GA1 - Mediastinum Flashcards

1
Q

Superior border of mediastinum

A

place connection the cupola or the superior thoracic aperature

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2
Q

Inferior border of mediastinum

A

diaphragm or inferior thoracic aperature

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3
Q

anterior border of mediastinum

A

sternum and costal cartilages

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4
Q

posterior border of mediastinum

A

T1 to T12 vertebrae and related ribs

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5
Q

4 subdivisions of mediastinum

A

superior, anterior inferior, middle inferior, posterior inferior

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6
Q

superior mediastinum lies between

A

manubrium sterni and the upper 4 thoracic vertebrae

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7
Q

superior mediastinum is bounded below by? above by? lateral by?

A

the sternal plane, plane of the thoracic inlet, mediastinal pleurae

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8
Q

superior mediastinum contains lower ends of which small muscles?

A

sternohyoid, sternothyroid, and longus colli

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9
Q

superior mediastinum contains the remnants of?

A

thymus gland

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10
Q

superior mediastinum contains what veins?

A

internal thoracic veins, brachiocephalic veins, upper half of superior vena cava (SVC), left superior intercostal

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11
Q

superior mediastinum contains what arteries?

A

internal thoracic, aortic arch, brachiocephalic, left common carotid, subclavian

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12
Q

superior mediastinum contains what nerves?

A

R and L vagi and phrenic nerve, left recurrent laryngeal, cardiac, superficial part of the cardiac plexus

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13
Q

superior mediastinum contains what structures?

A

trachea and esophagus

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14
Q

superior mediastinum contains which duct?

A

thoracic

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15
Q

the thoracic duct is a

A

lymphatic structure in the mediastinum

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16
Q

anterior mediastinum contains which nodes and vessels

A

lymph

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17
Q

anterior mediastinum contains a small portion of

A

thymus

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18
Q

anterior mediastinum contains the mediastinal branches of the

A

internal thoracic vessels

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19
Q

anterior mediastinum contains which ligaments

A

sternopericardial

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20
Q

anterior mediastinum contains which tissue type?

A

fat

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21
Q

middle mediastinum contains the covering of the heart

A

pericardium

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22
Q

middle mediastinum contains which major organ

A

heart

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23
Q

middle mediastinum contains which aorta

A

ascending

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24
Q

middle mediastinum contains lower half of the

A

superior vena cava

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25
Q

superior vena cava receives the

A

azygous venous arch posteriorly

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26
Q

middle mediastinum contains which part of the trachea?

A

tracheal bifurcation and both main bronchi

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27
Q

middle mediastinum contains the pulmonary

A

trunk and R and L pulmonary arteries and veins

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28
Q

middle mediastinum contains the R and L ______ nerves accompanied by the _______ vessels

A

phrenic; pericardiacophrenic

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29
Q

middle mediastinum contains the deep part of the _____ plexus

A

cardiac

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30
Q

middle mediastinum contains _______ lymph nodes

A

tracheobronchial

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31
Q

posterior mediastinum contains descending

A

aorta and its branches

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32
Q

posterior mediastinum contains posterior ______ VAN

A

intercostal

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33
Q

posterior mediastinum contains which veins

A

azygos, hemiazygos, accessory hemiazygos

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34
Q

posterior mediastinum contains which trunk with what nerve?

A

sympathetic; splanchnic

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35
Q

posterior mediastinum contains which major structure

A

esophagus

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36
Q

posterior mediastinum contains which lymphatic structure?

A

thoracic duct

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37
Q

posterior mediastinum contains which nerves that wrap around esophagus also?

A

vagus

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38
Q

ascending aorta arises from the ____ and ends at ___/____

A

heart; T4/T5

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39
Q

2 parts of the aorta

A

thoracic and abdominal

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40
Q

thoracic aorta has 2 branches

A

visceral and parietal

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41
Q

visceral aorta has 4 branching arteries

A

EPBM: esophageal, pericardial, bronchial, mediastinal

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42
Q

parietal aorta has 3 branching arteries

A

SSP: subcostal, superior phrenic, posterior intercostal

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43
Q

parietal means

A

wall/somatic

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44
Q

visceral means

A

organs

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45
Q

superior vena cava is in the _____ _____ mediastinum and drains into

A

middle superior; right atrium

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46
Q

superior vena cava tributaries?

