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Cardio Pulm > Lecture 15 - Superior and Posterior Mediastinum > Flashcards

Lecture 15 - Superior and Posterior Mediastinum Flashcards

1
Q

What separates the the post/ant mediastinum from the superior mediastinum

A

The bottom of the manubrium

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2
Q

What distinguishes the ant/post mediastinum and inferior

A

Top of the xiphoid process

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3
Q

What spinal segments are associated with the posterior mediastinum

A

T5-12

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4
Q

Where is the jugular notch

A

T2 in men and T3 in women

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5
Q

What joins to form the brachiocephalic vein

A

Subclavian and internal jugular

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6
Q

At what level is the trachea bifurcation and the beginning of the aortic arch

A

T4

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7
Q

Where do the phrenic nerves run in relation to the lung

A

Anterior

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8
Q

Where does the vagus nerve run

A

Posterior

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9
Q

What does the left recurrent laryngeal nerve go

A

Hooked around the ligamentum arteriosum

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10
Q

What nerves are involved in MI

A

Cardiac pain via left sympathetic nn and BP and O2 sensors via vagus n

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11
Q

What are the branches supposed to be off of the aortic arch

A
  1. Brachiocephalic trunk branches into R common carotid and R subclavian
  2. L common carotid
  3. L subclavian
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12
Q

What do the brochial AA supply

A

They go into the hilum of the lungs and supply primary, secondary, and tertiary brochioles

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13
Q

What do superior phrenic A supply

A

Diaphragm

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14
Q

What drains the R posterior thorax

A

Azygos v

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15
Q

Where is the hemiazygos v

A

Below T9 on the left side where it crosses behind the esophagus and dumps into azygos v

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16
Q

What are the branches of the internal thoracic A

A

Pericardiacophrenic A
Superior epigastric A (terminal)
Musculophrenic A (terminal)

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17
Q

What does the thoracic aorta give rises to

A

Superior phrenic AA

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18
Q

What are the 3 parts of the esophagus

A

Cervical (C6-T1)
Thoracic (T1-diaphragm hiatus)
Abdominal

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19
Q

What does the esophagus pierce

A

Left posterior diaphragm

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20
Q

What are the common constriction sites for the esophagus

A

Cricopharyngeus muscle in cervical region (C6)
Aortic arch (T4)
Left bronchus
Diaphragm (T10)

21
Q

Around the esophagus what nerve travels laterally? Where does it end up

A

Vagus N.

The L Vagus goes anterior
R Vagus goes posterior

22
Q

At what levels are the greater splanchnic NN

A

T5-9 presynaptic sympathetic fibers

Pass anteriorly through the diaphragm to relay in celiac ganglion

23
Q

What level are the lesser splanchnic nn

A

T10-11

24
Q

Where are the least splanchnic nn

A

T12

25
Q

What are thoracic splanchnic nn

A

Sympathetic presynaptic ganglion

26
Q

What are the gray communicans

A

Unmyelinated neurons

27
Q

What are white rami

A

Myelinated neurons

28
Q

Where does the right thoracic duct dump into

A

Right subclavian v

29
Q

Where does the thoracic duct dump into

A

L subclavian V

30
Q

Where does the thoracic duct run

A

Between azygos v and descending aorta

31
Q

Where does the thoracic duct terminate

A

Near the junction of the internal jugular v and subclavian v

32
Q

What can impinge on the vagus n

A

Mediastinal lymph nodes (lung cancer)

33
Q

Impinging on the left recurrent laryngeal n can cause

A

Hoarseness which can disrupt speech

34
Q

What keeps the ductus arteriosus open during development

A

Prostaglandins

35
Q

What normally causes the ductus arteriosus to close

A

Changes in o2 tension and blood flow decrease prostaglandin levels which cause SM to contract around 10-15H

36
Q

What are the consequences of PDA

A

LV hypertrophy with pulmonary congestion and congestive heart failure

37
Q

What causes an increased risk of PDA

A

Maternal rubella infection

38
Q

Where do we see more coarctation

A

Turner’s syndrome

39
Q

What is an aberrant origin of the right subclavian

A

Doesn’t come off brachiocephalic trunk instead comes off on the left most position and comes behind the esophagus

40
Q

What can occur with the R aortic arch

A

It can persist after development causing a double aortic arch

41
Q

Where are interrupted aortic arches more common

A

DiGeorge Syndrome

42
Q

What is a disrupted aortic arch

A

The left and right aortic arches degenerate so the L and R trunks are separate

43
Q

Where do the common carotid come from

A

The third aortic arch

44
Q

Where does the mature aortic arch come from

A

L 4th aortic arch

45
Q

Where does the left subclavian come from

A

7th intersegmental aortic arch

46
Q

What does the left recurrent laryngeal n get hooked to

A

Ligamentum arteriosum

47
Q

The R recurrent laryngeal gets hooked to the

A

R subclavian A

48
Q

Is preductal coarction or postductal worse?

A

Preductal, b/c postductal can still provide blood via collateral system through the L subclavian A which then connects to the internal thoracic A and intercostal A to the lower limb

49
Q

What can an aberrant R subclavian cause

A

Dysphagia since it wraps around the esophagus posteriorly

Cardio Pulm (22 decks)

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