trunk, where the right and left lymphatic trunks fail to fuse.

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Lower thoracic duct replacement

The lower thoracic duct is replaced by a plexus of lymphatic vessels and forms a single duct higher in the mediastinum.

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Two thoracic ducts

A rare variation where two complete thoracic ducts are present, indicating a failure of the lymphatic system to fully merge.

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Thoracic duct terminating into the azygos system

This is a variation where the thoracic duct empties into the azygos vein instead of the subclavian vein or internal jugular vein.

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Virchow's Node

An enlarged lymph node in the left supraclavicular region, often a sign of metastatic cancer.

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Troisier's Sign

A palpable mass in the left supraclavicular region caused by an enlarged Virchow's Node, often associated with gastric cancer.

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Thoracic Duct Involvement in Cancer

Cancer on the left side of the body can spread to the left supraclavicular lymph node via the thoracic duct, resulting in a noticeable enlargement.

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What is the significance of the left supraclavicular lymph node?

It's a key area for identifying potential cancer spread from the left side of the body, particularly in the case of gastric cancer.

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Study Notes

Anatomy Study Notes

  • Pericardium: A fibrous sac enclosing the heart and major blood vessels. It restricts excessive heart movement and provides a lubricated environment for free contraction. Located in the middle mediastinum, posterior to the sternum, and anterior to the T5-T8 vertebral levels.

Layers of Pericardium

  • Fibrous Pericardium: Strong, fibrous outer layer. Fuses with the large blood vessels. Attached to the central tendon of the diaphragm and sternopericardial ligament.
  • Serous Pericardium: Lines the fibrous pericardium and covers the heart. Two layers:
    • Parietal Layer: Lines the inner surface of the fibrous pericardium.
    • Visceral Layer (Epicardium): Adheres closely to the heart surface.
  • Pericardial Cavity: Slit-like space between the parietal and visceral layers. Contains ~50 mL of pericardial fluid for lubrication.

Clinical Correlation

  • Pericardial Effusion: Accumulation of excess fluid in the pericardial cavity. Can progress to cardiac tamponade if fluid buildup is severe. Typically associated with symptoms like chest pain, shortness of breath.
  • Cardiac Tamponade: A complication of pericardial effusion where the fluid puts pressure on the heart, limiting its ability to fill and contract. Symptoms include muffled heart sounds, distended jugular veins, and low blood pressure (Beck's Triad).
  • Pericarditis: Inflammation of the pericardium. The rubbing of the inflamed layers can produce a friction rub (a sound auscultated during a physical exam). Constrictive pericarditis leads to a rigid fibrous pericardium, impeding heart movement.
  • Pericardial Sinus: Spaces in the pericardium behind the heart formed by pericardial reflections.

Heart Overview

  • Heart: A specialized and enlarged hollow muscle vessel responsible for pumping blood. Consists of four chambers (two atria and two ventricles).
  • Heart Wall: Composed of three layers:
    • Epicardium: Outermost layer, continuous with the visceral pericardium.
    • Myocardium: Middle muscular layer primarily comprised of cardiac muscle.
    • Endocardium: Innermost layer lining the heart chambers to reduce friction and promote blood flow.
  • Chambers:
    • Atria: Thin-walled, low-pressure chambers receiving blood from veins, and pumping it into ventricles.
    • Ventricles: Thick-walled, high-pressure chambers pumping blood to lungs and body through arteries.

Heart Arterial Blood Supply

  • Right Coronary Artery (RCA): Supplies the right side of the heart and part of the interventricular septum. Often a dominant contributor to posterior descending artery.
  • Left Coronary Artery (LCA): Supplies primarily the left side. Branches into left anterior descending (LAD) and circumflex arteries. LAD is often the most frequently occluded branch.

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