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Medicine MD3001 cardiovascular system > Anterior and Superior Mediastinum > Flashcards

Anterior and Superior Mediastinum Flashcards

1
Q

What are the boundaries of the Anterior Mediastinum?

A

between the sternum and the pericardium

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2
Q

What are the boundaries of the Superior mediastinum?

A
  • between the thoracic inlet and the sternal angle at level T4/5
  • posterior to the manubrium of the sternum
  • anterior to T1- T4
  • oblique from manubrium upwards to T1
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3
Q

Which structure lies in the anterior mediastinum?

A

thymus

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4
Q

Where is the thymus situated?

A

from the jugular notch to the 4th costal cartilage

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5
Q

What is its structure and function?

A
  • bi-lobed

- T lymphocytes and recognition of self

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6
Q

What are the anatomical relations of the thymus?

A
  • SVC and Aorta
  • L+R Brachiocephalic veins
  • pleura, phrenic nerves, trachea
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7
Q

What is the blood supply and venous drainage of the thymus?

A
  • internal thoracic and inferior thyroid arteries

- left brachiocephalic vein

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8
Q

What are structures on the right of the mediastinum associated to?

A

veins and the right atrium of the heart

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9
Q

Which nerve runs with the trachea in the R Superior mediastinum?

A

R vagus nerve

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10
Q

What structure does the Right phrenic nerve run with in the Right superior mediastinum?

A

SVC

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11
Q

Which nerve runs with the aortic arch?

A

left vagus nerve

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12
Q

Which structure is the left phrenic nerve associated in the left superior mediastinum?

A

left ventricle of heart

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13
Q

What are the 3 planes of the superior mediastinum from most anterior to posterior?

A
  • venous
  • arterial
  • trachea and oesophagus
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14
Q

What does the SVC divide into superiorly?

A

Left and right brachiocephalic veins

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15
Q

what are the branches of the L+R BCVs and which is medial?

A
  • L+R internal Jugular vein, medially,

- L+R subclavian veins, laterally

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16
Q

What is the anatomical position of the bifurcation of the SVC to the L+R BCVs?

A

posterior to the 1st right costal cartilage

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17
Q

Where, anatomically, does the arch of the Azygous vein join the SVC?

A

posterior to the 2nd right costal cartilage

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18
Q

Where anatomically does the SVC enter the right atrium?

A

posterior to the 3rd right costal cartilage

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19
Q

Where does the azygous vein drain?

A

posterior chest wall

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20
Q

Where does the subclavian vein drain?

A

the upper limb

21
Q

what are the internal jugular veins responsible for draining?

A

head and neck

22
Q

Which veins drain into the Left BCV?

A
  • veins from anterior chest wall

- internal thoracic arteries

23
Q

Which surgical procedure are thyroid veins at risk and why?

A
  • drain into the LBCV, mainly in children they protrude above manubrium
  • hence are at risk during tracheotomy
24
Q

How are the vagus nerves related to the BCVs?

A

R+L vagus nerves are medial to the R+L BCVs

25
Q

How are the R+L phrenic nerves related to the BCVs?

A

lateral to the R+L BCVs

26
Q

What are the 3 branches of the aortic arch from right to left?

A
  • brachiocephalic trunk (BCT)
  • left common carotid artery
  • left subclavian artery
27
Q

what level is the arch situated at?

A

T4/5

28
Q

Where anatomically does the BCT divide and what structures does it give?

A
  • posterior to right sternoclavicular joint

- R subclavian and R common carotid

29
Q

where is left subclavian vein anatomically situated?

A

posterior and L of the trachea

30
Q

Which vessels do the R and L vagus nerves relate to?

A
  • R vagus nerve is anterior to the R subclavian artery

- L vagus nerve is lateral to the L common carotid artery

31
Q

Which 2 nerves relate to the arch of the aorta and how?

A

L vagus nerve and L phrenic nerve lateral to the arch

32
Q

What level does the Trachea start from and extend to?

A
  • starts at C6

- Carina (bifurcation to L+R main bronchi) at T4/5

33
Q

Which muscle alters tracheal diameter? Where is it located?

A
  • trachealis posterior

- posterior between the ends of the C shaped cartilage rings

34
Q

How is it associated with the oesophagus? which nerves associated with the trachea and the oesophagus?

A

trachea is anterior to the oesophagus and the left recurrent laryngeal nerve in-between

35
Q

How does the right main bronchus differ from the left?

A
  • wider
  • shorter
  • more vertical than the left
36
Q

What alters tracheal diameter at rest?

A

smooth muscle contraction

37
Q

What is the function of the oesophagus?

A

transport of food and fluid through the thorax and diaphragm into the stomach

38
Q

What is the anatomical position of the oesophagus?

A
  • starts at C6
  • passes immediately posterior to trachea and anterior to vertebral column
  • aortic arch is anterior on the left
39
Q

What is the function of the thoracic duct? What is it a continuation of?

A
  • lymphatic efferents from the rest of the body empty into the thoracic duct
  • cisterna chyli
40
Q

Which structures does it lie between? What level does it cross to the left side of the body?

A
  • thoracic (descending) aorta and azygous vein

- T4/5

41
Q

Which vein does the thoracic duct drain into?

A

the left brachiocephalic vein at the junction of the L IJV and LScV

42
Q

Which nodes do the nodes of the lung and the lung hilum drain into? Where are these nodes located

A
  • mediastinal nodes

- clustered around trachea and oesophagus

43
Q

Which nodes lie superior and inferior to the tracheal bifurcation?

A

superior and inferior tracheobronchial nodes

44
Q

Which vessels do the anterior nodes lie around?

A

around the brachiocephalic veins

45
Q

Which of 2 structures do all nodes drain into?

A
  • thoracic duct on the right

- communicate with deep cervical nodes

46
Q

how are lymph nodes clinically relevant?

A

may be involved in the spread of tumour

47
Q

What structure in the superior mediastinum can lung tumours affect?

A

the larynx causing a hoarse voice

48
Q

Which nodes can become palpable with a lung tumour?

A

lymph nodes in neck

Medicine MD3001 cardiovascular system (44 decks)

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