Anatomy Flashcards
Borders of the superior mediastinum
Superiorly-Superior thoracic aperture
Laterally- Pleura of lungs
Inferiorly- anterior manubrialsternal joint, posteriorly the lower region of TIV vertebrae
What is contained in the superior mediastinum
- Lower ends of sternohyoid, sternothyroid and longs colli muscles.
- Aortic arch
- Brachiocephalic artery
- Thoracic portions of left common carotid and left subclavian
- Brachiocephalic veins
- Upper half of the superior vena cava
- Vagus, cardiac, phrenic, recurrent laryngeal nerves
- Trachea
- Oesophagus
- Thoracic duct
- Thymus
- Lymph nodes
Describe the path of the left vagus nerve
From cranial nerve X. Passes posterior to ligamentum arteriosum and the left pulmonary trunk. At the point of ligament arteriosum it gives off a branch, the left recurrent pharyngeal nerve that also passes posterior to the ligamentum arteriosum wraps underneath the arch of the aorta and supplies the throat. The vagus then descends, passes posterior to hila of lung and forms the oesophageal plexus
Describe the path of the right vagus
From cranial nerve X, travels down to where the brachiocephalic trunk bifurcates into the right commons carotid and right subclavian. Nerve travels anterior to brachiocephalic trunk and gives off the right recurrent laryngeal nerve which passes posterior to the right common carotid artery. The vagus then descends, passes posterior to hila of lung and forms the oesophageal plexus
Describe the paths of the phrenic nerves
From C3, C4, C5. Travels lateral sides of heart, anterior to hila of lungs. Outside fibrous pericardium
Describe conditions that are associated with raised jugular venous pressure
Reflects right atrial pressure.
Fluid overload
Congestive heart failure
Where does the right coronary artery lie
In the atrioventricular groove anteriorly and in the coronary sinus posteriorly
Where does the left anterior descending artery lie
In the anterior interventricular groove
What are the structures in the ‘ski moguls’ in CXR from most superior
Aortic arch Pulmonary trunk L auricle Left ventricle Apex
What are the only arteries that fill on diastole and why
The coronary arteries. Because their openings sit within the aortic valve, the valve cusps close off the openings when the ventricles contract and aortic valves open.
Layers of the heart superficial to deep
Fibrous pericardium
Serous pericardium (parietal and visceral)
Myocardium
Endocardium
Why would you get shoulder pain with pericaditis?
Referred pain as innervation of the pericardium is the phrenic nerve which also innervates the shoulder
Describe the orientations if the pericardium and the heart
Pericardium has a vertical orientation with the apex at the superior end. The heart is obliquely orientated with the base posterior and right and the apex more anterior and left
Describe the transverse pericardial sinus, location and clinical relevance
Reflection of pericardium. Inferior to pulmonary trunk separating the pulmonary arteries from the pulmonary veins.
Describe the oblique pericardial sinus
Formed by a reflection of pericardium onto pulmonary veins.
