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ANAT 214 > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

Describe borders of sup mediastinum

A

Neck to thorax, continuous with neck
Sup = rib 1, t1 to jugular notch
Inf = sternal angle plane ~t4
Post = t1-t4 vertebrae
Ant = manubrium
Lat = mediastinal surface of lungs

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2
Q

Describe content of sup mediastinum = organs

A

Esophagus
Trachea
Thymus (technically belongs to ant mediastinum but can extend to sup)

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3
Q

Describe content of sup mediastinum = vessels

A

Aortic arch (bends and becomes thoracic aorta) and its first 3 branches
Left and right brachiocephalic veins
Svc
Arch of azygous
Pericardiophrenics (off internal thoracic artery)
Roots of great vessels

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4
Q

Describe brachiocephalic veins - sup mediastinum

A

Receive from internal jugular and subclavian (int jug in neck)
Forms svc when left and right brachiocephalics meet

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5
Q

Describe branches of aorta

A

After coronary arteries =
1. Brachiocephalic trunk (= common trunk of right common carotid and subclavian)
2. Left carotid artery
3. Left subclavian artery (towards arm)
ALL 3 go out through thoracic inlet

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6
Q

Describe content of sup mediastinum = lymphatics

A

Thoracic duct
Drains 3/4 of lymphatics of body
Back into venous system
Attaches where subclavian ,meets int jug

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7
Q

Describe content of sup mediastinum = nerves

A

Left and right vagus, left recurrent laryngeal (right = outside sup mediastinum)
Left and right phrenics, sympathetic chain (towards back)
Cardiac and pulmonary plexuses (psns and sns branches = sympathetic chain and vagus)

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8
Q

Describe what happens to vagus nerves in sup mediastinum

A

Runs in the neck and into superior thoracic aperture
Gives rise to psns nerves contributing to cardiac and pulmonary plexuses
Gives rise to recurrent laryngeal nerves (only left one in sup mediastinum)

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9
Q

Describe what happens to vagus nerves in sup mediastinum = recurrent branches

A

Right = loops under right subclavian or sometimes brachiocephalic trunk (outside mediastinum)
Left = loops under aortic arch, posterior (just behind) ligamentum arteriosum in sup mediastinum

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10
Q

What can lead to hoarseness

A

Recurrent laryngeal nerves are motor to most laryngeal muscles (phonation)- impingement of the nerves (like under aortic arch, vessels can pinch) = leads to hoarseness = raspy scratchy voice or dysphonia

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11
Q

Describe borders of anterior mediastinum

A

In front of middle but behind sternum
Sup = sternal angle
Inf = diaphragm
Post = pericardium - mid mediastinum
Ant = sternum
Lat = mediastinal surface of lungs

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12
Q

What is anterior mediastinum occupied by

A

Thymus Gland = lymphoid organ responsible for differentiation of T cells (lymphocytes), school for T cells to be educated, only for dev
Also lymph nodes, fat and ct

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13
Q

Describe thymus

A

Involved in immune system development so relatively larger in children/youth and will degenerate
Remainder of thymus = thymus fat, extends into sup mediastinum= fibrofatty tissue

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14
Q

Describe borders of middle mediastinum

A

Sup = sternal angle
Inf = diaphragm
Post = posterior surface of fibrous pericardium
Ant = anterior surface of fibrous pericardium
Lat = mediastinal surface of lungs

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15
Q

Describe important parts of middle mediastinum

A

Heart, roots of great vessels, nv (inside pericardium and outside), primary bronchi
Right and left pulmonary arteries
Right and left pulmonary veins = 4, root with coronary arteries emerging
Svc and ivc

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16
Q

Describe borders of posterior mediastinum

A

Top of thoracic and neck to abdomen
Sup = sternal angle
Inf = diaphragm
Post = vertebrae t5-t12
Ant = fibrous pericardium
Lat = mediastinal surface of lungs

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17
Q

Describe posterior and superior mediastinum

A

Post communicates freely with superior mediastinum = several structures continuous between the 2 =
Sympathetic chain, esophagus, nerves, aorta (arch +thoracic), azygous (arch and vein, hemi azygous vein, left only behind aorta), thoracic duct
Splanchnic nerves
Esophageal plexus

