الأولى أناتومي CVS (قبل التعديل)
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What is the size of the heart compared to?

  • The size of a person's hand's fist (correct)
  • The size of a small orange
  • The size of a baseball
  • The size of a grapefruit

    • Which structure primarily forms the apex of the heart?

  • Right ventricle
  • Right atrium
  • Left atrium
  • Left ventricle (correct)

    • What anatomical feature separates the two ventricles of the heart?

  • Inter atrial septum
  • Anterior interventricular groove (correct)
  • Atrioventricular septum
  • Coronary sulcus

    • Where does the base of the heart lie in relation to the thoracic vertebrae?

    <p>Opposite to the 5th to 8th thoracic vertebrae</p> Signup and view all the answers

    Which of the following is NOT a chamber of the heart?

    <p>Superior vena cava</p> Signup and view all the answers

    What type of sac surrounds the heart and its proximal great vessels?

    <p>Fibro-serous sac</p> Signup and view all the answers

    Which surface of the heart mainly rests on the diaphragm?

    <p>Sternocostal surface</p> Signup and view all the answers

    What is the primary function of the heart as described?

    <p>To keep circulation going</p> Signup and view all the answers

    Which artery is lodged in the posterior interventricular groove?

    <p>Posterior interventricular artery</p> Signup and view all the answers

    What structures compose the lower border of the heart?

    <p>Right ventricle and left ventricle</p> Signup and view all the answers

    Where is the apex of the heart located?

    <p>Left 5th intercostal space</p> Signup and view all the answers

    Which valve is located at the left 4th sternocostal junction?

    <p>Mitral valve</p> Signup and view all the answers

    What comprises the upper border of the heart?

    <p>Right and left atria</p> Signup and view all the answers

    At what point is the pulmonary valve located?

    <p>Left 3rd intercostal space, just left of the sternum</p> Signup and view all the answers

    Which structure is included in the left border of the heart?

    <p>Left auricle and left ventricle</p> Signup and view all the answers

    What area does the right border of the heart consist of?

    <p>Right atrium</p> Signup and view all the answers

    What is the outer layer of the pericardium called?

    <p>Fibrous pericardium</p> Signup and view all the answers

    Which arteries mainly supply the pericardium?

    <p>Pericardiophrenic and musculophrenic arteries</p> Signup and view all the answers

    Which nerve is responsible for the innervation of the fibrous pericardium?

    <p>Phrenic nerve</p> Signup and view all the answers

    What supplies the visceral layer of the serous pericardium?

    <p>Branches of coronary arteries</p> Signup and view all the answers

    Which veins are responsible for draining the pericardium?

    <p>Internal thoracic vein and azygos system tributaries</p> Signup and view all the answers

    Where does the ascending aorta begin?

    <p>At the aortic orifice of the left ventricle</p> Signup and view all the answers

    What does the superior vena cava terminate into?

    <p>The right atrium</p> Signup and view all the answers

    Which artery branches from the right aortic sinus?

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

    At what anatomical landmark does the ascending aorta become the arch of the aorta?

    <p>At the level of the left 3rd intercostal space</p> Signup and view all the answers

    Which statement is true regarding the pulmonary arteries?

    <p>The left pulmonary artery has one branch to the superior lobe</p> Signup and view all the answers

    What structure connects the left pulmonary artery to the aortic arch?

    <p>Ligamentum arteriosum</p> Signup and view all the answers

    How does the right pulmonary artery differ from the left?

    <p>It is longer</p> Signup and view all the answers

    What is the termination point of the pulmonary artery?

    <p>The lungs</p> Signup and view all the answers

    What type of vein is the azygos vein?

    <p>Drains the thoracic wall</p> Signup and view all the answers

    Which of the following best describes the term 'hilum' as used in relation to pulmonary arteries?

    <p>The point where the artery divides into branches</p> Signup and view all the answers

    Where is the transverse pericardial sinus located?

    <p>Anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk</p> Signup and view all the answers

    Which structure is located posterior to the oblique pericardial sinus?

