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Gross Anatomy I NYCC > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

Mediastinum is occupied by…

A
  • Mass of tissue between 2 pulmonary/pleural cavities
  • contains all thoracic viscera, nerves, and vessels except the lungs and those in thoracic wall
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2
Q

Mediastinum is covered by…

A
  • Mediastinal pleura
  • surrounded by blood & lymphatic vessels, lymph nodes, nerves & fat
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3
Q

Mediastinum extends from…

A
  • superior thoracic aperture to diaphragm
  • sternum & costal cartilages to bodies of thoracic vertebrae
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4
Q

Mediastinum primarily consists of hollow visceral structures united by…

A

Loose CT (often adipose)

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5
Q

Mediastinum is divided by…

A

Transverse thoracic plane at level of sternal angle & junction of T4-T5 (at IVD)

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6
Q

Name the divisions of the mediastinum

A
  • superior
  • inferior: anterior, middle, posterior
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7
Q

Contents of middle mediastinum

A
  • pericardium
  • heart
  • roots of great vessels
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8
Q

What is the pericardium?

A
  • Fibroserous membrane
  • closed sac covering heart and beginning of great vessels
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9
Q

Name the layers of the pericardium

A

Fibrous
Parietal serous
Visceral serous

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10
Q

Superior attachments of fibrous pericardium

A
  • continuous with tunica adventitia of great vessels
  • continuous with pretracheal layer of cervical fascia
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11
Q

Anterior attachments of fibrous pericardium

A

To posterior surface of sternum by sternopericardial ligaments

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12
Q

Posterior attachments of fibrous pericardium

A

Loose CT to structures of posterior mediastinum

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13
Q

Inferior attachments of fibrous pericardium

A

Continuous with central tendon of diaphragm

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14
Q

Pericardial cavity

A
  • space between opposing layers of parietal & visceral serous pericardium
  • contains fluid that enables heart to move & beat in frictionless environment
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15
Q

Visceral serous pericardium forms the ____

A

Epicardium

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16
Q

Visceral serous pericardium attachments

A

Extends onto beginning of great vessels, continuous with parietal layer of serous pericardium:
- where aorta & pulmonary trunk leave heart
- where superior vena cava (SVC) and inferior vena cava (IVC) and pulmonary veins leave atria

17
Q

Blood supply of pericardium

A
  • pericardiacophrenic a. (Branch of internal thoracic a)
  • musculophrenic a
  • bronchial, esophageal, superior phrenic aa of thoracic aorta
  • coronary aa (visceral serous pericardium only)
18
Q

Pericardium venous drainage

A
  • pericardiacophrenic vv = tributaries of brachioceophalic v or internal thoracic vv
  • various tributaries of azygous venous system
19
Q

Nerve supply to pericardium

A
  • phrenic nerves (C3-C5) = sensory, pain
  • vagus nerve (CN X) = parasympathetic
  • sympathetic trunks = vasomotor functions
20
Q

Location of superior mediastinum

A

Superior to transverse thoracic plane

21
Q

Contents of superior mediastinum

A
  • thymus
  • great vessels & veins
  • vagus, phrenic nerves
  • cardiac plexus
  • trachea
  • esophagus
  • recurrent laryngeal nerves
  • thoracic duct & lymphatic trunks
22
Q

Location of thymus

A
  • inferior neck & anterior portion of superior mediastinum anterior to fibrous pericardium
  • largely replaced by fat after puberty
23
Q

Great vessels of superior mediastinum

A
  • R & L brachiocephalic vv
  • SVC
  • ascending aorta
  • arch of aorta
  • thoracic (descending) aorta
  • arch of azygous v
  • brachiocephalic trunk
  • L common carotid a
  • L subclavian a
24
Q

Ligamentum arteriosum

A
  • remnant of fetal ductus arteriosus
  • passes from root of L pulmonary a to inferior surface of arch of aorta
25
Q

Where does Right vagus nerve enter the thorax?

A

Anterior to right subclavian a

26
Q

R vagus nerve gives rise to the ____

A

R. Recurrent laryngeal nerve

27
Q

Where does R vagus nerve travel in the superior mediastinum?

A

Posterior to R brachiocephalic vein, SVC, and root of lung

28
Q

Where does L vagus nerve enter mediastinum?

A

Between carotid and subclavian aa

29
Q

Where does L vagus nerve travel in the superior mediastinum?

A
  • Descends in neck posterior to left common carotid a.
  • at arch of aorta, diverges posterior to left phrenic nerve
30
Q

L vagus nerve gives rise to the ____

A

Left recurrent laryngeal nerve

31
Q

R recurrent laryngeal nerve

A
  • Hooks around R subclavian artery
  • ascends between trachea & esophagus to supply larynx
32
Q

L recurrent laryngeal nerve

A
  • passes inferior to arch of aorta, lateral to ligamentum arteriosum
  • ascends to larynx
33
Q

R phrenic nerve pathway

A
  • Passes along right side of R brachiocephalic vein, SVC, and pericardium over the R atrium
  • descends on right side of SVC to diaphragm
34
Q

L phrenic nerve pathway

A
  • descends between L subclavian & common carotid aa
  • crosses left surface of aortic arch to vagus nerve
  • runs along fibrous pericardium superficial to L atrium & ventricle to diaphragm
35
Q

Cardiac plexus

A
  • nerve network lies anterior to bifurcation of trachea
  • supplies sympathetics & parasympathetics to heart
36
Q

Trachea

A
  • respiratory structure
  • divides into L & R bronchus at level of sternal angle
37
Q

Esophagus

A
  • fibromuscular tube that extends from pharynx (back of throat)
  • enters mediastinum between trachea & vertebrae
38
Q

Location of thoracic duct

A

Lies on left side of esophagus, deep to arch of aorta

39
Q

Where does thoracic duct drain?

A

Into L brachiocephalic vein by confluence of L subclavian & internal jugular veins

Gross Anatomy I NYCC (15 decks)

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