Mediastinum Flashcards
What are the four areas of the mediastinum?
- Anterior
- Middle (where heart is)
- Superior
- Posterior
What is the anterior mediastinum filled with?
FAT
Where is the anterior mediastinum located?
between sternum and pericardial sac
Where is the superior mediastinum located?
space between root of neck and pericardial sac
What gland does the superior mediastinum contain?
THYMUS GLAND
What does the thymus gland do?
- produce T-lymphocytes
- extends partially into the anterior mediastinum
What are the great vessels of the heart?
- Aorta
- Pulmonary trunk
- Superior vena cava
What are the parts of the aorta?
ascending aorta
arch of the aorta
descending aorta
What does the pulmonary trunk carry?
deoxygenated blood
What is the function of the superior vena cava?
drains the entire head and neck and upper limbs
What are the nerves of the superior mediastinum?
- Phrenic nerve
- Vagus nerve
Where does the phrenic nerve originate from?
Cervical spinal nerve C3-C5 (ventral primary rami)
What does the phrenic nerve innervate?
DIAPHRAGN
Where does the vagus nerve originate from?
Brain stem
TRUE OR FALSE
The phrenic nerve is general somatic afferent.
TRUE
brings back sensory information from the parietal pleura
The functional component of the phrenic nerve is _______________________. Why?
general somatic efferent (GSE)
Because the diaphragm is skeletal muscle
How does the vagus nerve come down and innervate?
Comes down from brain stem
Turns around and goes back to larynx
Wraps around the esophagus (makes plexus there)
Goes down to diaphragm
What branches come off of the arch of the Aorta?
- Brachiocephalic artery (RIGHT SIDE)
- Left common carotid artery
- Left subclavian artery
The ______________ arteries branch from the ascending portion of the aorta.
CORONARY
How many coronary arteries come off of the ascending aorta?
TWO
1. Right coronary artery
2. Left coronary artery
On the right side, you have the brachiocephalic trunk that splits into what?
- right common carotid artery
- right subclavian artery
What does the subclavian artery become when it passes over the lateral aspect of the first red?
AXILLARY ARTERY
The brachial branches that goes to the esophagus is an example of a what?
UNPAIRED BRANCH TO VISCERA
Paired branches to the thoracic wall is called what?
INTERCOSTAL ARTERIES
Branching arteries go down until what?
THE DIAPHRAGM
What is the function of the ligamentum arteriosum?
attaches the pulmonary trunk to the arch of the aorta
Prior to birth, what is the ligamentum arteriosum?
DUCTUS ARTERIOSUS
What do you find on the left side of the ligamentum arteriosum?
A BRANCH OF VAGUS
Which branch of vagus goes under the arch of the aorta and behind the ligamentum arteriosum?
LEFT RECURRENT LARYNGEAL NERVE
What passes behind the ligamentum arteriosum and goes under the aorta?
LEFT RECURRENT LARYNGEAL NERVE
aka
INFERIOR LARYNGEAL NERVE
Where does the trachea bifurcate to?
The primary bronchi at the sternal plane ~T4-T5
Where is the esophagus located?
Behind trachea
Behind heart
Where is the posterior mediastinum located?
The space behind the pericardial sac
The area behind the heart
The space behind the pericardial sac contains what?
- Descending aorta
- Azygous veins
- Esophagus
- Thoracic duct
- Sympathetic nerves
What plexus wraps around the esophagus?
VAGUS PLEXUS
What does the thoracic duct do?
Bring ECF back to venous circulation (from lymph circulation)
What are in the sympathetic trunks?
Paravertebral ganglia
Splanchnic nerves are PRE- or POST- ganglionic?
PRE-GANGLIONIC
sympathetic
synapse at pre-vertebral
What are the veins of the thorax?
- Superior vena cava
- Inferior vena cava
- Azygous system
Where is the superior vena cava found?
Superior mediastinum
What does the superior vena cava do?
drains upper limbs and head and neck
What is the superior vena cava formed by?
RIGHT AND LEFT BRACHIOCEPHALIC VEINS
The brachiocephalic artery is ONLY on the ___________ (R/L/B) side, but the brachiocephalic vein is on ________________ (R/L/B) sides
RIGHT
BOTH
Where does the superior vena cava enter?
The right atria of the heart
What does the inferior vena cava do?
Drains lower limbs and abdomen
Where does the inferior vena cava pass through to enter where in the heart?
PASS THROUGH DIAPHRAGM
ENTERS RIGHT ATRIA OF HEART
What is the function of the azygous system?
Drains the thoracic wall
What is the right side of the azygous system?
AZYGOUS VEIN
The azygous vein is formed by what?
- Right ascending lumbar vein on the posterior abdominal wall
- Right intercostal veins
What is the left side of the azygous system?
HEMIAZYGOUS VEINS
Where does the azygous vein empty into?
The superior vena cava
Comes up right side (next to esophagus)
What does the vagus nerve do before it enter the diaphragm/abdominal region?
Forms a plexus
What is the hemiazygous veins formed by?
- Left ascending lumbar vein on posterior abdominal wall
- Left intercostal veins
The HEMIAZYGOUS VEIN crosses the __________ at about ______ to drain into the ____________.
MIDLINE
T8
AZYGOUS VEIN
What does the thoracic duct (lymph) arise from?
Cisterna chyli in the abdomen
What does the thoracic duct drain into?
JUNCTION between the:
1. Left internal jugular vein
2. Left subclavian vein
Is the thoracic duct thick or thin?
THIN AND FRAGILE
All lymph nodes in the thorax drain where?
Into the THORACIC DUCT
Where are lymph nodes in the thorax found?
- descending trachea
- esophagus
- vertebral column
- primary drainage to thoracic duct
What are the nerves of the thorax?
- Intercostal nerves
- Sympathetic trunks
- Splanchnic nerves
- Phrenic nerve
- Vagus nerve
Intercostal nerves are what type of nerves?
MIXED
Where will you find intercostal nerves?
ventral (anterior) primary rami of T1-T12
Where will you find the sympathetic trunks?
Parallel to vertebral column
Where pre-gang sympathetic fibers synapse
On either side of vertebral column
How many white rami communicates do we have and where?
14
T1-L2
from spinal nerve to ganglia
How many gray rami communicates do we have and where?
31
from ganglia to spinal nerves
What are splanchnic nerves?
Preganglionic sympathetic fibers
What is special about splanchnic nerves?
do not synapse in chain ganglia
pass into abdomen and synapse in ganglia on surface of abdominal aorta
Where is the phrenic nerve from?
ventral (anterior) primary rami C3-C5
SPINAL NERVES C3-C5
What is the functional component of the phrenic nerve?
GSE AND GSA
The vagus nerve branches into what?
- recurrent (inferior) laryngeal nerves
- esophageal plexus
On the right side, the vagus nerve goes where?
LOOPS UNDER THE RIGHT SUBCLAVIAN ARTERY
On the left side, where does the vagus nerve go?
LOOPS UNDER ARCH OF AORTA BEHIND LIGAMENTUM ARTERIOSUM
Both the left and right side of the vagus nerve ascends alongside what?
Trachea to larynx