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FM1020 > A: Mediastinum > Flashcards

A: Mediastinum Flashcards

1
Q

Superior mediastinum major contents:

A

Thymus glands
Veins: right + left brachiocephalic veins, superior vena cava, arch of azygous vein
Arteries: aortic arch + its branches (brachiocephalic, left common carotid, left subclavian arteries)
Nerves: left + right vagus, left recurrent laryngeal branch of left vagus, left + right phrenic nerves
Viscera: trachea, oesophagus and its plexus derived from left + right vagus nerves + branches from sympathetic chain
Thoracic duct

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2
Q

Posterior mediastinum major contents

A

DATES:
D - descending aorta
A - azygous venous system
T - thoracic duct
E - Oesophagus
S - sympathetic nerves + trunk

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3
Q

Anterior mediastinum contents

A

thymus gland
Fat
Lymph nodes
Connective tissue
Sternopericardial ligaments

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4
Q

Left brachiocephalic vein in children?

A

Rises above upper border of manubrium, so is less protected from injury as opposed to passing behind manubrium.

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5
Q

Right and left brachiocephalic veins unite to form what and where?

A

superior vena cava, behind lower edge of 1st RCC close to sternum

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6
Q

Path of superior vena cava - at what point does it enter right atrium?

A

Descends in front of lung root to open into right atrium behind lower edge of 3rd RCC. Receives azygous vein immediately before entering pericardial sac.

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7
Q

Azygous veins

A
  • Arise at L1/L2.
  • Passes through aortic hiatus to enter posterior mediastinum.
  • Continues up along right side of bodies of thoracic vertebrae.
  • Receives posterior intercostal veins
  • Azygous vein forms arch that passes over root of right lung + enters posterior aspect of superior vena cava, immediately before superior vena cava enters pericardial sac
  • Drains mediastinum + posterior thoracic + abdominal walls on right.
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8
Q

Hemiazygous veins

A
  • Drains mediastinum + lower posterior thoracic wall + abdominal wall on left.
  • Arises in abdomen by junction of veins
  • Passes through aortic hiatus to enter posterior mediastinum
  • Continues up on left side of bodies of thoracic vertebrae
  • Receives posterior intercostal veins
  • Hemiazygous crosses to right side to enter azygous vein, posterior to thoracic aorta.
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9
Q

Patent ductus arteriosus

A

Congenital heart defect where ductus arteriosus fails to close at birth. Oxygenated + deoxygenated blood mix.

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10
Q

Branches of ascending aorta

A

Right & left coronary arteries

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11
Q

Branches of aortic arch

A
  • Brachiocephalic artery. Divides into right subclavian + common carotid artery behind right sternoclavicular joint
  • Left common carotid artery: ascends through superior mediastinum and supplies left side of head and neck
  • Left subclavian artery: ascends through superior mediastinum, on left side of trachea. Enters neck + curves laterally on dome of pleura. Passes between anterior scalene + middle scalene.
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12
Q

Branches of descending aorta

A
  • posterior intercostal arteries. Supply intercostal spaces & thoracic wall
  • Oesophageal branches to oesophagus.
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13
Q

Vagus nerves innervations + where does it enter?

A
  • Provide parasympathetic innervation to thoracic viscera + carry sensory fibres from thoracic viscera about normal physiology processes + reflex activities.
  • Do not carry pain sensations
  • Enters superior mediastinum posterior to brachiocephalic veins.
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14
Q

Branches of vagus nerves

A

Lung - pulmonary plexus
Heart - cardiac plexus
Oesophagus

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15
Q

Origin of left recurrent laryngeal nerve

A

Left vagus close to aortic arch, loops under it

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16
Q

Origin of right recurrent laryngeal nerve

A

Loops around right subclavian artery in root of neck.

17
Q

Consequences of anatomy of right + left recurrent laryngeal nerves

A
  • Diseases of thorax (enlarged lymph nodes associated with lung cancer) more likely to involve LRLN rather than right, resulting in paralysis of left vocal cord, leading to hoarseness of voice.
  • Cancer of apex of right lung may affect RRLN, resulting in paralysis of right vocal cord, leading to hoarseness of voice.
18
Q

What do phrenic nerves arise from

A

C3,4,5

19
Q

What do phrenic nerves innervate

A

Motor to diaphragm
Sensory to central diaphragm, fibrous pericardium + parietal serous pericardium

20
Q

How are right and left sympathetic trunks connected to thoracic spinal nerves

A

White + gray rami communicans.

21
Q

Sympathectomy

A

Division of sympathetic trunks.
Can be used to reduce bp + hypertension by preventing vasoconstriction.

22
Q

Branches of sympathetic trunks

A

greater, lesser + least splanchnic nerves
Convey preganglionic sympathetic fibres from thoracic ganglia to preertebral ganglia of abdomen
Carry visceral afferent nerves from abdomen.

23
Q

Thoracic duct origin

A

Lymphatic duct that begins in abdomen as cisterna chyli.

24
Q

Diaphragm openings

A

I ate 10 eggs at 12
inferior Vena Cava = T8
Oesophagus, vagus trunks = T10 oesophageal hiatus
Aortic hiatus for aorta, thoracic duct = T12

25
Q

What structure is directly behind ductus arteriosus

A

Left recurrent laryngeal nerve

26
Q

Identify this vessel + its origin

A

Right coronary artery, right aortic sinus.

27
Q

Identify this vessel

A

Left coronary artery

28
Q

Name this vessel + its divisions

A

Brachiocephalic trunk.
Behind the right sternoclavicular joint.
Branches: right subclavian & right common carotid arteries

29
Q

Name the dilatation at the end of the right common carotid artery

A

Carotid sinus

30
Q

Identify this nerve and what it arises from.

A

Left recurrent laryngeal nerve –branch of Left vagus nerve

31
Q

Identify this nerve

A

Phrenic nerve

32
Q

Identify this vein + its course

A

hemiazygous
Arises in abdomen
Passes through diaphragm (left crus/aortic hiatus) –> posterior mediastinum.
Runs upward along left side of vertebral bodies
It receives left posterior intercostal veins.
crosses to right side, posterior to thoracic aorta,
empties into azygos vein.

33
Q

What kind of nerve fibres are found within vagus nerve?

A

Parasympathetic nerves and visceral afferent nerve fibers

34
Q

What is the relationship of the phrenic nerves to the aortic arch and
superior vena cava?

A

Left phrenic n: just lateral to aortic arch
Right phrenic n: just lateral to superior vena cava

35
Q

A sudden deceleration (e.g. road traffic accident) may cause injury to the
aorta at certain locations. List these locations

A

Aortic valve, attachment of ligamentum arteriosum, as it passes
through the diaphragm.

36
Q

Identify this nerve

A

Right recurrent laryngeal nerve

37
Q

Branches of descending aorta

A

Right and left bronchial arteries (to bronchi and lungs)
Oesophageal branches

38
Q

Where does the thoracic duct drain into the venous system?

A

At the junction of left internal jugular and left subclavian veins

39
Q

Identify this - which division of mediastinum is it located

A

Thoracic duct. Located in posterior & superior mediastinum.

FM1020 (21 decks)

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