    <p>Esophagus and descending aorta</p> Signup and view all the answers

    What happens during pericarditis?

    <p>Inflammation of the pericardium leading to pain in the chest</p> Signup and view all the answers

    What is the significance of the bare area of the heart?

    <p>It is the region not covered by pleura, located in the left 4th to 6th parasternal area</p> Signup and view all the answers

    Which structure lies anterior to the left atrium in the pericardial region?

    <p>Pulmonary trunk</p> Signup and view all the answers

    What does pericardial effusion refer to?

    <p>Accumulation of excess fluid within the pericardial sac</p> Signup and view all the answers

    Which of the following is the primary consequence of constrictive pericarditis?

    <p>Abnormal thickening of the pericardium that compresses the heart</p> Signup and view all the answers

    What anatomical feature is primarily bounded by the two atria in the region of the transverse pericardial sinus?

    <p>The ascending aorta</p> Signup and view all the answers

    Which layer of the pericardium is primarily involved in the blood supply from the coronary arteries?

    <p>Visceral layer of the serous pericardium</p> Signup and view all the answers

    Which vessels primarily drain the pericardium?

    <p>Tributaries of the azygos system</p> Signup and view all the answers

    What is the primary nerve responsible for supplying the fibrous pericardium?

    <p>Phrenic nerve</p> Signup and view all the answers

    Which arteries are NOT involved in supplying the pericardium?

    <p>Inferior vena cava branches</p> Signup and view all the answers

    Which of the following correctly pairs a layer of the pericardium with its function?

    <p>Visceral layer - autonomic innervation</p> Signup and view all the answers

    Which structure predominantly composes the right border of the heart?

    <p>Right atrium</p> Signup and view all the answers

    Where is the aortic valve located in relation to the sternum?

    <p>At the left 3rd sternocostal junction</p> Signup and view all the answers

    What constitutes the apex of the heart's location?

    <p>Left 5th intercostal space, 3.5 inches from the median plane</p> Signup and view all the answers

    Which arteries are included in the posterior interventricular groove?

    <p>Posterior interventricular artery</p> Signup and view all the answers

    Which structures form the upper border of the heart?

    <p>Two atria</p> Signup and view all the answers

    What is the anatomical representation of the lower border of the heart?

    <p>Composed of the right and left ventricles</p> Signup and view all the answers

    At which anatomical landmark is the tricuspid valve located?

    <p>Left 4th intercostal space near the midline</p> Signup and view all the answers

    Which point represents the location of the lower border of the 2nd left costal cartilage?

    <p>1.5 inches from the median plane</p> Signup and view all the answers

    Which of the following structures is associated with the coronary groove of the heart?

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

    What defines the primary orientation of the heart's apex?

    <p>Directed downwards, forwards, and to the left</p> Signup and view all the answers

    Which sulcus is associated with the separation of the two ventricles of the heart?

    <p>Anterior interventricular groove</p> Signup and view all the answers

    What anatomical feature primarily forms the base of the heart?

    <p>Left atrium</p> Signup and view all the answers

    Which surface of the heart is mainly formed by the left ventricle?

    <p>Diaphragmatic surface</p> Signup and view all the answers

    What is the anatomical significance of the coronary sulcus?

    <p>It separates the atria from the ventricles</p> Signup and view all the answers

    What percentage of the heart's shape can be described as conical?

    <p>Primarily conical</p> Signup and view all the answers

    In which part of the thoracic cavity does the heart primarily reside?

    <p>Middle mediastinum</p> Signup and view all the answers

    Which of the following accurately describes the boundaries of the transverse pericardial sinus?

    <p>Anterior: Pulmonary trunk &amp; ascending aorta; Below: Two atria</p> Signup and view all the answers

    Which structure is located posterior to the heart in the oblique pericardial sinus?

    <p>Fibrous pericardium &amp; posterior mediastinum</p> Signup and view all the answers

    What is a significant consequence of constrictive pericarditis?

    <p>Abnormal thickening of the pericardium compressing the heart</p> Signup and view all the answers

    What does pericardial effusion refer to?