A

brachiocephalic, azygous

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47
Q

tributaries to the azygous v

A

right superior intercosal v., hemiazygos, accessory hemizygos

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48
Q

the union of the R and L brachiocephalic vv form the

A

superior vena cava

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49
Q

L 1st posterior intercostal v drains

A

directly to the L brachiocephalic v

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50
Q

L 2-4 posterior intercostal v for the

A

L superior intercostal v

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51
Q

L superior intercostal v drains into

A

L brachiocephalic v

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52
Q

L 5-8 posterior intercostal v join to form

A

the accessory hemizygos v

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53
Q

accessory hemizygos crosses at ____ to drain into the ____

A

T8; azygous

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54
Q

L 9-11 posterior intercostal v form

A

hemizygos

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55
Q

hemizygos crosses at ___ to drain into

A

T9; azygous

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56
Q

hemizygos formed by the union of

A

L subcostal v and L ascending lumbar vv

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57
Q

azygous v is formed by the union of

A

R ascending lumbar vv and R subcostal v

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58
Q

R 5-11 posterior intercostal vv drain into

A

azgous

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59
Q

R 2-4 posterior intercostal v joins to form

A

R superior intercostal v

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60
Q

R 1 intercostal v drains into

A

R brachiocephalic

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61
Q

2 branches of ascending aorta

A

L and R coronary aa

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62
Q

coronary arteries responsible for

A

blood supply to the heart

63
Q

3 branches to the arch of the aorta

A

L brachiocephalic, L common carotid, L subclavian

64
Q

mneumonic for branches of the descending aorta

A

organs perishable by masteration subsequently show incapacitation

65
Q

directly infront of the azygos to the L is the

A

descending aorta

66
Q

the esophagus lies in both the ____ and ___ mediastinum

A

posterior and superior

67
Q

the esphagus is

A

a muscular collapsible tub about 10 inches long

68
Q

the abdominal portion of the esophagus is about ____ long

A

1/2 in

69
Q

esophagus enters the stomach at its

A

right side

70
Q

abdominal portion of the esophagus is covered by ___ on its ___ and ____ side

A

peritoneum; anterior and lateral

71
Q

anterior to the esophagus is the

A

left lobe of the liver

72
Q

posterior to the esophagus is the

A

left crus of the diaphragm

73
Q

blood supply of the abdominal portion of the esophagus

A

left gastric a

74
Q

nerve supply to the esophagus

A

vagus and sympathetic n arising from T1-T4

75
Q

blood supply to the thoracic portion of the esophagus

A

esophageal a

76
Q

blood supply to the neck portion of the esophagus

A

inferior thyroid aa

77
Q

vagus and sympathetic nerves arising from T1 -T4 form together to form

A

esophageal plexus

78
Q

esophageal plexus has 3 fibers

A

GVA, preganglionic parasympathetic fibers, and postganglionic sympathetic fibers

79
Q

preganglionic parasympathetic fibers of the esophagus

A

peristaltic movement; favors digestion

80
Q

postganglionic sympathetic fibers

A

inhibits motility

81
Q

visceral organs have 2 innervations

A

sympathetic and parasympathetic: opposite effects

82
Q

T1-T4 sympathetic nerves are

A

postganglionic

83
Q

thymus gland is

A

a flattened bilobed structure

84
Q

thymus gland continues to grow until ____, but then

A

puberty; undergoes involution

85
Q

when the thymus gland involutes, it

A

atrophies and replaced with fat

86
Q

when the thymus is fresh it has

A

a pink lobulated appearance

87
Q

thymus is the site of development of

A

T lymphocytes

88
Q

thymus gland has a rich blood supply from

A

inferior thyroid and internal thoracic

89
Q

the thymus gland is an _____ organ

A

immunological

90
Q

the thymus gland is largest in _____; smaller in_____

A

childhood; adulthood

91
Q

in the removal of the thymus

A

immunodeficiency occurs

92
Q

the thymus secretes

A

thymosin

93
Q

thymosin is responsible for

A

making lymphocytes immunocompetent

94
Q

longest cranial n in the body that travels all the way down to the abdomen

A

vagus n

95
Q

right vagus nerve enters thorax _____ to the right subclavian artery and gives off the ______ ____ nerve

A

anterior; recurrent laryngeal

96
Q

left vagus nerve descends int he neck ____ to the left common carotid; gives off the left _____ ____ nerve

A

posterior; recurrent laryngeal

97
Q

the left recurrent laryngeal nerve passes underneath the ____ ____ posterior to the _____ ____

A

aortic arch; ligamentum arteriosum

98
Q

both vagi nerves breaks up into braches to form the 3 plexuses

A

pulmonary, cardiac, esophageal

99
Q

vagus nerve enters the abdomen through the

A

esophageal opening

100
Q

what is the sole motor nerve that supplies the diaphragm?

A

phrenic

101
Q

phrenic nerve supplies sensory to the central portion of the

A

diaphragm

102
Q

phrenic nerves arise from

A

ventral primary rami of C3, C4, and C5

103
Q

motor branch of the cervical plexus

A

C3, C4, C5

104
Q

phrenic nerve descends down to ____ and ____ mediastinum

A

superior; middle

105
Q

what vessels run with the phrenic nerve?

