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IMF-077-02-0001-en	Why can a single mediastinal process such as enlargement, bleeding, or tumour produce symptoms in several systems?	Organs, vessels, nerves, lymphatics, and fascial planes are tightly related in the mediastinum, so one lesion can compress several systems.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0002-en	Why should compartment-based mediastinal mass differentials be used as tendencies rather than rules?	Cross-sectional imaging shows that lesions can span compartments, and each lesion type has typical tendencies rather than absolute locations.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0003-en	Why does rapid pericardial fluid cause tamponade at smaller volumes than slowly accumulating fluid?	Rapid accumulation raises intrapericardial pressure and compresses chambers, impairing filling, whereas slow accumulation lets the sac stretch; low-pressure right chambers are most vulnerable in diastole.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0004-en	How do the phrenic and vagus nerves differ in their relation to the lung roots, and why does it matter?	Phrenic nerves descend anterior to the roots with pericardiacophrenic vessels, while vagus nerves pass posterior, a relation that helps identify the nerves during surgery and imaging.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0005-en	What distinguishes the transverse from the oblique pericardial sinus?	The transverse sinus lies behind ascending aorta and pulmonary trunk and in front of superior vena cava, allowing surgical passage around arterial outflow; the oblique sinus is a cul-de-sac behind left atrium.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0006-en	Which chambers dominate the sternocostal and diaphragmatic surfaces of the heart?	The sternocostal surface is predominantly right ventricle, while the diaphragmatic surface is predominantly left ventricle with part of right.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0007-en	Why is the left ventricular wall thicker than the right?	The left ventricle ejects into the systemic circulation.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0008-en	What actually closes heart valves, and what is the true role of papillary muscles?	Closure depends on pressure reversal and cusp coaptation, not muscle contraction; papillary muscles prevent atrioventricular leaflet prolapse during systole but do not close valves.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0009-en	Why must atrial activation pass through the atrioventricular bundle to reach the ventricles?	The fibrous cardiac skeleton electrically insulates atria from ventricles everywhere except through the atrioventricular conduction bundle.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0010-en	How is coronary dominance defined, and why does it matter clinically?	Dominance is defined by the origin of the posterior interventricular artery, usually right coronary; it affects inferior and posterior territories and atrioventricular-node supply.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0011-en	Why does acute coronary occlusion commonly infarct myocardium, and why is subendocardium most vulnerable?	Coronaries are functional end arteries, so gradual narrowing may enlarge collaterals but acute occlusion does not; subendocardium suffers because systolic intramural pressure compresses vessels and perfusion is mainly diastolic.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0012-en	Why is cardiac ischaemic pain referred to the chest and medial arm, yet cardiac reflexes run in the vagus?	Visceral pain afferents travel with sympathetics to upper thoracic segments, producing referred chest and medial arm pain, whereas reflex afferents travel with the vagus.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0013-en	Why can an aortic aneurysm or left atrial enlargement cause hoarseness?	The left recurrent laryngeal nerve lies near the ligamentum arteriosum and aortic arch, so aneurysm or an enlarged left atrium can compress or affect it.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending
IMF-077-02-0014-en	Why are cardiac auscultation sites not the same as the surface projections of the valves?	They are locations where valve sound transmits toward the chest wall, so anatomy predicts radiation while echocardiography shows the actual moving valves.	Integrated Medical Foundations; chapter 77, TTS module 2; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: fa6e21a034a8b4ecec519388ffee6eaccadc82635c14568eba86f9421f787721; editorial review pending	imf lang::en chapter::077 module::077-02 review::pending