Lecture 5 - The Mediastinum Flashcards

1
Q

What are the 4 main regions of the mediastinum?

A

Superior and Inferior (anterior, middle, posterior)

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2
Q

What is the base of the superior mediastinum but the top border of the inferior mediastinum?

A

the sternal angle

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3
Q

What is the superior and inferior border of the mediastinum?

A

superior: rib 1 / superior thoracic aperture
inferior: diaphragm

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4
Q

What is the superior boundary of the mediastinum?

A

the superior thoracic aperture

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5
Q

What is the inferior boundary of the superior mediastinum?

A

the sternal angle

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6
Q

What is the lateral boundary of the mediastinum?

A

mediastinal surfaces of L+R lungs

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7
Q

What is the anterior boundary of the mediastinum?

A

manubrium

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8
Q

What is the posterior boundary of the superior mediastinum?

A

T1-T4 vertebrae

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9
Q

What are the organs found in the superior mediastinum?

A

esophagus, trachea and thymus

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10
Q

What are the vessels found in the superior mediastinum?

A

aortic arch + 3 branches
brachiocephalic veins (L+R)
SVC
arch of azygos
pericardiacophrenic vessels
thoracic duct

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11
Q

What are the nerves found in the superior mediastinum?

A

vagus nerves (L+R), left recurrent laryngeal nerve, phrenic nerves (L+R), sympathetic chains, & cardiac and pulmonary plexes

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12
Q

What do vagus nerves carry?

A

parasympathetic innervation
to many visceral structures

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13
Q

How do vagus nerves enter the thoracic cavity?

A

via superior thoracic aperture

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14
Q

What do some branches of the vagus nerve contribute to?

A

the cardiac plexus and pulmonary plexes

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15
Q

What does each vagus nerve give off?

A

a recurrent laryngeal branch

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16
Q

Which recurrent laryngeal branch is in the superior mediastinum?

A

the left one

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17
Q

What do recurrent laryngeal branches do?

A

innervate numerous neck structures

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18
Q

Where does the left recurrent laryngeal nerve pass?

A

posterior to the ligamentum arteriosum

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19
Q

What branch does the left recurrent laryngeal nerve come off of?

A

the right vagus nerve

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20
Q

What branch does the right recurrent laryngeal nerve come off of?

A

the left vagus nerve

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21
Q

Where does the left recurrent laryngeal nerve pass?

A

around the aortic arch

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22
Q

Where does the right recurrent laryngeal nerve pass?

A

around the left subclavian artery in the neck

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23
Q

What is the superior boundary of the anterior mediastinum?

A

sternal angle

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24
Q

What is the inferior boundary of the anterior mediastinum?

A

diaphragm

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25
Q

What is the lateral boundary of the anterior mediastinum?

A

mediastinal surfaces of the L+R lungs

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26
Q

What is the anterior boundary of the anterior mediastinum?

A

body of sternum

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27
Q

What is the posterior boundary of the anterior mediastinum?

A

pericardial sac

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28
Q

What are the organs found in the anterior mediastinum?

A

thymus (+ lymph nodes, adipose, loose connective tissue)

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29
Q

What is the anterior mediastinum primarily occupied by?

A

the thymus gland

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30
Q

What is the function of the thymus gland?

A

differentiation of T cells

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31
Q

Why is the thymus larger in early development?

A

because it is involved with immune system development

32
Q

What does the thymus degenerate and become into in adults?

A

fibro-fatty tissue

33
Q

What is the superior boundary of the middle mediastinum?

A

sternal angle

34
Q

What is the inferior boundary of the middle mediastinum?

A

diaphragm

35
Q

What is the lateral boundary of the middle mediastinum?

A

mediastinal surfaces of L+R lungs

36
Q

What is the anterior boundary of the middle mediastinum?

A

pericardial sac

37
Q

What is the posterior boundary of the middle mediastinum?

A

pericardial sac

38
Q

What are the organs found in the middle mediastinum?

A

heart

39
Q

What are the nerves found in the middle mediastinum?

A

phrenic nerves and cardiac+pulmonary plexes

40
Q

What are the vessels found in the middle mediastinum?

