CVR 14 Flashcards by Keith McElligott

How is the subclavian artery divided

Scalenus anterior

1st - vertebral artery
Thyrocervical trunk
internal thoracic
costocervical trunk

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Main structures in the posterior mediastinum?

oesophagus
descending aorta
azygos venous system
thoracic duct

Nervous
vagus and sympathetic splanchic

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what is wear and tear muosa

stratified squamous

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What absorbtion mucosa

columnar

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What do you know about the oseophagus?

located: anterior to thoracic vert, thoracic duct, azygos, descending aorta

right of airtic arch and desc aorta

left of azygos vein

Constrictions are: upper oseph sphincter 15 cm
aortic arch left main bronch
25cm
diaphragm and cardia - 40 cm

nerve - vagus symp and plexus

lymph - post mediastinal
supraclavicualr nodes

arterio up 1/3 inferior thyroid
middle 1/3 thoracic aorta
lower 1/3 left gastric

venous up brachiocephalic
azygos
portal (varices)

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Why is thoracic aneurysm dificult to treat?

Part of it is mobile and other isnt so there is a risk of shearing motion from rapid deacceleration

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Diaphragm attachments

crura, median acruate, medial arcuate, lower 6 cc, xiphoid

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Will the vena cava opening get bigger or smaller on inspiration

bigger

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Pain from diaphragm gets reffered where>

shoulder C345 motor to diaphragm but also sense to shoulder

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Where does the diaphragm extend?

T2-T12

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What level is the sternal angle at

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What is in the anterior and middle mediastinum

anterior = thymus
middle = pericardial sac

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Where is the superior mediastinum?

above ouis T1-T4
Bifurcation of trachea
bifurcation of pulmonary trunk
azygos termination
ligementum ateriosum

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What are the great venous vessels around the heart

internal jugular
subclavian
brachiocephalic
azygos

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Where are the brachiocephalic veins?

formed behind SC jt

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Where is the SVC

behind 1st CC

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Where does azygos join SVC

behind 2nd CC

Where does SVC meet RA

3rd CC

What are the branches at teh arch of the aorta

brachiocephalic, left CC, left subclavian

How is the subclavian divided?

Divided by scalenus anterior

1st - vertebral, thyrocervical, internal thoracic, costocervical trunk

Major structures of the posterior mediastinum

oesophagus, descending aorta, azygos venous, thoracic

nerves - vagus and symmpathetic splanchic

Where does the oesophagus begin and where does it peirce the diaphragm

C6 Cricoid cartilage and passes at T10

Layers of oesophagus>

outer longitudinal inner circular top 1/3 striated and lower 2/3 smooth

What is behind, left and right of oesohpagus?

behind - thoracic vert, thoracic duct, azygos vein, descending aorta

left - aortic arch and descending aorta

right - azygos vein

Anterior - trachea, left bronchus left atrium

Where are the constrictions of the oesophagus

from teeth 15 cm upper sphincter 25 - aortic arch left main bronchus 40 cm - diaphragm and cardia

nerve supply and lymph of oesophagus?

vagus and symp plexus and cells lymph posterior medistinal and suprclavicular

Blood supply of eosophagus>

upper 3rd inferior thyroid middle 3rd thoracic lower 3rd left gastric vein up brachiocephalic azygos portal - varices

Signs of eosophageal carcinoma

dysphagia, wieghtloss, palpable supraclavicular lymph, | metastese to liver and brain

Name the branches of descending aorta?

Visceral - pericardial bronchial oesophageeal Parietal - mediastinal, intercostal 12th, superior phrenic 1-2 intercostals

What is marfans syndrome?

Marfan syndrome (MFS) is a genetic disorder of the connective tissue. The degree to which people are affected varies. People with Marfan tend to be tall, and thin, with long arms, legs, fingers, and toes. They also typically have flexible joints and scoliosis.

What is the thoracic duct?

The thoracic duct is the largest lymphatic vessel in the human body. Around 75% of the lymph from the entire body (aside from the right upper limb, right breast, right lung and right side of the head and neck) passes through the thoracic duct. starts on right side ascending then moves behind esophagus at T5. Drains everything below diaphragm and left side above into brachiocephalic

What nerve can cause hoarsness around the heart?

Many congenital heart defects such as a patent ductus arteriosus can irritate the left recurrent laryngeal nerve, leading to dysphonia (hoarse voice).= vagus nerve

What are the attachments of the diaphragm?

crura, median acuate ligament, medial arcuate, lower 6 CC, xiphoid

Where are the major openings in the diaphragm?

T8 - IVC, right phrenic nerve T10 - oesophagus, vagi T12 - aorta thoracic duct, azygos vein

What passes through the crura?

splanchic nerves

What passes through the medial arcuate ligaments

sympathetic trunks

Describe teh phrenic nerve

C345

Where do the superior thoracic arteries arise from

thoracic aorta

What happens to the IVC on inspiration?

widens encouraging venous return

Is the aorta affected by respiration

Where is pain referred in the diaphragm>

C4 shoulder