Mediastinum

Question 1

mediastinum is divided by an imaginary plane that runs from the

Answer 1

sternal angle to the T4 vertebrae

Question 2

superior mediastinum

Answer 2

bounded anteriorly by the manubrium and posteriorly by the vertebral bodies of T1-T4

Question 3

inferior mediastinum

Answer 3

bounded anteriorly by the body of the sternum and posteriorly by the vertebral bodies of the lower and 8 thoracic vertebrae

Question 4

the inferior mediastinum is further subdivided into the (3)

Answer 4

anterior mediastinum
middle mediastinum
posterior mediastinum

Question 5

anterior mediastinum

Answer 5

space between the pericardium and the sternum

Question 6

middle mediastinum

Answer 6

pericardium and heart

Question 7

posterior mediastinum

Answer 7

between the pericardium and the vertebral column

Question 8

the superior mediastinum contains

Answer 8

neural, vascular and respiratory structures passing from the adjacent regions of the neck and abdomen (via the inferior mediastinum)

Question 9

in children, the superior mediastinum also contains the

Answer 9

thymus

Question 10

the thymus contributes to the

Answer 10

development and maintenance of the immune system

Question 11

the thymus is large in childhood but

Answer 11

involutes after puberty and is replaced by fatty tissue

Question 12

the thymus is located in the

Answer 12

lower part of the neck and anterior part of the superior mediastinum

Question 13

the thymus lies posterior to the — and in children can extend into the

Answer 13

manubrium

in children can extend into the anterior mediastinum to lie anterior to the pericardium

Question 14

the thymus blood supply is from the

Answer 14

internal thoracic arteries

Question 15

the thymus venous drainage is via the

Answer 15

internal thoracic and brachiocephalic veins

Question 16

the great systemic blood vessels of the heart lie within the

Answer 16

superior mediastinum

Question 17

the great systemic blood vessels main branches arise before passing through the

Answer 17

superior thoracic aperture

Question 18

great vessels (3)

Answer 18

arch of the aorta
pulmonary trunk
superior vena cava

Question 19

these tributaries of the superior vena cava are located within the superior mediastinum (4)

Answer 19

–Brachiocephalic veins –draining blood from the upper body.
–Left superior intercostal vein –collects blood from the left 2nd and 3rd intercostal vein. It drains into the left brachiocephalic vein.
–Supreme intercostal vein –drains the vein from first intercostal space directly into the brachiocephalic veins.
–Azygos vein –receiving blood from the right posterior intercostal veins.

Question 20

SVC returns blood from

Answer 20

all structures superior to the diaphragm except for the lungs and the heart

Question 21

the pulmonary trunk exits from the

Answer 21

right ventricle

Question 22

the pulmonary trunk is initially anterior to the

Answer 22

aorta

Question 23

the pulmonary trunk moves

Answer 23

medially and posteriorly

Question 24

the pulmonary trunk bifurcates into the

Answer 24

left and right pulmonary arteries

Question 25

the aorta begins with ascending aorta at the

Answer 25

aortic office of the left ventricle

Question 26

the branches of the left and right

Answer 26

coronary arteries

Question 27

the major branches of the aortic arch arise within the

Answer 27

superior mediastinum

Question 28

the aortic arch branches into (3)

Answer 28

brachiocephalic artery left common carotid artery left subclavian artery

Question 29

brachiocephalic artery

Answer 29

supplying the right side of the head and neck and the right upper limb

Question 30

left common carotid artery

Answer 30

to the left side of the head and neck

Question 31

left subclavian artery

Answer 31

to the left upper limb

Question 32

aberrant right subclavian artery

Answer 32

most common arch anomaly not a true ring usually asymptomatic sometimes dysphagia lusonia when dilated subclavian artery compresses esophagus posteriorly

Question 33

innominate artery compression syndrome

Answer 33

in children the brachiocephalic (innominate) artery is located more to the left and may compress the trachea anteriorly

Question 34

right arch mirror image

Answer 34

mirror-image variety of the left arch asymptomatic associated congenital heart disease in 98%, mostly tetralogy of allot

Question 35

right arch with aberrant left subclavian

Answer 35

left subclavian artery is the last branch | obstructing anomaly

Question 36

double aortic arch

Answer 36

complete ring enriches esophagus and trachea | four vessel sign

Question 37

double arch with atretic segment

Answer 37

left arch is very small and has atretic posterior segment | still a four vessel sign

Question 38

the superior mediastinum, the vagus nerve has - paths

Answer 38

two

Question 39

Right vagus nerve

Answer 39

runs parallel to the trachea and passes posteriorly to the superior vena cava and the right primary bronchus

Question 40

Left vagus nerve

Answer 40

enters the superior mediastinum between the left common carotid and the left subclavian arteries. It descends anteriorly to the aortic arch (9), before travelling posterior to the left bronchus

Question 41

The right recurrent laryngeal hooks around the right subclavian artery and ascends between the

Answer 41

trachea & esophagus to supply the larynx

Question 42

The left recurrent laryngeal nerve arises from the

Answer 42

left vagus nerve as it passes the aortic arch. It loops under the arch, to the left of ligamentum arteriosum (11), before continuing its journey to the larynx in the tracheal-esophageal groove.

