Duffy lecture 7 Flashcards
What happens @ angle of Louis/T4?
- Bifurcation of trachea 2. Bifurcation of pulmonary trunk 3. Azygos termination 4. Ligamentum arteriosum
Brachiocephalic veins - where are they formed, where do they unite?
Formed behind SC joint, unite behind 1st CC - S VC
Where does the SVC enter the RA?
Behind the 3rd CC
Where does the azygos vein enter the SVC?
@ the 2nd CC
Where does the trachea originate?
From cricoid cartilage - C6
What is the structure of the trachea
Cartilages in wall - not complete rings Ciliated columnar epithelium
What is the blood supply of the trachea?
Inferior thyroid & bronchial arteries
Where is the referred pain of the phrenic nerve
from diaphragm to shoulder tip
What is the branch of the vagus nerve
reccurent laryngeal - Left around ligamentum arteriosum - Right around subclavian artery
What do the recurrent laryngeal nerves supply
Trachea and upper oesophagus
Where does the posterior mediastinum extend from?
T5-T12
Where does the oesophagus extend from & how long is it
C6 - Cardia of stomach 25 cm
What are the 3 constrictions of the oesophagus
- cricopharyngeus - 15cm 2. aortic arch/left main bronchus - 25cm 3. diaphragm - 38-40cm Possible 4th constriction with enlarged RA
above the diaphragm, what is the oesophagus stuck to
aorta
I Am Lost
What is the blood supply to the oesophagus
Upper 1/3 - inferior thyroid
Middle 1/3 - aortic branches
Lower 1/3 - left gastric
what is the venous drainage of the oesophagus
Upper 1/3 - brachiocephalic Middle 1/3 - azygos Lower 1/3 - left gastric
What is the nerve supply of the oesophagus
Vagus - parasympathetic Sympathetic trunks
Where is the referred pain of the vagus nerve
Neck Arm Chest wall Similar to cardiac pain
What is the lymph drainage of the oesophagus
Deep cervical nodes
Tracheobronchial
Coeliac => why oesophageal cancer spreads
What is the path of the thoracic duct
passes up from cysterna chyli on the right passes behind oesophagus @ T4-T5 then goes to left subclavian/internal jugular angle Right side drains by duct to right BCV {has valves}
What does the thoracic duct drain
Right arm Right head right neck
What veins form the azygos vein
Right subcostal and ascending lumbar veins
Path of azygos vein
Through diaphragm at T12
Loops over right main bronchus to SVC - hemiazygos is tributary @ T8, 9
Venous drainage of thorax
Mediastinal view from the right
Mediastinal view from the left
Nerves descending down vertebrae
