Lecture 8 - Mediastinum and Great Vessels Flashcards
What divides the superior and inferior mediastinum?
Plane of louis - therough the sternal angle
Which vertebrae is the sternal angle at?
B/w T4/5
What is in the Superior mediastinum?
Thymus Great Vessels Trachea (l main bronchus, Right main bronchus) Oesophagus Thoracic duct
What is the most superficial of the great vessels?
the veins
Where the brachiocephalic vein forms, you can see the ______ duct draining
lympathic
What are the branches of the arch of aorta (from Righ to Left)?
Brachiocephalic A (which bracnches into R. subclavian and R common carotid)
L. Common carotid
L. Subclavian
What is the Ligamentum arteriosum?
Remnant of Ductus Arterious - Leftover from fetal circulation, shuts down at birth
looks like a ligament between Pulmonary trunk and arch of aorta
Where does phrenic nerve run?
anterior to the hilum, lateral to the heart (with the pericardium)
Where does the vagus nerve run?
posterior to the roots of the lung, but on the left it runs anterior to the aorta
The L recurrent Laryngeal nerve branches from the ___ nerve and then arches back up ______ the aorta and the the laryngeal muscles.
The L recurrent Laryngeal nerve branches from the vagus and then arches back up underneath the aorta and the the laryngeal muscles.
The right laryngeal nerves goes underneath the ______ artery
The right laryngeal nerves goes underneath the subclavian artery
trachea bifurcates where?
at the plane of louis
The oseophagus deviates slightly to the __ to reach the stomach (once through the diaphragm)
Left
Thoracic duct projects off to the __ and the dumps into the brachiocephalic vein
Thoracic duct projects off to the left and the dumps into the brachiocephalic vein
What is in the anterior mediastinum?
Fat
Lymph nodes
Int. thoracic vessels
inferior part of the thymus in children
What is in the middle mediastinum?
Heart and roots of the great vessels
Whats in the posterior mediastinum?
Hearts been taken out so can see:
Oseophagus, thoracic duct bagus body of vertebrae descending aorta
The descending aorta is on which side?
left
Where does the left vagus nerve sit?
on the ant. surface of the oseophagus
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
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
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
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
Describe the oesophagus
which mediastinum is it in?
Posterior mediatinum
Thick walled muscular tube
3 layers
important for peristalsis
Flattened in the ant. posterior direction
What drains the oesophagus?
the azygous system of veins
Pain associated with the oesophagus might be referred to the _____ ____- dermatomes much like heart pain
Pain associated with the oesophagus might be referred to the upper thoracic dermatomes much like heart pain
So oesophagus pain can be confused with …
Heart pain
Where will you find the sympathetic trunk?
In the posterior mediastinum - runs in the paravertebral gutter
Describe the movement of the Thoracic duct
Starts moving left at the plane of louis - takes all lymph from the lower limbs and left side of thorax
The Azygous system of veins drains everything in the ____
thorax - goes to the SVC
The Azygous Veins is on which side?
Right side
Everything on the lerft drains into the _____ or _______ vein
Everything on the lerft drains into the accessory or hemiazygous vein
Which veinw receives the intercostal veins?
Hemiazygous - lower intercostals
Accessory - upper intercostal
What drains the oesophagus veins and bronchial veins?
Azygous system