Question 43

the vagus nerve travels through the neck with the

Answer 43

internal jugular veins and the common carotid arteries

Question 44

the right and left vagus nerves give off parasympathetic branches that contribute to the

Answer 44

cardiac and pulmonary plexuses

Question 45

After the nerves pass behind the main bronchi, they converge on the esophagus and form the

Answer 45

esophageal plexus

Question 46

Just superior to the diaphragm, the plexus gives rise to two

Answer 46

vagal trunks (the anterior and posterior vagal trunks)

Question 47

The vagi give off the recurrent laryngeal branches that ascend to the larynx to innervate

Answer 47

all but one muscle of the larynx

Question 48

The right recurrent laryngeal nerve does not enter the mediastinum--it hooks around the --- --- --- before ascending to the right side of the larynx.

Answer 48

right subclavian artery

Question 49

The right recurrent laryngeal nerve is also spatially related to the

Answer 49

apex of the right lung

Question 50

The left recurrent laryngeal nerve hooks around the aortic arch and ascends in the groove between the

Answer 50

trachea and the esophagus

Question 51

The left recurrent laryngeal nerve is also spatially related to the

Answer 51

lymph nodes of the aortic arch

Question 52

The recurrent laryngeal nerves may be injured as a result of (4)

Answer 52

trauma, during surgery, as a result of tumor spread, or due to other means

Question 53

Injury to the recurrent laryngeal nerves can result in (4)

Answer 53

unproductive cough, a weakened voice (hoarseness) or loss of voice (aphonia) and cause problems in the respiratory tract

Question 54

ligamentum arteriosum

Answer 54

A fibrous remnant of the ductus arteriosus extending between the aortic arch and the pulmonary trunk

Question 55

Ductus arteriosus

Answer 55

a fetal blood vessel that connects the left pulmonary artery to the descending aorta

Question 56

In utero, the ductus arteriosus serves as a

Answer 56

bypass for the lungs

Question 57

the phrenic nerve provides

Answer 57

motor to the diaphragm, sensory to the mediastinal and diaphragmatic pleura

Question 58

phrenic nerve pathway

Answer 58

From the anterior surface of the anterior scalene muscle, the phrenic nerves (roots C3, C4 and C5) enter the superior mediastinum lateral to the great vessels. They then descend anteriorly into the middle mediastinum, passing anteriorly to the hilum of the lungs.

Question 59

Cardiac nerves originate from the

Answer 59

superior, middle and inferior cardiac ganglia

Question 60

cardiac nerves form the

Answer 60

form the superficial and deep cardiac plexuses in the superior mediastinum

Question 61

The superior plexus sits between the

Answer 61

aortic arch and right pulmonary vein

Question 62

The deep plexus lies on the surface of the trachea at the point of

Answer 62

bifurcation

Question 63

Sympathetic trunk runs bilaterally to the vertebral bodies along

Answer 63

the entire length of the vertebral column

Question 64

trachea descends anterior to the

Answer 64

esophagus

Question 65

posterior surface of the trachea is flat where applied to the

Answer 65

esophagus

Question 66

trachea ends at the level of the

Answer 66

sternal angle

Question 67

the trachea divides into the

Answer 67

left and right primary bronchi

Question 68

thoracic aorta is also known as the

Answer 68

descending aorta

Question 69

thoracic aorta begins at the

Answer 69

inferior border of T4

Question 70

thoracic aorta descending on the left side of the

Answer 70

T5-T12 vertebrae

Question 71

thoracic aorta becomes the abdominal aorta when it passes through the

Answer 71

aortic hiatus (thoracic duct and azygous vein)

Question 72

thoracic aorta supplies the

Answer 72

ntercostal spaces and thoracic viscera (bronchial aa., esophageal aa., mediastinal aa., superior phrenic aa., and occasionally some“percardioacophrenic aa.”)

Question 73

esophagus is posterior to the

Answer 73

arch of aorta, pericardium/left atrium

Question 74

the esophagus passes through the

Answer 74

esophageal hiatus

Question 75

esophagus has -- and -- vagal trunks

Answer 75

anterior and posterior

Question 76

what is the largest lymphatic channel in the body?

Answer 76

the thoracic duct

Question 77

where does the thoracic duct originate from?

Answer 77

cisterna chili in the abdomen and scents through the posterior and superior mediastina to drain into the union of the left internal jugular and subclavian

Question 78

The thoracic duct drains lymph from the whole body except for the (4)

Answer 78

right side of the head and neck, the right upper limb, and the right side of the thorax and upper surface of the liver

Question 79

These drain into the right jugular, subclavian, and bronchomediastinal trunks which enter the veins on the right side of the neck as the

Answer 79

right lymphatic duct

Question 80

The superficial tissues of the chest wall (e.g., breasts) drain into the (2)

Answer 80

axillary and internal thoracic nodes

Question 81

The deeper tissues drain into the (4)

Answer 81

internal thoracic, intercostal, and diaphragmatic nodes, and subsequently into the thoracic duct

Question 82

The heart drains via lymphatic vessels that follow the coronary arteries and ultimately drain to the

Answer 82

inferior tracheobronchial nodes

Question 83

Deep lymphatics of the lungs follow

Answer 83

air passages