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SESSION 10 - Middle Mediastinum, Pericardium, Heart
And Great Vessels
1. '2 - 3 - 6 - 5 1/2' How do these numbers relate to the surface markings of the
2. Between which vessels would your finger be if it was in the transverse sinus of
the pericardium?
3. Where would you find the oblique sinus of the pericardium?
4. What is the blood supply and nerve supply of the pericardium?
5. Does the anterior surface of the heart consist of two-thirds of left or right
6. Which chamber of the heart lies at its base?
7. Before more sophisticated techniques were available, a barium swallow was
performed to detect the size of one of the chambers of the heart. Which one?
8. What vertebral level indicates the pulmonary arteries, the bifurcation of the
trachea and the under side of the arch of the aorta?
9. Which chamber lies at the apex of the heart in the 5th intercostal space?
Which valve can you hear closing here?
10. Which aortic sinus gives rise to the right coronary artery? What is its first
branch in 60% of people?
11. Name two other branches of the right coronary artery.
12. What do we mean by left cardiac dominance?
13. Which arteries normally supply most of the interventricular septum?
14. In 90% of people the AV node is supplied by a branch of which coronary
15. Which artery runs in the left anterior and then left posterior atrioventricular
16. The great cardiac vein eventually drains into the coronary sinus. In which
groove does it commence?
17. Which veins are said to drain some 20-30% of all venous blood from the
18. Where precisely does the coronary sinus empty into the heart?
19. Concerning the fetal circulation, which statements are correct:
(a) In the fetus blood flows from the aorta to the pulmonary artery in the
ductus arteriosus.
(b) After birth the ductus arteriosus closes due to the diminishing levels of
maternal prostaglandin.
(c) After birth, in some rare congenital cardiac anomalies, it is necessary
to keep the ductus arteriosus open to relieve the high pulmonary
pressure. This is achieved by giving indomethacin.
(d) With the first fetal breath after birth, the pressure rises in the left
atrium causing the foramen ovale to close.
(e) With the first fetal breath after birth, the pressure rises in the right
atrium causing the foramen ovale to close.
20. Is the muscle in the right auricle called the trabeculae carneae or musculi
21. What is the embryonic derivation of the smooth walled right atrium?
22. In fetal life, what was the purpose of the valve of the inferior vena cava?
23. Name the three cusps of the tricuspid valve.
24. If you open both atria and feel between them there is a thin oval area. What is
it? Was this thin area originally the septum primum or secundum?
25. How would you locate the sinu-atrial node?
26. What is the name of the band of tissue arising from the right branch of the
Bundle of His that supplies the anterior papillary muscle in the right ventricle?
27. How many cusps are supplied with chordae tendineae from a single papillary
muscle. (a) one, (b) two or (c) three?
28. Where would you listen to hear the action of the aortic valve?
29. The normal thickness of the left ventricle is (a) 10mm, (b) 15mm or (c) 20mm.
30. How many cusps does the mitral valve have and what are they called?
31. What is the nearest, most convenient artery to use for coronary artery bypass
32. What veins join to become the superior vena cava? What is the surface
marking for this occurrence?
33. What nerves contribute to the cardiac plexuses?
34. Which of the following congenital cardiac anomalies might give a cyanosed
(a) Persistent ductus arteriosus
(b) Pulmonary atresia (stenosis) with patent ductus arteriosus
(c) Interatrial septal defect
(d) Tricuspid atresia (stenosis) with atrial septal defect
(e) Interventricular septal defect