1. Lower part of the neck and the anterior part of the superior mediastinum 2. Posterior to the manubrium 3. Can extend into the anterior mediastinum

4: Mediastinum Flashcards by Shonte Reed

What is the additional structure that is found in the superior mediastinum of kids

Thymus

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Thymus contributes to the development and maintenance of the

Immune system

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Describe the size of the thymus in childhood, and after puberty

Large, then involuted after puberty and replaced by fatty tissue

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Location of thymus

Lower part of the neck and the anterior part of the superior mediastinum
Posterior to the manubrium
Can extend into the anterior mediastinum

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Blood supply of the thymus is from

Internal thoracic arteries

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Venous drainage of the thymus

Internal thoracic to the SC, BC, SVC

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What lies within the superior mediastinum before passing through the superior thoracic aperture

Great vessels

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What are the great vessels

Superior vena cava
Pulmonary trunk
Arch of the aorta

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What are the tributaries of he superior vena cava

Brachiocephalic
Left superior intercostal vein
Supreme intercostal vein
Azygos vein

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Superior vena cava returns blood from all structures

Superior to the diaphragm except for the heart and the lungs

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Superior vena cava returns blood from all structures superior to the diaphragm except

The heart and the lung

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The accessory azygos vein is formed by the union of

The 4th to 7th posterior intercostal veins

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Accessory hemiazygos empties in tho the

Azygos vein

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Where does the pulmonary trunk exit

From the right ventricle

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Describe the position or location of the pulmonary trunk

Initially anterior to the aorta
Move medically and posteriorly
Bifurcated into the L/R pulmonary arteries

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Where does the aorta arise

From the left ventricle

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What are the branches of the ascending aorta

Coronary arteries

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What are the major branches off the aortic arch

Brachiocephalic
Left common carotid
Left subclavian

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What dos the brachiocephalic artery supply

The right side of the head and neck

2. Right upper limb

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What dos the left common carotid artery supply

Left side of the head and neck

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What dos the left subclavian artery supply

Left upper limb

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Brachiocephalic drains blood from

The upper body

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Left superior intercostal vein collects blood from

The left 2 intercostal vein and drains to left brachiocephalic

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Supreme intercostal vein drains

From 1st intercostal space directly into the brachiocephalic veins

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Azygos vein receives blood from

The right posterior intercostal, and accessory/hemiazygos systems

Superior mediastinum end at what T level

T4/5

describe an Aneurysm of the aorta

Massive amount of blood being pumped and gets trapped, usually lethal

Where the vagus nerve located and how may paths does it have

Located in the superior/posterior mediastinum

What is the path of the right vagus nerve

1. Runs parallel to the trachea | 2. Passes posteriorly to the superior vena cava & right bronchus

What is the path of the left vagus nerve

1. Enters the superior mediastinum between left common carotid and left subclavian arteries 2. Descends anteriorly to the aortic arch 3. Then travels posterior to the left bronchus

Where does the right recurrent laryngeal hook

1. Around the right subclavian artery | 2. Amends between the trachea and esophagus

Where does the left recurrent laryngeal hook

1. Loops under the aortic arch 2. Left of the ligamentum arteriosum 3. Continues to the larynx in the tracheal-esophageal groove

What doe the recurrent laryngeal arteries supply

The larynx

The vagus nerve travels through the neck with what vessels

The internal jugular vein and the common carotid arteries

The parasympathetic branches of the vagus nerve contribute to

The cardiac and pulmonary plexuses

What happen to the vagus nerve after it pass posterior to the bronchi

They converge on the esophagus and from the esophageal plexus

Just superior to the diaphragm, the vagus nerve gives rise

To two vagaries trunks, right become anterior, left becomes posterior

Doe the right laryngeal nerve enter the mediastinum

No, hooks around right subclavian artery and travels to the larynx

The right recurrent laryngeal artery is also spatially related to

Apex of the right lung

The left recurrent laryngeal artery is also spatially related to

Lymph nodes of the aortic arch

Injury to recurrent laryngeal nerves symptoms

Cough, weak voice/hoarse, loss of voice/aphonia

What is the ligamentum arteriosus

A fibrous remnant of the ductus arteriosus

Where is the ligamentum arteriosus located

Between the aortic arch and pulmonary trunk

What is the ductus arteriosus

Fetal blood vessel that serves as a bypass for the lungs. Left pulmonary artery and aorta

Is you get compression or swelling (aneurysm) or the aortic arch what nerve could be affect

Left recurrent laryngeal

Nerves of the superior mediastinum

1. Vagus 2. Phrenic 3. Cardiac (superior and deep plexuses) 4. Sympathetic trunk

Where does the phrenic nerve come from

1. Anterior surface of scalene muscles (C3-5 roots) 2. Enters superior mediastinum lateral to great vessels 3. Descends anteriorly in to middle mediastinum 4. Passing anteriorly to the hilum of the lung

Phrenic nerve supplies motor innervation to

Diaphragm

Phrenic nerve supplies s sort innervation to

Mediastinal and diaphragmatic pleura

Cardiac nerves originate from

Superior, middle, inferior cardiac ganglia

Superior cardiac plexus sits between

Aortic arch and right pulmonary vein

Deep cardiac plexus lies on

The surface of the trachea where it bifurcates

Sympathetic trunk runs

Bilaterally to the vertebral bodies along the entire vertebral column

Trachea descends

Anterior to esophagus

Posterior surface of trachea is

Flat where esophagus is

Trachea ends at the level of _______, the divide in to

The sternal angle, in to l/r primary bronchi

is the Azygos vein is posterior/anterior to trachea

Posterior

is the descending aorta posterior/anterior to trachea

Posterior

is the pulmonary arteries posterior/anterior to trachea

Where is the aortic arch in comparison with trachea

Anterior and moves laterally posteriorly

Supervisor vena cava in relation to the trachea

Lies Anterior

Brachiocephalic veins in relation to the aortic arch

Anterior, superior

Thoracic aortic is found in which mediastinum

Posterior mediastinum

Thoraci arota begins at

Inferior border of T4

Thoracic aorta descends on which side of the vertebral column

Left

Thoracic aorta supplies

Intercostal spaces and thoracic viscera

Esophagus location in relation to aortic arch

Posterior

Esophogus found in which mediastinum compartments

Superior and posterior

What is the largest lymphatic channel in the body and which mediastinum in it apart of

Thoracic duct, superior and posterior.

The thoracic duct originates from

The cisterna chyli in the abdomen

Thoracic duct drain lymph’s from the whole body except (where do the exceptions drain)

1. Right side of head and neck 2. Right upper limb 3. Right side of thorax They drain in to the right lymphatic duct