    <p>Accumulation of excess fluid in the pericardial sac</p> Signup and view all the answers

    Which anatomical feature forms the anterior boundary of the oblique pericardial sinus?

    <p>Left atrium</p> Signup and view all the answers

    What is the primary role of a pericardial tap?

    <p>To remove excess fluid from the pericardial cavity</p> Signup and view all the answers

    Which area is known as the bare area of the heart?

    <p>Area in the left 4th to 6th parasternal space not covered by pleura</p> Signup and view all the answers

    In the context of the transverse pericardial sinus, which structures are found above and below this sinus?

    <p>Above: Right pulmonary artery; Below: Right atrium</p> Signup and view all the answers

    What is the origin point of the ascending aorta?

    <p>Aortic orifice of the left ventricle</p> Signup and view all the answers

    Which vessel connects the right atrium to the aorta at the level of the right 2nd costal cartilage?

    <p>Superior vena cava</p> Signup and view all the answers

    How does the right pulmonary artery compare to the left pulmonary artery in terms of length?

    <p>Longer than the left pulmonary artery</p> Signup and view all the answers

    What is the termination point of the pulmonary artery?

    <p>Concavity of the aortic arch</p> Signup and view all the answers

    Which structure attaches the left pulmonary artery to the aortic arch?

    <p>Ligamentum arteriosum</p> Signup and view all the answers

    Which of the following describes the branches of the right and left pulmonary arteries?

    <p>Right divides into two branches, left divides into one branch</p> Signup and view all the answers

    Which veins contribute to the formation of the superior vena cava?

    <p>Right and left brachiocephalic veins</p> Signup and view all the answers

    What anatomical feature does the aorta become as it rises behind the sternum?

    <p>Aortic arch</p> Signup and view all the answers

    At which anatomical landmark does the pulmonary artery begin from the right ventricle?

    <p>Infundibulum of the right ventricle</p> Signup and view all the answers

    What describes the mode of division for the pulmonary arteries at the hilum?

    <p>Right divides into two branches; left divides into one branch</p> Signup and view all the answers

    Study Notes

    The Cardiovascular System

    • Heart: A muscular pump responsible for circulating blood throughout the body
    • Size: Approximately the size of a clenched fist
    • Location: Middle mediastinum
    • Shape: Conical structure

    Pericardium

    • A fibro-serous sac surrounding the heart and the proximal parts of the great vessels
    • Consists of two layers: an outer fibrous pericardium and an inner serous pericardium

    Heart Chambers and Grooves

    • Four chambers:
      • Right atrium
      • Right ventricle
      • Left atrium
      • Left ventricle
    • Four grooves:
      • Atrioventricular groove
      • Anterior and posterior interventricular grooves
      • Interatrial groove

    Heart Apex

    • Points downwards, forward, and towards the left
    • Formed by the left ventricle
    • Located at the level of the left 5th intercostal space, 3.5 inches from the midline

    Heart Base

    • Faces backwards
    • Formed by the two atria, mainly the left atrium
    • Located opposite the middle thoracic vertebrae (5-8)
    • Bounded inferiorly by the coronary sulcus, where the coronary sinus is located

    Heart Surfaces

    • Four surfaces:
      • Sternocostal surface: Formed by the two ventricles, mainly the left ventricle. It rests on the chest wall.
      • Diaphragmatic surface: Formed by the two ventricles, mainly the left ventricle. It faces the diaphragm.
      • Right surface: Consists of the right auricle
      • Left surface: Consists of the left auricle and left ventricle

    Heart Borders

    • Four borders:
      • Upper border: Formed by the two atria
      • Right border: Formed by the right atrium
      • Lower border: Formed by the right ventricle and left ventricle
      • Left border: Formed by the left ventricle and left auricle

    Point Locations

    • Four points:
      • Point 1: Lower border of the 2nd left costal cartilage, 1.5 inches from the median plane
      • Point 2: Upper border of the right 3rd costal cartilage, 1 inch from the median plane
      • Point 3: Upper border of the right 6th costal cartilage, 1 inch from its junction with the sternum
      • Point 4: Apex, located at the left 5th intercostal space, 3.5 inches from the median plane

