Lecture 8 - Mediastinum and Great Vessels

Question 1

What divides the superior and inferior mediastinum?

Answer 1

Plane of louis - therough the sternal angle

Question 2

Which vertebrae is the sternal angle at?

Answer 2

B/w T4/5

Question 3

What is in the Superior mediastinum?

Answer 3

Thymus
Great Vessels
Trachea (l main bronchus, Right main bronchus)
Oesophagus
Thoracic duct

Question 4

What is the most superficial of the great vessels?

Answer 4

the veins

Question 5

Where the brachiocephalic vein forms, you can see the ______ duct draining

Answer 5

lympathic

Question 6

What are the branches of the arch of aorta (from Righ to Left)?

Answer 6

Brachiocephalic A (which bracnches into R. subclavian and R common carotid)

L. Common carotid

L. Subclavian

Question 7

What is the Ligamentum arteriosum?

Answer 7

Remnant of Ductus Arterious - Leftover from fetal circulation, shuts down at birth

looks like a ligament between Pulmonary trunk and arch of aorta

Question 8

Where does phrenic nerve run?

Answer 8

anterior to the hilum, lateral to the heart (with the pericardium)

Question 9

Where does the vagus nerve run?

Answer 9

posterior to the roots of the lung, but on the left it runs anterior to the aorta

Question 10

The L recurrent Laryngeal nerve branches from the ___ nerve and then arches back up ______ the aorta and the the laryngeal muscles.

Answer 10

The L recurrent Laryngeal nerve branches from the vagus and then arches back up underneath the aorta and the the laryngeal muscles.

Question 11

The right laryngeal nerves goes underneath the ______ artery

Answer 11

The right laryngeal nerves goes underneath the subclavian artery

Question 12

trachea bifurcates where?

Answer 12

at the plane of louis

Question 13

The oseophagus deviates slightly to the __ to reach the stomach (once through the diaphragm)

Answer 13

Left

Question 14

Thoracic duct projects off to the __ and the dumps into the brachiocephalic vein

Answer 14

Thoracic duct projects off to the left and the dumps into the brachiocephalic vein

Question 15

What is in the anterior mediastinum?

Answer 15

Fat
Lymph nodes
Int. thoracic vessels
inferior part of the thymus in children

Question 16

What is in the middle mediastinum?

Answer 16

Heart and roots of the great vessels

Question 17

Whats in the posterior mediastinum?

Answer 17

Hearts been taken out so can see:

Oseophagus, 
thoracic duct
bagus
body of vertebrae
descending aorta

Question 18

The descending aorta is on which side?

Answer 18

left

Question 19

Where does the left vagus nerve sit?

Answer 19

on the ant. surface of the oseophagus

Question 20

The oesophagus has a plexus of ______ around it - Left vagus is related to one side whereas the right vagus is on the ______ aspect of the oesophagus which gives off heaps of nerves

Answer 20

The oesophagus has a plexus of nerves around it - Left vagus is related to one side whereas the right vagus is on the posterior aspect of the oesophagus which gives off heaps of nerves

Question 21

As the desecending aorta goes down it gives off small branches - segmental arteries which become the ________ _______arteries

They also give off ________ branches, and some bronchial arteries

Answer 21

As the desecending aorta goes down it gives off small branches - segmental arteries which become the posterior intercostal arteries

They also give off oesophageal branches, and some bronchial arteries

Question 22

Describe the oesophagus

which mediastinum is it in?

Answer 22

Posterior mediatinum

Thick walled muscular tube

3 layers

important for peristalsis

Flattened in the ant. posterior direction

Question 23

What drains the oesophagus?

Answer 23

the azygous system of veins

Question 24

Pain associated with the oesophagus might be referred to the _____ ____- dermatomes much like heart pain

Answer 24

Pain associated with the oesophagus might be referred to the upper thoracic dermatomes much like heart pain

Question 25

So oesophagus pain can be confused with …

Answer 25

Heart pain

Question 26

Where will you find the sympathetic trunk?

Answer 26

In the posterior mediastinum - runs in the paravertebral gutter

Question 27

Describe the movement of the Thoracic duct

Answer 27

Starts moving left at the plane of louis - takes all lymph from the lower limbs and left side of thorax

Question 28

The Azygous system of veins drains everything in the ____

Answer 28

thorax - goes to the SVC

Question 29

The Azygous Veins is on which side?

Answer 29

Right side

Question 30

Everything on the lerft drains into the _____ or _______ vein

Answer 30

Everything on the lerft drains into the accessory or hemiazygous vein

Question 31

Which veinw receives the intercostal veins?

Answer 31

Hemiazygous - lower intercostals

Accessory - upper intercostal

Question 32

What drains the oesophagus veins and bronchial veins?

Answer 32

Azygous system