haenrcprricrtrdium. Veins of the neck and face are
engorged as the venae cavae are not able to pour
blood in the right atrium. Pericardial tapping is done
to take out the blood from the pericardial cavity. It
is done as ar1 emergency measure,
Case 2
A 40-year-old lady while playing tennis, suddenly
fell down, holding onto her chest and left arm due
to severe pain.. Why is the pain in her chest?
. Why is the pain in her left arm?
Ans; Tennis is a very strenuous galne. The lady
fainted as there was more need for the oxygen" Since
it could not be supplied, the myocarclium got
ischaernic which caused visceral pain, e pain is
carried by afferents which travel mostly with left side
sympathetic nerves to the thoracic r:ne and thoracic
2-5 seg;ments of the spinal cord. Since somatic nerves
(T1-T5) also travel to the sarne segments, the pain is
referred to the skin area" T1 supplies the medial side
of arm and T2-T5 supply the intercostal spaces.
Case 3
A L0-year-old boy had mild cough and fever. The
physician could feel the increased rate of his pulse,
but could not hear the heartbeat on the left side of
his chest. After some thought the physician was able
to feel the heart beat as well.. Where is the normal apex beat heard?
o Name the congenital anomaly of the heart which
could cause inability of heart beat to be felt on the
left side.
Ans: Apex beat is norrnally hear:d in the left fifth
intercostai space, 9 cm from midsternal line, within
the left lateral line. e congenital anomaly ir"r this
case is dextrocardia, when the heart is placed on the
right side of the heart. The apex beat is heard in right
{ifth intercostal space. to the right of the inferic-rr end
of the sternum.
QUESTIONS- Trabecular carnae of right ventricle is in all
following forms except:
PERICARDIUM AND HEARTa. Ridges b. Bridges
c. Papillary muscles d. Chordae tendinae- Right coronary artery arises from which sinus?
a. Anterior aortic sinus
b. Right posterior aortic sinus
c. Left posterior aortic sinus
d. From anterior and posterior aortic sinuses - Blood to the interventricular septum is supplied by:
a. Only right coronary artery
b. Only left coronary artery
c. Anterior half by right coronary artery and
posterior half by left coronary artery
d. Anterior 2/3rd by left coronary artery and
posterior L/3rd by right coronary artery - Coronary arteries anastomose with all the following
arteries except:
a. Vasa vasorum of the aorta
b. Vasa vasorum of pulmonary arteries
c. Bronchial arteries
d. Anterior intercostal arteries
Rough part of left ventricle develops from:
a. Whole of primitive ventricular chamber
b. Proximal part of bulbus cordis
c. Middle part of bulbus cordis
d. Distal part of bulbus cordis
'1,.
,
MUTTIPLE CHOICE
The structures covering the heart are:
a. Fibrous pericardium
b. Parietal layer of serous pericardium
c. Pericardial cavity
d. Al1of the above
Boundaries of oblique sinus are all except:
a. Superior and inferior cavae on right side
b. Anteriorly by left atrium
c. Posteriorly by right atrium
d. Left side by left pulmonary veins
Boundaries of base of heart are formedby allexcept:
a. Four pulmonary veins
b. Oesophagus and descending aorta
c. Pericardium
d. Ascending aorta
Apex of the heart is felt at:
a. B cm lateral to midclavicular line in left 5th
intercostal space
b. 9 cm lateral to midclavicular line
intercostal space
c. 9 cm lateral to midclavicular line
intercostal space
d. 9 cm lateral to midclavicular line in right sth L0.
intercostal space- Entry channels of heart are all except:
a. Superior vena cava b. Inferior vena cava
c. 4 pulmonary veins d. Pulmonary trunk
ANSWERSin left 5th
in left 6th
x.E
o
-tr
F
C\I
o
o
o
L.d 2.c 3.d 4.b s.d 6.d a
7.a 8.d 9.d 10.a