9 11 Anatomy-Table 1 Flashcards
What is Dyspnea
difficulty breathing
What is Dysphagia
difficullty swallowing
How can Enlargement of the aorta lead to horseness of voice
by pressing on the left recurent laryngial nerve. (a branch of the vegas nerve)
How can Enlargement of the aorta lead to engorgement of veins in upper limbs and face/
obstuctionof the SVC
How can Enlargement of the aorta lead to dyspnea
compresssion of trachea
How can Enlargement of the aorta lead to Dyshpagia
compression of esophagus
how can we identify the trachia in a CT
the inside is the same color as the lungs! (black)
what part of the airway is i the inferior and superior of the metiastynum
the trachea is in the superior, and the left and right primary branches and the corina enter into the inferior
what are the structures under the sternal angel?
rib 2; aortic arch (begin and end); Trachia branch (corina); Pulmonary trunck (splitting towards the two lungs); Ligamentum arteriosus; azygous vein (just before it goes into the back of the SVC); Nerves (the L Recurent larengeal verve of the vegas nerves coming down, and the sympathetic chain); Thorasic duct (the largest lymphatic vessel
what are the brachial syphalic?
this is left and right biforcation of the SVC that then biforcates to give rise to the L/R Jugular, and L/R sub-clavical veins.
what is more ventral in the thorax, arteries or veins?
the viens are on a more vental plane.
what are the major arteries to the head from the aortic arch
the right common corroded artery and the left common corroded artery
what are the major branches off of the aortic arch from the aortic valve outward?
Brachiocephalic truck (that quickly bi-forcates to the right subclavian and the right common carotid); Left com Carotid; and the left subclavian
what is a coarct
a norrowing (like putting a belt on something!
explain how blood cold bypass a coarct in the aorta
up the arotic arch, up the left subclavian, down the internal thoracic artery, and through the intercostal artery, and then back to the post coarct abdominal aorta.
what sections of the body don’t drain into the thoracic duct
the R. upper quadrant of the body, including the right side of the head, and right shoulder, and the right arm.
explain referred pain
pain in visceral organs is often perceived to be somatic in origin, referred to somatic regions of the body that receive innervation from the same spinal cord segments.
what would cause the right jugular pulse?
the closure of the tricuspid valve during systole and the contraction of the RA during the end of diastole
What muscle is innervated by the long thoracic nerve?
the anterior seratus muscle
what spinal cord level provides the source of the greater splanchnic nerve?
the sympathetic innervation for the posterior mediastinum and causes dilation o arteriors supplying the foregut (stomach liver etc.) comes from the spinal cord T5-T9 level and through the sympathetic chain.
where is the sternal angle?
at the anterior T2 rib level just below the manubrium, where the sternal body and the manubrium meet
what is another name for the sternal angle?
The Manubrial sternal joint
what is the angle of the manubrial sternal joint?
163 Degree
what rib articulates the sternal angel
2nd
what vetebral leve is the TTP?
T4
what is the TTP
the transverse thorasic plane
what is the significance of the Transverse thorasic plane
the TTP divides the Superior and inferior mediastinum and indicates the location for RAT PLANT
What is RAT PLANT
Rib 2; Aortic arch (begining and end); Trachea biforcation; pulmonary trunk biforcation; ligamentum arteriorsum; Azygos Vein; Nerves (the Vegas nerve and the left and right recurent laryngeal nerve);Thoracic duct crossing over from right to left.
What is the structure at the biforcation of the trachia?
corina
What are the branches off of the corina?
the R and L primary bronchi
where does the azygos vein enter the SVC
it arches above the right primary bronchus to enter the back of the SVC.
What provides parasympathetic inervation to the cardiopulmonary plexus?
the right and left vegas nerve or CN ten that comes from the brain stem.
What are the divisions of the mediastinum?
Superior and inferior, seperated by the TTP. The Inferior M.S. is divided into the Anterior/middle/posterior (divided by the borders of the heart). The Superior media stinum is divided into a Glandular plane, venous plane, arterial/nerve plane, visceral plane, and lymphatic plane.
