Final Gross - The Superior and Posterior Mediastinum Flashcards
This is the median space between 2 pleural sacs
mediastinum
What are the boarders of the mediastinum
extends from thoracic inlet to diaphragm
sternum to 12th thoracic vertebrae
This is located most anterior in the superior mediastinum
thymus gland
What blood vessels are found in the superior midiastinum
SVC right and left brachiocephalic vein arch of the aorta brachiocephalic trunk left common carotid artery left subclavian artery
What nerves are found in the superior mediastinum
right and left vagus
right and left phrenic
left recurrent laryngeal
What structures are found in the superior mediastinum
trachea
esophagus
thoracic duct
This structure is prominent and active during childhood and prior to puberty, and is functionally inactive and atrophies in adults; may be a fatty mass
thymus
This vein converges at right margin of the manubrium becoming the SVC
brachiocephalic
The left brachiocephalic crosses the trachea anterior or posterior?
anterior; and it crosses all major vessels too
What vertebrae level is the aortic arch
T4-T5
What structures does the aorta arch over
left pulmonary artery
left main bronchus
What great arteries does the aorta give rise to
brachiocephalic trunk
left common carotid
left subclavian
This enters the thorax between subclavian vein and artery descending posterior to the root of the lung
vagus nerve
What type of innervation does vagus supply
parasympathetic innervation to thorax (and abdomen)
This enters the thorax between the subclavian artery and vein descending anterior to the root of the lung
phrenic nerve
What type of innervation does phrenic supply
somatic innervation to the diaphragm
At what vertebral level does the trachea bifurcate at
inferior limit of the superior mediastinum
T4/T5
What is the bifurcation point of the trachea called and what is found there
carina
numerous lymph nodes
Where do foreign bodies usually aspirate into and why
right main bronchus
it is shorter and wider than the left main bronchus
right is more vertically orientated
carina is usually positioned more left of midline
This pierces the diaphragm at T10
esophagus
That stomach may herniate through what
the esophageal hiatus = hiatal hernia
A type I hiatal hernia is also known as what
sliding hiatal hernia
A type II hiatal hernia is also known as what
paraesophageal hernia
In this hiatal hernia the stomach slides freely into the thorax, is the most common and is asymptomatic
type 1; sliding
In this hiatal hernia it invoves the fundus and often fixed in position risking gastric blood supply
type II; paraesophageal
What structures are found in the posterior mediastinum
esophagus
esophageal plexus
thoracic duct
What vessels are found in the posterior mediastinum
azygos system of veins
descending aorta
What nerves are found in the posterior mediastinum
thoracic splanchnic nerves
greater, lesser, and least
What makes up the esophageal plexus
left and right vagus nerves; forming vagal trunks, due to gut rotation during development
Which vagus nerve makes up the anterior vagal trunk
left vagus
Which vagus nerve makes up the posterior vagal trunk
right vagus
This provides venous drainage for the thorax
azygos system of veins
This drains the intercostal veins from the right side of the thorax
azygos vein
This drains the left thorax
hemiazygous
accessory hemiazygous
What does the hemiazygous and accessory hemiazygous drain into
azygous vein
roughy at T8/T9, but variations are common
The azygous veins crosses what to drain into SVC
over right superior bronchus
This lies just left of the esophagus and gives rise to posterior intercostal arteries supplying thorax
descending aorta
The descending aorta gives off branches to supply what
trachea
bronchi
esophagus
This lies posterior to esophagus and anterior to vertebral bodies between the azygoes and descending aorta
thoracic duct
Where does the thoracic duct pass through the diaphragm
with descending aorta
Where does the thoracic duct drain lymph from
the body beneath the diaphragm and left upper body
Where does the thoracic duct drain lymph into
venous angle between left subclavian and left IJV
This is the accumulation of lymph in the pleural cavity
chylothorax
What is chylothroax a result from
torn or leaking thoracic duct often from lymphoma or trauma during thoracic surgery
Where are the thoracic splanchnic nerve derived from
sympathetic chain ganglia located along lateral aspect of vertebral bodies
What do the thoracic splanchinc nerves innervate
the abdomen;
greater lesser and least
Where do the thoracic autonomic (symp and psymp) nerve originate from
sympathetic; T1-T5
parasympathetic; CN X
What are the thoracic autonomic plexuses
cardiac
pulmonary
esophageal
