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Anatomy Exam 3 > Lecture 19 > Flashcards

Lecture 19 Flashcards

1
Q

Mediastinum

A

Space between lungs; consists of superior mediastinum (subdivided into retrosternal and prevertebral) and inferior mediastinum (subdivided into anterior, middle, posterior)

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2
Q

Retrosternal Subdivision of Superior Mediastinum

A

Contains great vessels and branches and the thymus

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3
Q

Prevertebral Subdivision of Superior Mediastinum

A

Contains trachea, esophagus, thoracic duct, sympathetic trunks, and Vagus Nerves

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4
Q

Anterior Subdivision of Inferior Mediastinum

A

Contains thymus, fat, and lymph nodes

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5
Q

Middle Subdivision of Inferior Mediastinum

A

Contains pericardium, phrenic Nerves, pericardiacophrenic artery, and heart and great vessels

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6
Q

Posterior Subdivision of Inferior Mediastinum

A

Contains esophagus, thoracic duct, aorta and branches, vagus nerves, sympathetic trunks, and azygos system of veins

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7
Q

Thymus

A

Located behind manubrium, covered by pleura of the lungs; blood supply by anterior mediastinal arteries from internal thoracic artery and Inferior thyroid arteries from subclavian artery; venous drainage into left brachiocephalic vein; innervated by parasympathetic vagus nerves and sympathetic cardiac sympathetic plexus

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8
Q

Pericardium

A

Encloses heart, consists of arterial and venous mesocardium; also has transverse sinus, which is the space between arterial and venous mesocardium, and the oblique sinus, which is the space between right and left pulmonary veins; blood supply by pericardial and pericardiacophrenic arteries and musculophrenic arteries; innervated by CN X, phrenic nerve, sympathetic trunk

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9
Q

Parietal (Serous) Pericardium

A

Fused to fibrous pericardium

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10
Q

Fibrous Pericardium

A

Fused with central tendon of diaphragm

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11
Q

Pericardiacophrenic Ligament

A

Fused with sternum

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12
Q

Esophagus

A

Runs from base of neck to left of the midline to midline at the level of the aortic arch to left of the midline as it passes through the diaphragm; located behind the trachea, in front of vertebral column, to the right of the thoracic aorta and passes through diaphragm at T10 level; blood supply by bronchial, left gastric, left Inferior phrenic arteries and the thoracic aorta; innervated by esophageal plexus (continuation of posterior pulmonary plexus and formed by left and right vagus nerves)

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13
Q

What innervates upper third of esophagus?

A

This is voluntary muscle and is innervated by recurrent laryngeal nerve

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14
Q

What innervates the lower two-thirds of the esophagus?

A

This is involuntary muscle and is innervated by vagus sympathetic chain

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15
Q

Thoracic Aorta

A

Continuation of aortic arch, begins at lower border of T4 (stern also angle) and lies left of midline; ends at diaphragm T12 and pierces diaphragm and continues as abdominal aorta

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16
Q

Branches of Thoracic Aorta

A

Pericardial branches to posterior pericardium, two bronchial branches to left of bronchus, small superior (10%) and large Inferior (90%) esophageal branches, branch to posterior mediastinum, nine pairs of intercostal arteries, one pair subcostal arteries, and superior phrenic arteries to superior surface of diaphragm

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17
Q

Azygos Vein

A

Formed below level of diaphragm by union of right ascending lumbar vein and right subcostal vein; ascends along right side of thoracic vertebral column, arches over root of right lung and enters superior vena cava; tributaries from right intercostal veins (5-11), superior intercostal vein (drains intercostal spaces 2-4), hemiazygos vein, and accessory hemiazygos vein

18
Q

Hemiazygos Vein

A

Formed below level of diaphragm by union of left ascending lumbar vein and left subcostal vein; pierces diaphragm, ascends along left side of vertebral bodies to level of T9 and crosses vertebral body and empties into azygos vein

19
Q

Accessory Hemiazygos Vein

A

Runs left side of upper thoracic vertebral bodies, receives blood from superior intercostal vein and from left intercostal veins 4-8, crosses vertebral body and empties into azygos vein

20
Q

Parasternal Nodes

A

Lie behind sternum along course of internal thoracic artery, receives lymph from thoracic wall, upper anterior abdominal wall, and diaphragm; also receives significant amount of lymph from mammary gland and dumps into parasternal lymph channel

21
Q

Posterior Intercostal Nodes

A

Lie behind posterior intercostal space between heads of ribs, receives lymph from thoracic wall and paravertebral regions; drains into thoracic duct from left and lower right and drains into right lymphatic duct from upper right

22
Q

Diaphragmatic Nodes

A

Lie on upper surface of diaphragm, receives lymph from diaphragm, pericardium, and upper surface of liver; drains to parasternal and posterior mediastinal nodes

23
Q

Posterior Mediastinal Nodes

A

Lie along esophagus and descending thoracic aorta

24
Q

Brachiocephalic Nodes

A

Lie along brachiocephalic veins

25
Q

Lymph Trunks

A

Bronchiomediastinal lymph trunks: receive lymph from posterior mediastinal nodes, brachiocephalic nodes, tracheobronchial nodes, parasternal nodes