A

pericardiacophrenic

106
Q

ligamentum arteriosum is the remnant of the

A

ductus arteriosus

107
Q

ligamentum arteriosum connects

A

aortic arch with pulmonary artery

108
Q

after birth when the lungs expand the duct of the ductus arteriosum will

A

constrict and remove communication from artery and aorta

109
Q

when the ducts of the ductus arteriosum constrict, it will undergo

A

fibrosus

110
Q

Patent ductus arteriosus

A

when the ducts fail to close

111
Q

PDA causes

A

blood from aorto to go into the pulmonary artery; increase pressure in pulmonary artery –> pulmonary embolism –> fluid in alveoli –> difficulty breathing –> cyanosis

112
Q

thoracic duct is a ____ ____ vessel

A

thin walled; lymphatic

113
Q

thoracic duct has no

A

smooth muscle; flimsy

114
Q

thoracic duct returns all lymph from

A

all body below diaphragm and left half of the body above the diaphragm

115
Q

thoracic duct arises as an occasional dilation called the

A

cisterna chyli

116
Q

cisterna chyli is at the level of

A

L2

117
Q

cisterna chyli recieves the

A

R and L lumbar trunks; intestinal trunk drains into the left Lumbar trunk

118
Q

thoracic duct lies between

A

azygos and descending aorta

119
Q

during surgery, the thoracic duct can get cut leading to the

A

leaking out of chyle into the thorax (chylothorax)

120
Q

chylothorax

A

fluid in the chest

121
Q

thoracynthesis

A

need to take fluid out of the thorax with a needle; fluid will confirm chyle

122
Q

thoracic chain ganglia are regions of synapse between

A

pre and post sympathetic ganglionic neurons

123
Q

thoracic chain ganglia contain

A

cell bodies of postganglionic sympathetic neurons

124
Q

thoracic sympathetic trunk is the most _____ placed structure in the mediastinum

A

laterally

125
Q

Thoracic sympathetic trunk leaves the thorax next to the ___ ____ passing behind the ___ ___ ___

A

T12 body; medial arcuate ligament

126
Q

SP fibers destined to head and neck arise from

A

T1-T2; T3

127
Q

grey rami communicans are

A

bundles of post-gg fibers passing from each thoracic ganglion to the corresponding nerve

128
Q

SP fibers can enter the white rami and go up the sympathetic chain and synapse in the

A

cervical ganglion

129
Q

3 options for a sympathetic postganglionic fiber after synapsing in the cervical ganglion

A

connect with cervical spinal nerves vi grey rami communicans; connect with carotid arteries; go down and form cardiac n going to the heart

130
Q

thoracic splanchnic nerves

A

post ganglionic sympathetic fibers going to thoracic visceral organs T1-T4

131
Q

abdominopelvic splanchnic nerves pass through

A

paravertebral ganglia and dont synapse

132
Q

abdominopelvic splanchnic nerves are

A

pre gg sympathetic fibers

133
Q

abdominopelvic splanchnic arise from

A

T5-T12

134
Q

Abdominopelvic splanchnic pass through the diaphragm and synapse with the

A

prevertebral ganglia of the abdomen

135
Q

greater splanchnic nerves

A

T5-T9

136
Q

lesser splanchnic nerves

A

T10-T11

137
Q

least splanchnic nerves

A

T12

138
Q

cell body contains

A

nucleus and most of cytoplasn

139
Q

prevertebral ganglia lies

A

infront of abdominal aorta

140
Q

preganglionic sympathetic cell bodies in

A

lateral horn of T1-L2

141
Q

parasympathetic postganglionic bodies lie in two ganglia

A

cranial and intramural (next to or within the target organ)

142
Q

cranial ganglia: pre fibers are? post fibers are?

A

long/short

143
Q

intramural ganglia: pre fibers are? post fibers are?

A

long/short

144
Q

paravertebral ganlia: pre fibers are? post fibers are?

A

short/long

145
Q

prevertebral ganglia: pre fibers are? post fibers are?

A

medium in length/ medium in length

146
Q

abdominopelvic splanchnic nerves: pre fibers are? post fibers are?

A

medium in length/ medium length

147
Q

above T1 and below L2 there is only

A

grey rami communicans

148
Q

spinal nerves from ventral rami: T1-T11 go to? T12 goes to

A

intercostal; subcostal

149
Q

spinal nerves from dorsal rami go directly to

A

skin and deep back muscles

150
Q

typical thoracic intercostal nerves level

A

T3-T6

151
Q

thoracoabdominal intercostal nerves level

A

T7-T11

152
Q

Typical intercostal nerves have 2 branches

A

lateral cutaneous branch and an anterior cutaneous branch

153
Q

dermatomes are

A

segments of skin supplied by a single spinal nerve; imaginary strip of skin