    Valve Locations

    • Four valves:
      • Pulmonary valve: Left 3rd sternocostal junction
      • Aortic valve: Left 3rd intercostal space, just left of the sternum
      • Mitral valve: Left 4th sternocostal junction
      • Tricuspid valve: 4th intercostal space near the midline

    Pericardium Blood Supply

    • Arterial: Pericardiophrenic and musculophrenic arteries (branches of the internal thoracic artery), Pericardial branches of bronchial, esophageal, and superior phrenic arteries
    • Venous: Tributaries of the azygos system, Pericardiophrenic veins draining into the internal thoracic vein

    Pericardium Nerve Supply

    • Fibrous pericardium & parietal layer: Supplied by the phrenic nerves.
    • Visceral layer: Innervated by branches of the sympathetic trunks and the vagus nerves.

    Pericardial Sinuses

    • Transverse Pericardial Sinus: Located anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk.
    • Oblique Pericardial Sinus: Located posterior to the heart in the pericardial sac.

    Applied Anatomy

    • Pericarditis: Inflammation of the pericardium.
    • Pericardial effusion: Accumulation of excess fluid within the pericardial sac.
    • Constrictive pericarditis: Abnormal thickening of the pericardium that restricts heart movement.
    • Pericardial tap: Procedure involving the aspiration or removal of fluid from the pericardial cavity.
    • Bare area of the heart: Region not covered by the pleura, located in the left 4th to 6th parasternal area.

    Great Vessels

    • Ascending aorta: Begins at the aortic orifice of the left ventricle, ends as the arch of the aorta.
    • Pulmonary artery: From the upper end of the infundibulum of the right ventricle to the concavity of the aortic arch.
    • Superior vena cava: At the lower border of the right 1st costal cartilage to the right atrium.

    Pulmonary Artery

    • Right pulmonary artery: Longer, splits at the hilum into two branches (smaller to the superior lobe and larger to the middle and inferior lobes).
    • Left pulmonary artery: Shorter, splits at the hilum into two branches (one to the superior lobe and the other to the inferior lobe).

    The Heart

    • The heart is a muscular pump
    • It is about the size of an individual’s fist
    • It is located within the middle mediastinum
    • It is conical in shape
    • It is surrounded by a fibro-serous sac called pericardium
    • This structure covers the heart and the proximal part of its major blood vessels
    • The heart has four chambers: right atrium, right ventricle, left atrium, left ventricle
    • There are four grooves on the heart: atrioventricular, anterior and posterior interventricular, and interatrial

    Heart Location

    • The apex points downwards, forwards and to the left
    • It is formed by the left ventricle
    • It sits at the level of the left 5th intercostal space 3.5 inches from the midline
    • The base points backwards
    • It is formed by the two atria, primarily the left atrium
    • It lies opposite the middle thoracic vertebrae (5-8)
    • It is bounded inferiorly by the coronary sulcus, which contains the coronary sinus

    The Heart Surfaces

    • The sternocostal surface faces the sternum and ribs
    • It is formed by the two ventricles, especially the left ventricle
    • The diaphragmatic surface rests on the diaphragm
    • It is separated from the heart’s base by the coronary sulcus
    • It is formed by the two ventricles, mainly the left ventricle
    • The right surface is formed by the right auricle
    • The left surface is formed by the left auricle and left ventricle

    The Heart Borders

    • The upper border is formed by the two atria
    • The right border is formed by the right atrium
    • The lower border is formed by the right ventricle and left ventricle
    • The left border is formed by the left ventricle and left auricle

    Surface Anatomy of the Heart

    • Point 1 is located at the lower border of the 2nd left costal cartilage, 1.5 inches from the median plane
    • Point 2 is located at the upper border of the right 3rd costal cartilage, 1 inch from the median plane
    • Point 3 is located at the upper border of the right 6th costal cartilage, 1 inch from its junction with the sternum
    • Point 4 is located at the apex in the left 5th intercostal space, 3.5 inches from the median plane

