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Thorax > Anatomy. > Flashcards

Anatomy. Flashcards

1
Q

What is the extent of the mediastinum?

A

Anteriorly: Ribs from 1-7.
Posteriorly: Vertebral column.
Superiorly: Thoracic inlet.
Inferiorly: Diaphragm.

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2
Q

What is the thoracic inlet covered by?

A

Subpleural membrane.

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3
Q

What happens to the mediastinum if the patient is in supine position?

A

The abdominal viscera spreads horizontally pushing the mediastinum superiorly.

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4
Q

What happens to the mediastinum if the patient is in an erect position?

A

Gravity takes place. Mediastinum moves inferiorly with abdominal viscera holding it together.

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5
Q

What are the borders of the superior mediastinum?

A

Superiorly: Thoracic Inlet.
Inferiorly: Imaginary line of angle of louis.
Posteriorly: Thoracic vertebrae 1-4.
Anteriorly: Ribs 1-2.

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6
Q

What are the contents of the superior mediastinum shown on the left side?

A

Aortic arch.
Left common carotid artery.
Left subclavian artery.
Brachiocephalic vein.
Brachiocephalic artery.
Left vagus nerve.
Superior intercostal vein.
Left jugular vein,

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7
Q

What are the contents of the superior mediastinum shown on the right side?

A

Trachea.
Oesophagus.
Superior vena cava.
azygous arch.
Phrenic nerve.

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8
Q

What are the major contents of the superior mediastinum?

A

Paravertebral muscles - sternohyoid and sternothyroid.
Caediac plexus.
Thymus.
Recurrent laryngeal nerve.
Thoracic duct.

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9
Q

What is the thymus important for?

A

Cell-mediated immunity.

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10
Q

Where would the trachea be located?

A

Posterior to the superior vena cava and anterior to the oesophagus.

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11
Q

What are the contents of the superior mediastinum shown on the anterior side?

A

Arch of aorta.
Superior vena cava.
Brachiocephalic vein.
Trachea.
Vagus nerves/recurrent laryngeal nerves

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12
Q

What is the pathway of the left vagus nerve?

A

Left vagus becomes left recurrent laryngeal nerve which descends and loops around the arch of aorta. It then ascends towards the thyroid gland - supplies larynx muscles except for cricothyroid.

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13
Q

What is the pathway of the right vagus nerve?

A

Right vagus becomes right recurrent laryngeal nerve which descends and loops around the right subclavian artery. It then ascends towards the thyroid gland - supplies larynx muscles except for cricothyroid.

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14
Q

What happens if recurrent laryngeal nerves are damaged?

A

Phonation is affected (vocal cords).

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15
Q

A surgeon is doing thyroid surgery, what nerves does she need to be aware of?

A

Recurrent laryngeal nerves.

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16
Q

What are the borders of the anterior mediastinum?

A

Anteriorly: Ribs 3-7.
Posteriorly: Pericardium.
Superiorly: Angle of louis.
Inferiorly: Diaphragm.
Laterally: Mediastinal Pleura

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17
Q

What are the contents of the anterior mediastinum?

A

Thymus.
Lymph.
Internal thoracic artery (musculophrenic - medial. superior epigastric - lateral).

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18
Q

What is the remains of thymus replaced by?

A

Adipose tissue.

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19
Q

What are the borders of the middle mediastinum?

A

Anteriorly: Pericardium.
Posteriorly: Pericardium.
Superiorly: Angle of louis.
Inferiorly: Diaphragm.
Laterally: Mediastinal pleura.

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20
Q

What are the contents of the middle mediastinum?

A

Heart.
Great vessels.
Lymph.
Bifurcation of the trachea happens.

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21
Q

Which is the broadest part of the mediastinum?

A

Middle mediastinum.

22
Q

Which is the smallest part of the mediastinum?

A

Anterior mediastinum.

23
Q

What are the great vessels?

A

Superior vena cava.
Aorta.
Pulmonary trunk.
Pulmonary veins.
Azygous vein.
Inferior vena cava.
Right pulmonary artery.

24
Q

What are the borders of the posterior mediastinum?