26
Q

Left Thoracic Duct

A

Arises from cisterns chili at union of right and left lumbar trunks; begins on the front of vertebral body T12 or L1, runs up through the thorax along the front of the vertebral column; at first it lies to the right of midline, but moved over to the left side when it reaches level of T5; receives most of lymph from body below diaphragm, drains left side of thoracic cavity and part of right, receives lymph from left internal jugular lymph trunk, left subclavian lymph trunk, and empties into venous system at junction of left internal jugular vein and left subclavian vein

27
Q

Right Thoracic Duct

A

Drains upper right thoracic cavity, igniting upper extremity, and right side of head and neck; empties into venous system at junction of right jugular vein and right subclavian vein

28
Q

50 Tracheobronchial Lymph Nodes

A

Some of the largest lymph nodes in the body; include paratracheal, superior tracheobronchial, inferior tracheobronchial, bronchopulmonary, and pulmonary

29
Q

Thoracic Sympathetic Chain

A

Lies against neck of ribs and costovertebral junctions; 12 Thoracic Ganglia pairs: first one often fused with inferior cervical ganglia (referred to as stellate ganglion collectively); cervical ganglia divided into superior, middle, and inferior

30
Q

Which spinal cord levels are responsible for the preganglionic sympathetic supply to the thoracic viscera?

A

T1-5

31
Q

Where do the postganglionics of the thoracic cavity come from?

A

Superior, middle, and inferior cervical ganglia; T1-5 are paravertebral ganglia; exit the chain as direct fibers and travel downwards to enter the thorax as cardiopulmonary splanchnic nerves

32
Q

Splanchnic Nerves

A

Composed of pregnaglionic fibers and visceral sensory fibers and supply abdominal viscera; synapse in prevertebral ganglia; greater is T5-9 and synapses in celiac ganglion; lesser is T10-11 and synapses in the superior mesenteric ganglion; least is T12 and synapses in the aorticorenal ganglion

33
Q

Vagus Nerve

A

CN X; major parasympathetic supply to thoracic and abdominal viscera; runs parallel to esophagus (innervates esophagus), passes posterior to root of lung on each side, pierces diaphragm with esophagus and becomes gastric nerve, supplies viscera in thoracic cavity; right vagus nerve becomes posterior vagus trunk and left vagus nerve becomes anterior vagus trunk

34
Q

Branches of Vagi

A

Cardiac branches to cardiac plexus, pulmonary branches to pulmonary plexus, esophageal branches to esophageal plexus, left recurrent laryngeal nerve from left vagus and right recurrent laryngeal from right vagus

35
Q

Phrenic Nerve

A

Arises in neck from ventral rami of C3-5 with C4 being major contributor; passes anterior to pulmonary root on each side (only nerve to do so); sole motor innervation to diaphragm; sensory fibers to pericardium, mediastinal pleura, and pleura and peritoneal coverings of diaphragm; pain via phrenic nerves usually referred to base of neck and tip of shoulder; accompanied by pericardiacophrenic arteries (branches of internal thoracic arteries)

36
Q

Respiratory Diaphragm

A

Muscular sheet with an inferior and a superior fascia; superior fascia = parietal thoracic fascia and the inferior fascia = transversalis fascia; seperates thorax and abdomen and in moderate expiration, reaches level of 5th rib on right side and 5th IC space on left

37
Q

Origins and Attachments of Respiratory Diaphragm

A

Origins:
Sternal = Xiphoid Process
Costal = Lower 6 ribs and cartilages
Lumbar = Lumbar vertebrae and crura

Attachments:
Ribs, TV12, distal end of sternum, central tendon (Y shaped attached to lumbar vertebrae via crura, pulls radiating fibers of the diaphragm together to form a dome-shaped muscle; right side is largest part, left is smallest part)

38
Q

Functions of Respiratory Diaphragm

A

Contraction flattens the muscle and increases the thoracic volume, creates a negative pressure in the thoracic cavity and a positive pressure in the abdominal cavity; floating ribs help to counteract the action of the diaphragm; if the abdominal cavity were surrounded by a bony cage, it would NOT be able to compensate for the increase in pressure

39
Q

Openings in the Diaphragm and Structures that run through them

A

T8 Caval Foramen: inferior vena cava, accompanied by right phrenic nerve

T10 Esophageal Hiatus: esophagus, accompanied by vagus nerve

T12 Aortic Hiatus: aorta, accompanied by greater splanchnic nerve

40
Q

Nerve and Arterial Supply to Diaphragm

A 
Nerve: 
Phrenic nerve (C3-5)

Arterial:
Superior Aspect - pericardiacophrenic artery from internal thoracic, musculophrenic artery from internal thoracic, and superior phrenic artery from aorta

Inferior Aspect - inferior phrenic artery from aorta

41
Q

Crura of Diaphragm

A

Forms muscular pillars, originate from lumbar vertebrae; right from L3, swings left and forms a weak sphincter around the esophagus; left from L2

42
Q

Arcuate of Diaphragm

A

Median, around aortic opening, bridges proximal ends of crura; medial (lumbocostal arches) from deep fascia of psoas major muscle from transverse process to body of L1; lateral (lumbocostal arches) from deep fascia of quadratus lumborum muscle from transverse processes of L1 to rib 12

Anatomy Exam 3 (10 decks)

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