Mediastinum Flashcards

1
Q

Boundaries

A

Pulmonary cavity, sternum and vertebral column

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2
Q

Mediastinal changes

A

Widen with tumors, effusions
Narrow with lung masses, pleural effusionsI

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3
Q

Inferior mediastinum

A

Anterior - contains fat, vessels, remnants of thymus
Middle - contains heart, great vessels, arch of azygos, phrenic n, main bronchi
Posterior

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4
Q

Heart coverings

A

Fibrous pericardium, serous pericardium

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5
Q

Serous pericardium

A

Parietal, visceral
Separated by sinuses

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6
Q

Visceral pericardium

A

Endo - mto - endo

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7
Q

Transverse sinus

A

Between aorta/pulm trunk and SVC/IVC

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8
Q

Oblique sinus

A

Behind left atrium, allows It expand

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9
Q

Beck’s triad

A

Cardiac tamponade - due to blood accumulation in pericardium
Hypotension, jugular v. distension, muffled heart sounds

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10
Q

Pericarditis

A

Inflammation of pericardium
Friction rub
Nerve that radiates pain is phrenic

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11
Q

Pericardial effusion

A

Fluid in pericardium

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12
Q

Hemopericardium

A

Blood in pericardium

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13
Q

Pericardiocentesis

A

Remove fluid in pericardial effusion and hemopericardium, in left 5th or 6th ICS, infrasternally or laterally

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14
Q

Arterial supply of pericardium

A

Pericardiacophrenic artery
Cononary arteries (on visceral pericardium)

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15
Q

Venous supply of pericardium

A

Pericardiacophrenic veins
Azygous veins

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16
Q

Innervation of pericardium

A

Sensory - phrenic n.
Sympathetic - cardiopulmonary splanchnic n. (T1-T4)
Parasympathetic - vagus nerve

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17
Q

Superior mediastinum

A

Above sternal angle
Contains brachiocephalic veins, SVC, azygos, arch of aorta, brachiocephalic trunk, cc and subclavian, thymus, thoracic duct, trachea, esophagus, vagus and phrenic n

18
Q

Thymus

A

Lymphoid organ
2 lobes
Involutes after puberty
Thymoma = tumor

19
Q

Left brachiocephalic vein

A

Longer and runs diagonally over aortic arch
Unites with right at 1st costal cartilage - svc

20
Q

Azygos arch

A

Loops superiorly around root of right lung, empties into SVC

21
Q

SVCS

A

Obstruction of SVC, swelling in face, neck, upper body, arms, SOB

22
Q

Arch of aorta

A

Begins and ends over sternal angle
ABCS
Arch, brachiocephalic trunk, cc, subclavian

23
Q

Coarctation of aorta

A

Narrowing stenosis, often near ligaments arteriosum

Brachial artery pressure increased, femoral pressure decreased, femoral pulses delayed

24
Q

Aortic arch aneurysm

A

Left recurrent laryngeal nerve stretches, hoarseness

25
Q

Phrenic nerve

A

Anterior to root of lung

26
Q

Vagus nerve

A

Posterior to root of lung, gives off recurrent laryngeal

27
Q

Left recurrent laryngeal

A

Loops under arch of aorta/ligamentum arteriosum
Between esophagus and trachea

28
Q

Right recurrent laryngeal

A

Hook under subclavian artery

29
Q

Ligamentum arteriosum

A

Connects aorta to left pulmonary artery

30
Q

Trachea

A

Begins at C6, cricoid cartilage
Bifurcates at sternal angle
Lies more right

31
Q

Esophagus

A

Fibromascular tube
Posterior to trachea
Lies more to the left
Narrows at aortic arch and esophageal hiatus

32
Q

Descending thoracic aorta

A

T4 down
Gives off esophageal, pericardial, bronchial, posterior intercostal and subcostal a

33
Q

Chylothorax

A

Accumulation of lymph from lymph escaping vulnerable thoracic duct
Differentiate from effusion by testing triglycerides

34
Q

Virchow’s node

A

Enlarged lymph node in supraclavicular fossa
Associated with testicular, GI, gastric cancer metastasis

35
Q

Accessory hemiazygous

A

T5-T8
Left, crosses to right side

36
Q

Hemiazygous

A

T9-T11
Left, crosses to right side

37
Q

Azygous drainage

A

T1 drains into brachiocephalic vein
T2-T4 drain into left superior intercostalS vein

38
Q

SVC obstruction

A

Collateral circulation helps

39
Q

Thoracic duct

A

Between azygos and esophagus

40
Q

Sternal angle

A

T4/T5

Arch of aorta
Arch of azygos vein
Superior lobe of the right lung
Superior vena cava