Anatomy: Practical 1 - Mediastinum Flashcards

1
Q

what are the divisions of the mediastinum?

A

superior

anterior

middle

posterior

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2
Q

label xo

A
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3
Q

At which vertebral level does the trans-thoracic plane lie?

A

T4/5 - identified at sternal angle

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4
Q

is thymus in inferior or superior mediastinum?

is heart in inferior or superior mediastinum?

is trachea in inferior or superior mediastinum?

A

thymus: both

heart: inferior

trachea: superior

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5
Q

where do you find the apex of the heart?

A

5th intercostal space in the mid-clavicular line

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6
Q

where are the ascultation points of the heart valves?

A

The aortic area is found in the 2nd intercostal space to the right of the sternum.

The pulmonic area is found in the 2nd intercostal space to the left of the sternum.

The tricuspid area is found in the 4th intercostal space to the left of the sternum, where other right heart sounds will also be heard.

Finally, the mitral area is found in the 5th intercostal space along the mid-clavicular line, where left heart sounds can also be heard.

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7
Q

what does the superior mediastinum mostly contain?

A

mainly contains the great vessels

&

  • *nerves:**
  • vagus nerves descends down the neck through the carotid sheath into the thorax
  • Here, it gives off the recurrent laryngeal nerves (motor to vocal cords)
  • The right recurrent laryngeal nerve loops underneath the right subclavian artery and travels back up to the larynx
  • The left recurrent laryngeal nerve branches off to hook under the arch of the aorta next to the ligamentum arteriosum and ascends to the larynx
  • phrenic nerve
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8
Q

where does the phrenic nerve enter the superior mediastinum?

A

between the subclavian artery and the origin of the subclavian vein

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9
Q

label 1-6 xo

A

1: azygous vein
2: right subclavian artery
3: left brachiocephalic vein
4: left internal jugular vein
5: left common carotid artery
6: right common carotid artery

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10
Q
A
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11
Q
A
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12
Q

match these xo

A
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13
Q

which nerves are 1-4?

A
1 = **right vagus nerve** (gives rise to.. the right recurrent laryngeal nerve)
2 = **right recurrent laryngeal nerve** - branches from the vagus nerve and loops under the right subclavian artery before travelling to layrnx
3 = **right recurrent laryngeal nerve** -
4 = **left vagus nerve**
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14
Q

describe the path of innervation from vagus nerve to right recurrent laryngeal nerve

A

vagus nerve -> branches and loops under the right subclavian artery - > before travelling to layrnx

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15
Q

label A-E

A
A = Right brachiocephalic vein
B = Left common carotid artery
C = right phrenic nerve
D = right subclavian vein
E = left vagus nerve
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16
Q

what type of cartilage makes the trachea?

the trachea starts and finishes at which vertebrae levels ?

A

hyaline cartilage

starts: C6
ends: T4

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17
Q

What is the bifurcation into the left and right main bronchi called?

what vert level?

A

carina

t4/5

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18
Q
A

1: left common carotid artery
2: right common carotid artery

19
Q

which structures are found in anterior mediastinum?

A

not many - mostly fat and the remnant of the thymus

20
Q

which structures are found in middle mediastinum?

A

heart and its pericardial sac

21
Q

The nerve supply of the fibrous and parietal pericardium is from the X nerves?

A

The nerve supply of the fibrous and parietal pericardium is from the phrenic nerves (C3-C5).

22
Q

The pericardial sac is fused with the ….. …… of the great vessels.

A

The pericardial sac is fused with the tunica adventitia of the great vessels.

23
Q

The posterior mediastinum is located between …. (vert. levls), posterior to the pericardium and the diaphragm, and between the … ….

A

The posterior mediastinum is located between T5-12, posterior to the pericardium and the diaphragm, and between the parietal pleura of the 2 lungs.

24
Q

Which structures are found in the posterior mediastinum? (5)

A

azygos and hemizygos veins

descending aorta

oesophagus

thoracic duct

vagus nerves

25
Q
A

1 - posterior intercostal arteries

2 - anterior intercostal arteries

3 - thoracic descending aorta

  1. right internal thoracic (mammary) artery
  2. right subclavian artery

6 left subclavian artery

7 left internal thoracic (mammary) artery

26
Q

which vein is this?