What are the structures of the inferior- posterior media stinum?
“D.A.T.E.S” Descending Aorta, Azygos veins, Thoracic Duct; Esophagus; Sympathetic trunk
what is the derivitive of the word Mediastinum?
Midway
What lies in the Anterior division of the inferior mediastinum?
the Thymus
What is in the middle mediastinum
heart
what is in the posterior mediastinum?
DATES
How could a block in the Descending aorta lead to a high blood pressure in the intercostal arteries?
the descending aorta gives rise segmentally to the intercostal arteries.
how could a RBC make a circumfrecal trip around the mediastinum?
the posterior and anterior intercostal arteries are connected usually through anastimosis.
How could a swelling of the diaphram block off blood flow to the lower extremities?
the aorta travels through the diaphram at the T12 vetebral layer through the aortic hyatas.
Describe the orientation of the Azygos system
The azygos vein goes up the right side of the vetebra colomn and over the right primary bronchi and into the back of the SVC; the Accessory Hemiazygos is on the left and drains the left posterior intercostal, and the Hemizygos is on the lower left and drains the lower lefter IC posterior veins.
how could a anatomical narrowing of the hemizygos lead to problems in the abdominal?
the hemiazygos vein drains the abdominal region as well as the left posterior IC
how much lymph per day in the thoracic duct
4 L
you get punched in the diaphram, what is squashed first…the esophagus or the descending aorta?
the esophagus goes through the diaphram at the T10 level, and the aorta not until the T12.
the diaphram contacts and swells at the T10 level, what structure are we concerned will get squished?
the Esophagus and the Vegas nerve that travels on the anterior and posterior of the esophagus.
Oh no…an unknow infection just infected the celiac gangleon, will this possibly effect the parasympathetic?
YES, THE vegas nerve goes to the celiac gangleon on the way to synapse at the fore and midgut structures!.
what is the eophageal plexus?
the tagle of vegas nerve around the esophagus.
The same infection at the celiac gangleon will affect the synapse of what sympathetic?
the Greater splanchnic nerve (T5-T9 origin)
what is the destiny of the post gangleonic neuronal cell bodies in the Sympathetic chain?
they go to the sweadt glands and the head neck and heart and lungs.
Describe the path of a visceral sensory neuron from the heart:
from the heart along the sypmathetic nerve path back passing through the chain, through the white communicon, through the ventral ramus, trunk dorsal root and lateral horn!
how could impinging on the internal nodal fiber lead to loss of sympathetic control of anything above T1
the sympathetics travel out the ventral root, to the gray matter communicon to the chain, up and down the nodal fibers to the right level (even above the T1 level) and then synapse and out the white matter comunicoon to the target.
Where does the lesser splanchinic nerve arise?
T10-T11
wherer does the least splanchnic nerve arise?
T12
where do the splanchinic nerves synapse?
the pre-aortic gangleon.
what are the planes of the superior mediastinum highlighted by Dr. Morten?
the Venous plane, the Arterial plane, and the Visceral plane (esophagus/trachea)
there is a block int eh venous return just before the heart, but only the left side of the face, and the left side of the body seem to be affecte?! how
the block must be in the right brachiocephalic vein above the junction with the left brachiocephalic n.
Describe the venous plane of the superior mediastinum
the SVC branches to the left and right brachiocephalic, which branch to the left and right internal jugular, and the left and right subclavian.
where does the thoracic duct terminate
at the branch of the left brachiocephalic Vein (where it becomes the jugular and subclav.
what section of the body is drained by the thoracic duct?
the whole body but the upper right quadrent.
describe the arterial branches of the aortic arch
first is the brachiocephalic artery trunk that then will biforcate to the right subclavian artery and the right common corotid artery. Then the left common carotid artery, and then the left sublcavian artery both come directly off of the arotic arch
what lies in the visceral plane of the superior mediastinum?
the trachea and the esophagus.
