CVR 14 Flashcards
How is the subclavian artery divided
Scalenus anterior
1st - vertebral artery
Thyrocervical trunk
internal thoracic
costocervical trunk
Main structures in the posterior mediastinum?
oesophagus
descending aorta
azygos venous system
thoracic duct
Nervous
vagus and sympathetic splanchic
what is wear and tear muosa
stratified squamous
What absorbtion mucosa
columnar
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)
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
Diaphragm attachments
crura, median acruate, medial arcuate, lower 6 cc, xiphoid
Will the vena cava opening get bigger or smaller on inspiration
bigger
Pain from diaphragm gets reffered where>
shoulder C345 motor to diaphragm but also sense to shoulder
Where does the diaphragm extend?
T2-T12
What level is the sternal angle at
T4
What is in the anterior and middle mediastinum
anterior = thymus middle = pericardial sac
Where is the superior mediastinum?
above ouis T1-T4 Bifurcation of trachea bifurcation of pulmonary trunk azygos termination ligementum ateriosum
What are the great venous vessels around the heart
internal jugular
subclavian
brachiocephalic
azygos
Where are the brachiocephalic veins?
formed behind SC jt
Where is the SVC
behind 1st CC
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
no
Where is pain referred in the diaphragm>
C4 shoulder