A

azygous vein

27
Q

what is this?

A

azygos vein

28
Q

what are the two main tributaties of the azygos vein?

A

hemiazygos vein and the accessory hemiazygos vein.

29
Q

?

A

hemiazygous vein

30
Q

?

A

accessory hemiazygos vein

31
Q

name where each is found (superior, posterior, anterior and middle mediastinum)

  • Brachiocephalic veins
  • thymus:
  • descending aorta:
  • left current laryngeal nerve:
  • thoracic duct:
  • azygos vein:
  • left common carotid artery:
A
  • Brachiocephalic veins: superior mediastinum
  • thymus: anterior
  • descending aorta: posterior mediastinum
  • left current laryngeal nerve: superior mediastinum
  • thoracic duct: posterior mediastinum
  • azygos vein: posterior mediastinum
  • left common carotid artery: superior mediastinum
32
Q

what are the subdivisions of the inferior mediastinum?

A

anterior, middle and posterior mediastinum

33
Q

what and where is the carotid sheath? - which structures are in it?

A

carotid sheath: tThe carotid sheath is one of four accumulations of deep cervical fascia or fibrous connective tissue of the neck which surrounds the great vessels of the neck. inside including the carotid artery, jugular vein, vagus nerve, and sympathetic plexus. It arises in the base of the neck and terminates at the skull base

34
Q

describe phrenic nerve location / which type of nerve fibres it contains.

where are the nerve roots?

what does the phrenic nerve cause during inhalation / exhalation?

A

The phrenic nerve originates from the anterior rami of the C3 through C5 nerve roots and consists of motor, sensory, and sympathetic nerve fibers. It provides complete motor innervation to the diaphragm and sensation to the central tendon aspect of the diaphragm.

nerve roots: anterior rami of C3, C4 and C5

The motor innervation activation will cause the diaphragm to contract with inspiration, resulting in a flattened diaphragm and increased intrapleural space.

During exhalation, the diaphragm relaxes and returns to the dual dome shape. The phrenic nerve also provides touch and pain sensory innervation to the <strong>mediastinal pleura and the pericardium</strong> in addition to the intercostal nerves.

35
Q

what structures do the left and right recurrent laryngeal nerves hook under?

A

right RLN: goes under right subclavian artery then traveling upwards.

left RLN: left nerve looping under the aortic arch

36
Q

which nerve contributs the oesphageal plexus?

A

vagus nerve

37
Q

where do u find the left and right coronary artery?

A

right coronary artery: The right coronary artery emerges from the aorta into the AV groove.

left coronary artery: between pulmonary trunk and left atra

38
Q
A
39
Q

what is the crista terminalis?

where found?

A

The interior surface of the right atrium can be divided into two parts, each with a distinct embryological origin. These two parts (sinus venarum and atrium proper) are separated by a muscular ridge called the crista terminalis

(sinus venarum: smooth walls

atrium proper: rough walls)

40
Q

what are the interatrail and interventrical septums?

A

The interatrial septum is a solid muscular wall that separates the right and left atria.

interventrical septum the stout wall separating the ventricles, the lower chambers of the heart, from one another

41
Q

what is the trabeculae carnae?

what is pectinate muscle?

where each found?

A

The trabeculae carneae are rounded or irregular muscular columns which project from the inner surface of the right and left ventricle of the heart. These are different from the pectinate muscles, which are present in the atria of the heart.

The pectinate muscles (musculi pectinati) are parallel muscular ridges in the walls of the atria of the heart.

42
Q
  1. which three veins drain into the right atrium?

2 which vessels emerge from th aortic sinus?

A
  1. superior and inferior vena cava and the coronary sinus.

2.

The left posterior aortic sinus gives rise to the left coronary artery.

The anterior aortic sinus gives rise to the right coronary artery.

The right posterior aortic sinus usually gives rise to no vessels, and is often known as the non-coronary sinus.

43
Q

what are the 4 main valves of the heart?

A

tricuspid valve: located between the right atrium and the right ventricle.

pulmonary valve: located between the right ventricle and the pulmonary artery.

mitral valve: located between the left atrium and the left ventricle.

aortic valve: located between the left ventricle and the aorta.