1. veins 2. great arterial vessels, ligament arteriosum 3. trachea, vagus n. esophagus, thoracic aorta 4. thoracic duct and azygos venous system 5. mediastinal autonomic n.

Mediastina Flashcards by Alegra Mendez

boundaries of anterior mediastinum

anterior - transversus thoracis m., sternum, costal cartilages

posterior - fibrous pericardium

lateral - parietal pleura

How well did you know this?

Not at all

Perfectly

contents of anterior mediastinum

sternopericardial ligaments 
thymus (pre-puberty)
internal thoracic vessels
fat, lymph nodes
nerves

How well did you know this?

Not at all

Perfectly

n. of cardiac plexus mostly arise from…

vagus (CN X)

sympathetic trunk

How well did you know this?

Not at all

Perfectly

layers of mediastina

veins
great arterial vessels, ligament arteriosum
trachea, vagus n. esophagus, thoracic aorta
thoracic duct and azygos venous system
mediastinal autonomic n.

How well did you know this?

Not at all

Perfectly

retroesophageal R subclavian

no brachiocephalic trunk. RSA coming right off aorta and traveling behind esophagus
40% of Down syndrome pt

Dysphagia common

How well did you know this?

Not at all

Perfectly

ligamentum arteriosus

vestige of fetal life ductus arteriosus, scars down bc of high oxygen content
from pulmonary trunk to arch of aorta

shunts venous blood into the aorta

How well did you know this?

Not at all

Perfectly

ductus arteriosus

blood that gets into fetal RV and through pulmonary trunk takes shunt (ductus arteriosus)

blood is partly venous but also has maternal oxygenated blood

How well did you know this?

Not at all

Perfectly

fetal blood flow

umbilical vein from placenta –> liver –> RA –> deflected toward foramen ovale by valve of IVC –> LV then out

How well did you know this?

Not at all

Perfectly

ligamentum venosum

scarring down of umbilical vein after birth

How well did you know this?

Not at all

Perfectly

if aspirate something, would it go to R or L bronchus?

R bronchi - more vertically oriented and larger

How well did you know this?

Not at all

Perfectly

primary target of vagus n.

abd and below, but also innervates larynx

How well did you know this?

Not at all

Perfectly

esophagus

long tube from C6 (cricopharynxgeus m.) to T10)

How well did you know this?

Not at all

Perfectly

landmark for IVC

How well did you know this?

Not at all

Perfectly

landmark for esophageal hiatus

T10

How well did you know this?

Not at all

Perfectly

landmark for thoracic aorta becoming abdominal

T12

How well did you know this?

Not at all

Perfectly

main trunks of of nerves covering esophagus

mainly from vagus m.

also some sympathetic fibers

How well did you know this?

Not at all

Perfectly

L vagus n. travels _____ to esophagus

R vagus n. travels _____ to esophagus

L –> anterior

R –> posterior

“LARP”

How well did you know this?

Not at all

Perfectly

Gives more clear views of heart and valves, particularly useful it pt is obese

trans-esophageal echocardiography

How well did you know this?

Not at all

Perfectly

hiatal hernia

weakening of R crus of diaphragm, pt of stomach goes into thorax

comm in elderly

How well did you know this?

Not at all

Perfectly

thoracic (descending) aorta

T4/T5 to T12

firmly tethered by posterior intercostals

other unpaired branches

esophageal a.
bronchial a.
pericardial a. (to dorsal pericardium)

aortic hiatus

T12

Where thoracic aorta pierces diaphragm, becomes abdominal aorta

cisterna chyli

Dilation of lymph vessels at L1-L3 where thoracic duct begins .
Changes from R to L side of aorta at T4.
Empties into L venous angle

thoracic duct runs anterior to

anterior longitudinal ligament

thoracic duct traverses from R to L at which spinal level

~T4

thoracic duct empties into

L. venous angle (junction of L. internal jugular v. and L. subclavian v.)

RUQ drains into ______, while the rest drains into _____

RUQ --> right lymphatic duct | Everything else --> thoracic duct (and sometimes lower left lobe of lung)

Thoracic duct drains all but upper quadrant with the exception of...

lower left lobe of lung, left atrium, left ventricle

lymphatic drainage of heart

right side --> left (thoracic duct) | left side --> right (R lymphatic duct)

mediastinal lymph nodes

``` Virchow's node (sentinal node) posterior mediastinal nodes paratracheal nodes superior/inferior tracheobronchial nodes superior phrenic nodes ``` bronchopulmonary/hilar nodes in lung root

Enlarged Virchow's node can be first sign of...

gastric cancer

system of veins draining thoracic and abd wall

azygos veins

azygous v. forms from

ascending lumbar veins uniting with posterior intercostal veins

hemiazygous v.

tributaries training into azygous v. --> highly variable hemiazygous v. --> just above diaphragm then a break then accessory hemizygous would be above

Azygous vein functions

drains post. thoracic and abd walls provides direct connection between IVC and SVC provides imp venous shunts in SVC/IVC pathology

Azygos v. has valves, T or F?

``` False No valves (like most non-extremity veins) ```

IVC filters can function to

collect blood clots from legs so they don't travel up to lungs

SVC blocked... different routes for venous blood to RA?

1. back up and travel thru azygous arch. down azygous v., join IVC and go up to heart. 2. travel thru internal thoracic v. (on either side of sternum), connect to anterior intercostal v., which go around and become posterior intercostal v., join azygous v., go down and join heart via IVC

mediastinal autonomic n.

parasympathetic sympathetic - cardiopulmonary splanchnic - thoracic splanchnic

cardipulmonary splanchnic n.

sympathetic originating from T1-T4 1st neurons... can either synapse at thoracic ganglia and post-synaptic fibers can travel to heart/trachea/esophagus... OR can travel upwards to synapse at cervical ganglia, then travel back down as superior/middle/inferior cardiac n. to innervate heart (trachea/esophagus.. to lesser extent)

thoracic splanchnic n.

originate at T5-T12 pass through paravertebral ganglia (in abd), then post-ganglionic gibers follow blood vessels to abd targets unite to form 3 distinct n. (greater, lesser, and least splanchnic n.) all splanchnic n. fibers in thorax are preganglionic

greater splanchnic n.

T5-T9

lesser splanchnic n.

T10-T11

least splanchnic n.

T12

thoracic splanchnic n. have functions in thorax | T or F

F, only arise from thorax region bc that's where sympathetic fibers arise all function is BELOW diaphragm

periarterial sympathetic plexus

post-ganglionic sympathetics fibers follows this to their targets

ganglia of abd

celiac ganglia aorticorenal ganglion superior mesenteric ganglion and plexus inferior mesenteric ganglion

thyroid ima artery

from brachiocephalic trunk | to isthmus of thyroid

landmark for carina

T4/T5

damage of recurrent laryngeal nerves

Caused by aortic aneurisms, enlarged lymph nodes, tumors. Hoarseness may be indicative of mediastinal pathology (even though vocal cords are way higher up).