Mediastinal lymph nodes

Question 1

Name the levels of the mediastinal lymph nodes

Answer 1

1) highest mediastinal
2) (R&L) upper paratracheal
3)a: prevascular, p: retrotracheal
4) (R&L) lower paratracheal
5) AP window
6) para-aortic
7) subcarinal
8) paraesophageal
9) pulmonary ligament
10) hilar
11) interlobar

Question 2

where are the level one lymph nodes located?

Answer 2

Anything anterior to the first rib! Very superior!!! If on RC they give you a lymph node that is in front of level two or four, it is most likely 3a (prevascular!)

Question 3

what separates 2 and 4 right from left?

Answer 3

R is everything past the left lateral trachea

Question 4

What separates 2 from 4 sup/inf?

Answer 4

2 becomes 4 as soon as you see the upper border of teh aortic arch!

Question 5

3p is located between ant-post? What separates it from 4?

When does 3p end?

Answer 5

The trachea and the vertebrae! separated by a line drawn along the posterior border of the trachea!

3P ends at the carina, so anything below the carina is now station 7

Question 6

When does level 6 start?Does 3a still exist at this time?

Answer 6

At the upper border of the aortic arch (same when 2 become 4). Yes! 3A still exists anteriorly to the ascending aorta, 6 is medially to the ascending aorta.

Question 7

What is the inferior border of subcarinal (station 7)

Answer 7

Upper border of the lower lobe bronchus (on left) or bronchus intermedius on right

Question 8

Name the path from trachea -> bronchus right and left

Answer 8

Right:
Trachea -> right main bronchus (upper lobe bronchus branches off of here) -> bronchus intermedius (middle and lower lobe bronchus then branch from here)

Left:
Trachea -> left main bronchus -> Upper lobe bronchus and lower lobe bronchus