Duffy lecture 7

Question 1

What happens @ angle of Louis/T4?

Answer 1

1. Bifurcation of trachea 2. Bifurcation of pulmonary trunk 3. Azygos termination 4. Ligamentum arteriosum

Question 2

Brachiocephalic veins - where are they formed, where do they unite?

Answer 2

Formed behind SC joint, unite behind 1st CC - S VC

Question 3

Where does the SVC enter the RA?

Answer 3

Behind the 3rd CC

Question 4

Where does the azygos vein enter the SVC?

Answer 4

@ the 2nd CC

Question 5

Where does the trachea originate?

Answer 5

From cricoid cartilage - C6

Question 6

What is the structure of the trachea

Answer 6

Cartilages in wall - not complete rings Ciliated columnar epithelium

Question 7

What is the blood supply of the trachea?

Answer 7

Inferior thyroid & bronchial arteries

Question 8

Where is the referred pain of the phrenic nerve

Answer 8

from diaphragm to shoulder tip

Question 9

What is the branch of the vagus nerve

Answer 9

reccurent laryngeal - Left around ligamentum arteriosum - Right around subclavian artery

Question 10

What do the recurrent laryngeal nerves supply

Answer 10

Trachea and upper oesophagus

Question 11

Where does the posterior mediastinum extend from?

Answer 11

T5-T12

Question 12

Where does the oesophagus extend from & how long is it

Answer 12

C6 - Cardia of stomach 25 cm

Question 13

What are the 3 constrictions of the oesophagus

Answer 13

1. cricopharyngeus - 15cm 2. aortic arch/left main bronchus - 25cm 3. diaphragm - 38-40cm Possible 4th constriction with enlarged RA

Question 14

above the diaphragm, what is the oesophagus stuck to

Answer 14

aorta

Question 15

I Am Lost

What is the blood supply to the oesophagus

Answer 15

Upper 1/3 - inferior thyroid

Middle 1/3 - aortic branches

Lower 1/3 - left gastric

Question 16

what is the venous drainage of the oesophagus

Answer 16

Upper 1/3 - brachiocephalic Middle 1/3 - azygos Lower 1/3 - left gastric

Question 17

What is the nerve supply of the oesophagus

Answer 17

Vagus - parasympathetic Sympathetic trunks

Question 18

Where is the referred pain of the vagus nerve

Answer 18

Neck Arm Chest wall Similar to cardiac pain

Question 19

What is the lymph drainage of the oesophagus

Answer 19

Deep cervical nodes

Tracheobronchial

Coeliac => why oesophageal cancer spreads

Question 20

What is the path of the thoracic duct

Answer 20

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}

Question 21

What does the thoracic duct drain

Answer 21

Right arm Right head right neck

Question 22

What veins form the azygos vein

Answer 22

Right subcostal and ascending lumbar veins

Question 23

Path of azygos vein

Answer 23

Through diaphragm at T12

Loops over right main bronchus to SVC - hemiazygos is tributary @ T8, 9

Question 24

Venous drainage of thorax

Answer 24

Question 25

Mediastinal view from the right

Answer 25

Question 26

Mediastinal view from the left

Answer 26

Question 27

Nerves descending down vertebrae

Answer 27