mediastinum and the heart

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heart & middle mediastinum mediastinum and the heart mediastinum is a space between the right and left lungs (the space not occupied by the lungs) it extends from the sternum anteriorly to the thoracic vertebrae posteriorly and from superior to inferior thoracic apertures mediastinum changes in the mediastinum mediastinum may change its size or position due to pathological changes in the thoracic cavity widening of mediastinum (change in size): -may be caused by: hemorrhage (bleeding) from trauma of great vessels enlarged lymph nodes (e.g., in case of cancer) congestive heart failure shifting of mediastinum (change in position): -may be caused by colapse of a lung: e.g., in case of pneumothorax, hemothorax knowledge of relationship of structures within the mediastinum is important for correctly reading of: x-rays films mri scans (magnetic resonance imaging) and ct scans (computed tomography) relationship of structures lying at the transverse section through superior mediastinum at the …

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closely attaches to the heart and forms the epicardium, the outer layer of the cardiac wall pericardial cavity – a potential space b/n the two serous layers pericardium pericardium pericardium nerve & vessels passing through the pericardium: phrenic nerve and pericardiacophrenic vessels run in the pericardium on their way to the diaphragm pericardium moves with: the heart great vessels sternum (attached by sternopericardial ligament) central tendon of diaphragm because of fusion of pericardium with the above structures pericardium cont.. pericardial sinuses two sinuses lie b/n the two layers of serous pericardium -transverse sinus behind pulmonary trunk (pt) and ascending aorta (aa); the sinus provides a space for tying pt or aa during surgery -oblique sinus lies behind the heart, surrounded by pulmonary veins and ivc transverse sinus oblique sinus blood & nerve supply of the pericardium blood supply: internal thoracic artery (mainly) pericardiacophrenic artery (branch of internal thoracic a) small …

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ior (diaphragmatic) left (pulmonary) four chambers: right & left ventricles right & left atria four valves: tricuspid pulmonary aortic mitral 1=right atrium, 2=right ventricle, 3=left ventricle, 4=superior vena cava, 5=ascending aorta, 6=pulmonary trunk, 7&8= right & left brachiocephalic veins, 9= right subclavian artery & vein, 10=internal jugular vein 1 2 3 4 5 6 7 8 9 10 apex base of heart borders right border formed by: superior vena cava (svc) right atrium (ra) inferior vena cava (ivc) left border formed by: aortic arch (looks like knob or knuckle on x-ray film) pulmonary trunk left auricle (la) left ventricle (lv) superior border formed by: right atrium with auricle left atrium with auricle inferior border formed by: right ventricle (mainly) left ventricle svc ra ivc lv la pt aa surfaces of the heart anterior (sternocostal) surface formed by: right ventricle (mainly) left ventricle inferior surface formed by: left ventricle (mainly) right …

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rdae tendineae to anterior & posterior wall of left ventricle via papillary muscles tricuspid (rt. atrioventricular): lies behind the midline of the sternum at the level of 5th ics has anterior, posterior & septal cusps chordae tendineae attach to adjacent sides of two cusps and to papillary muscles tv pv av mv 2nd costal cartilage 3rd 4th 5th 3rd ics n.b.: all 4 valves lie behind sternum auscultation points of the valves a= aortic valve sound p= pulmonary valve sound t= tricuspid valve sound m= mitral (bicuspid) valve sound apex (apical beat) – found at left 5th intercostal space, just medial to midclavicular line or about 9 cm from the midline of the sternum. anatomical position of the valves is not important clinically; where best heard is much more important 1 2 3 4 5 6 a p t m rt 2nd ics near the sternal border lt 2nd ics …

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the wall of the heart chambers of the heart right and left atria - are receiving chambers they lie above the ventricles right atrium receives deoxygenated blood from the body via the svc and ivc left atrium receives oxygenated blood from the lungs via the right and left pairs of pulmonary veins right and left ventricles - are pumping chambers right ventricle pumps deoxygenated blood to the lungs via the pulmonary trunk left ventricle pumps oxygenated blood to all parts of the body via the aorta features of the right atrium (ra) auricle, a side-room of the ra openings of: svc ivc coronary sinus rt. atrioventricular (av) valve - orifice sinus venarum (smooth posterior part) pectinate muscle (rough anterior part) inter-atrial septum fossa ovalis (with the edge, limbus fossa) crista terminalis divides the smooth & rough parts of rt. atrium svc ivc opening for coronary sinus right av valve features …

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heart & middle mediastinum mediastinum and the heart mediastinum is a space between the right and left lungs (the space not occupied by the lungs) it extends from the sternum anteriorly to the thoracic vertebrae posteriorly and from superior to inferior thoracic apertures mediastinum changes in the mediastinum mediastinum may change its size or position due to pathological changes in the thoracic cavity widening of mediastinum (change in size): -may be caused by: hemorrhage (bleeding) from trauma of great vessels enlarged lymph nodes (e.g., in case of cancer) congestive heart failure shifting of mediastinum (change in position): -may be caused by colapse of a lung: e.g., in case of pneumothorax, hemothorax knowledge of relationship of structures within the mediastinum is …

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