    Surface Anatomy of the Valves

    • The pulmonary valve is located at the left 3rd sternocostal junction
    • The aortic valve is located at the left 3rd intercostal space, just left of the sternum
    • The mitral valve is located at the left 4th sternocostal junction
    • The tricuspid valve is located at the 4th intercostal space near the midline
    • The fibrous pericardium is the outermost layer of the pericardium.
    • The inner serous sac contains the parietal and visceral layer

    The Pericardium

    • The pericardium is made of the outer fibrous layer and the inner serous sac
    • The serous sac consists of the parietal and visceral layer.
    • The arterial blood supply of the pericardium originates from the pericardiophrenic and musculophrenic arteries.
    • These are branches of the internal thoracic artery
    • Pericardial branches of the bronchoesophageal and superior phrenic arteries also contribute to the arterial supply
    • The visceral layer of the serous pericardium is supplied by branches from the coronary arteries.
    • Venous drainage is through tributaries of the azygos system
    • Pericardiophrenic veins also drain into the internal thoracic vein
    • The fibrous pericardium and the parietal layer of the serous pericardium receive innervation from the phrenic nerves
    • Autonomic fibres from the sympathetic trunks and the vagus nerves innervate the visceral layer of the serous pericardium.

    Pericardial Sinuses

    • The transverse pericardial sinus is located anterior to the superior vena cava and posterior to the ascending aorta and pulmonary trunk

    • It is bound anteriorly by the pulmonary trunk & ascending aorta

    • Posteriorly, it is bound by the SVC and the upper part of the atria

    • Above, it is bound by the right pulmonary artery

    • Below, it is bound by the atria, primarily the left atrium

    • The oblique pericardial sinus lies posterior to the heart within the pericardial sac

    • It is bound anteriorly by the back of the left atrium

    • It is bound posteriorly by the fibrous pericardium and the posterior mediastinum, including the esophagus and descending aorta

    • On the left side, it is bound by the two left pulmonary veins

    • On the right side, it is bound by the two right pulmonary veins and the inferior vena cava

    Applied Anatomy

    • Pericarditis is inflammation of the pericardium
    • Pericardial effusion is an excess of fluid within the pericardial sac
    • Constrictive pericarditis is a condition in which the pericardium abnormally thickens, compressing the heart and impairing its function
    • Pericardial tap is a procedure in which fluid is removed from the pericardial cavity
    • The bare area of the heart in the left 4th to 6th parasternal area is the region not covered by the pleura

    Great Vessels

    • The ascending aorta begins at the aortic orifice of the left ventricle
    • It passes behind the left margin of the sternum at the level of the left 3rd intercostal space and continues as the aortic arch.
    • Branches of the ascending aorta include the right coronary artery (from the right aortic sinus) and the left coronary artery (from the left aortic sinus)
    • The pulmonary artery starts at the upper end of the infundibulum of the right ventricle and terminates in the concavity of the aortic arch
    • It is positioned behind the sternal end of the left 3rd costal cartilage, opposite the sternal end of the left 2nd costal cartilage
    • It has two branches: the right pulmonary artery and the left pulmonary artery.
    • The superior vena cava begins at the lower border of the right 1st costal cartilage by the union of the right and left brachiocephalic veins
    • It terminates in the right atrium, opposite the right 3rd costal cartilage
    • It receives blood from the right and left brachiocephalic veins and the azygos vein at the level of the right 2nd costal cartilage.

    Pulmonary Arteries

    • The right pulmonary artery is longer than the left pulmonary artery
    • Each artery divides into two branches at the hilum of the lung.
    • The right pulmonary artery branches into: a smaller branch to the superior lobe; a larger branch that travels to the middle and inferior lobes of the right lung.
    • The left pulmonary artery branches into one branch to the superior lobe and another branch to the inferior lobe of the left lung.
    • The ligamentum arteriosum connects the pulmonary artery to the aortic arch.

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