A

coronary arteries, cardiac veins, pericardiacophrenic vessels

41
Q

What are the respiratory structures found in the middle mediastinum?

A

tracheal bifurcation and primary bronchi

42
Q

What are the roots of great vessels found in the middle mediastinum?

A

aorta, pulmonary trunk, pulmonary arteries, pulmonary veins, superior vena cava, & inferior vena cava

43
Q

What is the superior boundary of the posterior mediastinum?

A

sternal angle

44
Q

What is the inferior boundary of the posterior mediastinum?

A

diaphragm

45
Q

What is the lateral boundary of the posterior mediastinum?

A

mediastinal surfaces of L+R lungs

46
Q

What is the anterior boundary of the posterior mediastinum?

A

pericardial sac

47
Q

What is the posterior boundary of the posterior mediastinum?

A

T5-T12 vertebrae

48
Q

What are the organs found in the posterior mediastinum?

A

esophagus

49
Q

What are the vessels found in the posterior mediastinum?

A

descending (thoracic) aorta
azygos vein
hemiazygos vein
accessory hemiazygos vein
thoracic duct

50
Q

What are the nerves found in the posterior mediastinum?

A

vagus nerves (L+R), anterior and posterior vagal trunks, esophageal plexus, sympathetic chains, & thoracic splanchnic nerves (greater, lesser, and least)

51
Q

What does the posterior mediastinum communicate freely with?

A

the superior mediastinum and numerous structures continuous between them

52
Q

What does the thoracic aorta give rise to?

A

posterior arteries supplying the thoracic wall

53
Q

Which 2 posterior arteries supply the thoracic wall?

A
  • Posterior intercostal arteries inferior to ribs 3–11, bilaterally
  • Subcostal arteries inferior to rib 12, bilaterally
54
Q

Where does the thoracic aorta pass?

A

behind diaphragm at T12

55
Q

What accompanies the thoracic aorta (2)?

A

the azygos vein and thoracic duct

56
Q

What is the order of the azygos veins?

A
  1. SVC
  2. azygos vein
  3. accessory hemiazygos vein
  4. hemiazygos vein
  5. IVC
57
Q

Where do the azygos veins drain?

A

posterior thoracic wall

58
Q

What do azygos veins offer?

A

collateral passage for venous blood to bypass blockages in the vena cave

59
Q

What is the cisterna chyli?

A

dilation at confluence of abdominal lymph trunks

60
Q

What is the esophagus?

A

muscular tube connecting the pharynx and stomach

61
Q

Where does the esophagus travel?

A

through superior and posterior mediastina

62
Q

Where does the esophagus pass through the diaphragm? What is it accompanied by?

A

at T10
accompanied by vagal trunks

63
Q

What causes the vagus nerves to shift into anterior and posterior positions?

A

the 90 degree clockwise rotation of the gastrointestinal tract during embryological development

64
Q

What vagal trunk is the left vagus nerve part of?

A

the anterior vagal trunk

65
Q

What vagal trunk is the right vagus nerve part of?

A

the posterior vagal trunk

66
Q

What is the esophageal plexus formed from?

A

branches of vagal nerves and branches from sympathetic chain

67
Q

Vagus nerves pass ____ to the root of lung structures while the phrenic nerves pass ____.

A

posterior, anterior

68
Q

Where is the sympathetic chain located?

A

lateral to the vertebral bodies in thoracic
& abdominal regions

69
Q

What are the 3 paired thoracic splanchnic nerves associated with?

A

thoracic spinal levels

70
Q

What do the 3 paired thoracic splanchnic nerves carry?

A

sympathetic (visceral motor) & visceral sensory information

71
Q

Where do the thoracic splanchnic nerves branch off?

A

sympathetic chains and run obliquely (posterior to anterior & superior to inferior)

72
Q

How do the thoracic splanchnic nerves reach the abdominal cavity?

A

pierce through OR pass behind the diaphragm to reach the abdominal cavity

73
Q

What are the names of the 3 thoracic splanchnic nerves?

A

greater, lesser, least

74
Q

What is the level of the greater splanchnic nerve?

A

T5-T9

75
Q

What is the level of the lesser splanchnic nerve?

A

T10-T11

76
Q

What is the level of the least splanchnic nerve?

A

T12