Lecture 19: Mediastinum and Respiratory Diaphragm

Question 1

What is the mediastinum?

Answer 1

the space between lungs

Question 2

The superior mediastinum is separated from inferior by horizontal plane between ______ and ____

Answer 2

sternal angle and IV discs

Question 3

What are the subdivisions of the superior mediastinum?

Answer 3

retrosternal

prevertebral

Question 4

What are the subdivisions of the inferior mediastinum?

Answer 4

anterior
middle
posterior

Question 5

What is in the retrosternal superior mediastinum?

Answer 5

great vessels and branches

thymus

Question 6

What is in the prevertebral superior mediastinum?

Answer 6

trachea
esophagus
thoracic duct
sympathetic trunks
vagus nerves

Question 7

What is in the anterior inferior mediastinum?

Answer 7

thymus
fat
lymph nodes

Question 8

What is in the middle inferior mediastinum?

Answer 8

pericardium
phrenic nerves
pericardiacophrenic artery
heart and great vessels

Question 9

What is in the posterior inferior mediastinum?

Answer 9

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

Question 10

What does the pericardium do?

Answer 10

encloses heart

Question 11

What is the transverse sinus?

Answer 11

space between arterial and venous mesocardium

Question 12

What is the oblique sinus?

Answer 12

space between right and left pulmonary veins

Question 13

Where does the esophagus pass through diaphragm?

Answer 13

T10

Question 14

How does the azygous vein form?

Answer 14

union of right ascending lumbar vein and high subcostal vein

Question 15

What side is the azygous vein on?

Answer 15

right

Question 16

Where does the hemiazygous vein run?

Answer 16

left

Question 17

Where does the parasternal node receive lymph?

Answer 17

thoracic wall, upper anterior abdominal wall, diaphragm. mammary gland

Question 18

Where does the posterior intercostal nodes receive lymph?

Answer 18

thoracic wall and paravertebral regions

Question 19

Where does the diaphragmatic nodes receive lymph?

Answer 19

diaphragm, pericardium, upper surface of liver

Question 20

Where does the does the bronchiomediastinal lymph trunks receive lymph?

Answer 20

posterior mediastinal nodes
brachiocephalic nodes
tracheobronchial nodes
parasternal nodes

Question 21

What does the left thoracic duct arise from?

Answer 21

cisterna chyli

Question 22

Where does the left thoracic duct receive most of its lymph?

Answer 22

below the diaphragm, left internal jugular lymph trunk, left subclavian lymph trunk

Question 23

Where does the left thoracic duct empty?

Answer 23

left internal jugular vein

left subclavian vein

Question 24

What does the right thoracic duct drain?

Answer 24

upper right thoracic cavity, right upper extremity, right side of head and neck

Question 25

Where does the rich thoracic duct empty?

Answer 25

right internal jugular vein | right subclavian vein

Question 26

What nerve is the major parasympathetic supply to thoracic and abdominal viscera?

Answer 26

vagus nerve

Question 27

Where does the phrenic nerve arise from?

Answer 27

in neck from ventral rami of C3-5

Question 28

What is a diaphragm?

Answer 28

muscular sheet with an inferior and superior fascia

Question 29

In moderate expiration, the diaphragm reaches what?

Answer 29

level of 5th rib on right side and 5th IC space on left

Question 30

diaphragm origin sternal part

Answer 30

diploid process

Question 31

diaphragm origin costal part

Answer 31

lower 6 ribs and cartilages

Question 32

diaphragm origin lumbar part

Answer 32

lumbar vertebrae and crura right: L1-3 left: L1-2

Question 33

What are the attachments of the respiratory diaphragm?

Answer 33

ribs TV 12 distal end of sternum central tendon

Question 34

What are the functions of the diaphragm?

Answer 34

• 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

Question 35

What counteracts the action of the diaphragm?

Answer 35

floating ribs

Question 36

What pierces the diaphragm at T8?

Answer 36

inferior vena cava | accompanied by right phrenic nerve

Question 37

What pierces diaphragm at T10?

Answer 37

esophagus | vagus nerve accompanies it

Question 38

What pierces the aortic hiatus?

Answer 38

aorta | accompanied by greater splanchnic nerve

Question 39

What is the nerve supply of the central tendon?

Answer 39

phrenic nerve | C3-5