A

Anteriorly: Pericardium
Posteriorly: Vertebral column.
Superiorly: Inlet.
Inferiorly: Diaphragm.
Laterally: Mediastinal pleura.

25
Q

What are the contents of the posterior mediastinum shown on the left side?

A

Intercostal vessels and nerve.
Left recurrent laryngeal nerve.
Hemiazygous vein.
Left vagus nerve.
Thoracic aorta

26
Q

What are the contents of the posterior mediastinum shown on the right side?

A

Azygous vein.
Right recurrent laryngeal nerve.
Right vagus nerve.
Thoracic duct.
Oesophagus,
Greater splanchnic nerves.

27
Q

What are the greater splanchnic nerves?

A

Visceral nerves on either side of the vertebral column. They arise from the thoracic sympathetic trunk.

28
Q

What are the thoracic splanchnic nerves?

A

Greater - T5-T10.
Lesser - T10-T11.
Least - T12.

29
Q

What is the pathway of the azygous vein?

A

Arises from inferior vena cava in the abdomen. Ascends to enter the posterior mediastinum through the aortic hiatus at T12. It continues to the superior mediastinum and forms an arch. It then drains into the superior vena cava in the middle mediastinum.

30
Q

What is the pathway of the accessory hemiazygous vein?

A

Situated in the anterior mediastinum and the upper part of the posterior mediastinum. It drains into the azygous vein and T7, while the hemiazygous vein (situated in the posterior mediastinum) drains into the azygous vein at T8.

31
Q

What is the pathway of the thoracic duct?

A

At L2, it starts at cisterna chyli and ascend to the root of the neck through the aortic hiatus.
It is situated anterior to the vertebral column and is posterior to the oesophagus.
At T5, it moves towards the left and enters the superior mediastinum between the oesophagus and the left pleura, then forms an arch above the clavicle.
It ends by opening into the left subclavian vein with internal jugular vein *brachiocephalic vein).

32
Q

Why would a patient need a mediastinoscopy?

A

Examine mediastinum. Remove lymph when cancerous.

33
Q

What are the risks of medistinoscopy?

A

Bleeding.
Infection.
Paralysis of recurrent laryngeal nerve.
Puncture of lungs.

34
Q

What is sarcoidosis?

A

Inflammatory disease that affect lymph and lungs.

35
Q

What masses occur in the anterior mediastinum?

A

Thymomas.
Lymphomas.
Retrosternal thyroid mass.

36
Q

What masses occur in the middle mediastinum?

A

Underlying cancer (enlarged lymph).
Bronchogenic cysts.
Thoracic aortic aneurysm.

37
Q

What masses occur in the posterior mediastinum?

A

Sarcoma.
Oesophageal cancer.
Neurogenic tumour.
Paraspinal abscesses.
Ectopic thyroid tissue.

38
Q

What can large masses in the mediastinum cause?

A

Respiratory insufficiency.
Decreased blood pressure.
Decreased blood flow.

39
Q

Where would masses occur in children?

A

In the posterior mediastinum and are benign.

40
Q

Where would masses occur in adults?

A

Anterior mediastinum and are malignant.

41
Q

What are bronchogenic cysts?

A

Congenital malformations of the bronchial tree.

42
Q

What are sarcoma?

A

Cancers that begin in bones and connective tissue.

43
Q

Where would neurogenic tumours arise?

A

In tissues derived from the embryonic neural crest such as peripheral nerves of the spinal cord.

44
Q

What is a thoracic aortic aneurysm?

A

Dilation of aorta due to weakness of arterial wall.

45
Q

What would form at the sight of the thoracic aortic aneurysm?

A

Atherosclerotic plaque.

46
Q

What is the atherosclerotic plaque?

A

A clot that increases chance of a stroke.

47
Q

Why would the thoracic aortic aneurysm rupture?

A

Because the artery wall thins at this spot, and may burst under stress.

48
Q

What can cause mediastinal hematoma?

A

Trauma, which causes laceration of great vessels, leading to a haemorrhage into the mediastinum.

49
Q

What is mediastinal lymphadenopathy?

A

Enlarged malignant mediastinal lymph nodes.

50
Q
A

Thorax (1 decks)

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