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18
Q

Describe azygous and hemi azygous veins

A

drain posterior thoracic (intercostal veins) and abdominal walls but azygous also offers a collateral passage for venous blood to bypass blockages in vena Cavan = cavo-caval anastomoses (ivc to svc) = another way for venous blood to make it back to heart

19
Q

Describe azygous vein specifically

A

Unpaired
Starts in abdomen
On right
Hooks on hilum and drains into svc

20
Q

Describe hemi azygous vein specifically

A

Left side but jumps over vertebrae and drains into azygous first

21
Q

What is thoracic duct

A

Main collecting duct
Drains 3/4ths of body lymph, rest= drained by right lymphatic duct

22
Q

Where does thoracic duct drain

A

Both into brachiocephalic veins At venous angles = right and left
Where int jug and subclavian meet to form brachiocephalic

23
Q

Describe thoracic aorta - descending

A

Thoracic portion of aorta = gives rise to posterior intercostal arteries from rib 3 to 12
(10 pairs, last = subcostal)
Anastomose with anterior counter parts from internal thoracic arteries

24
Q

What can we find in posterior thoracic wall

A

Neurovascular bundle = posterior intercostal arteries (from aorta), posterior intercostal veins (to azygous/hemi azygous), intercostal nerves (passing into space between innermost and internal intercostal muscles)

25
Q

Can we see thoracic aorta branches in post mediastinum

A

Nahhhhh
Since passsing behind azygous, behind esophagus

26
Q

Describe esophagus generally

A

Muscular tube that connects pharynx to stomach
Runs through superior and posterior mediastinum

27
Q

Describe esophagus in posterior mediastinum

A

First to right of thoracic aorta but moves anteriorly to it as it passed inferiority through diaphragm

28
Q

Describe esophageal hiatus

A

Anterior to aortic hiatus (against vertebral Column)

29
Q

Describe vagus nerve as enters post mediastinum

A

In sup = vagus gave psns Fibers to cardiac and pulmonary plexuses —> now as enter post= vagus nerves pass posteriorly to hilum of lungs, lateral to eso

30
Q

What does larp mean

A

Left vagus = anterior vagal trunk
Right vagus = posterior vagal trunk (bind eso, for plexus)

31
Q

Describe esophageal plexus

A

Vagal trunks send branches to each other and join with branches from sympathetic chain to form esophageal plexus = ans innervation to esophageal smoooth muscle - peristalsis

32
Q

Where do vagal trunks go

A

Continue through diaphragm with esophageal to provide psns innervation to abdomen- gi tract

33
Q

Describe sympathetic chain

A

Bilateral ganglionated chain that runs from base of skull to coccyx, on either side, transmitting sympathetic info to be distributed broadly

34
Q

Describe sympathetic chain in posterior mediastinum

A

Located on either side of vertebral bodies, anterior to costovertebral joint, in close association with spinal nerves from same level

35
Q

Describe sympathetic system = ans

A

Psns and ans efferent signals relayed via 2 neurons = pre and post ganglionic neuron, synapse somewhere in body

36
Q

Describe sympathetic system = psns

A

Synapses tend to be close to target organs

37
Q

Describe sympathetic system - sns

A

Synapses occur in ganglia further from target organs
Has broad distribution to periphery =skin, sweat glands and to viscera (no psns in skin)
Pathways and synapses of pre and post ganglionic neurons depends on target organs

38
Q

Describe sympathetic innervation for thoracic and cervical viscera

A

Preganglionic Fibers travel in sympathetic chain to same or different spinal levels, synapse in ganglia and then post ganglionic Fibers emerge and join to form named sympathetic nerves to their organs (cardiac nerves, pulmonary nerves)
Paravertebral ganglia

39
Q

Describe sympathetic in certain for abdominopelvic viscera

A

Preganglionic Fibers pass through sympathetic chain w/o synapse, join Fibers from other levels to form splanchnic nerves
Synapse occurs instead in ganglia situated in front of the abdominal aorta = 3 splanchnics
Prevertebral ganglia

40
Q

Where are plexuses located

A

Psns and sns = plexuses near organs they control (cardiac, pulmonary and esophageal)

41
Q

How many splanchnic nerves

A

3

42
Q

Describe the 3 thoracic splanchnic nerves- gen

A

Visible running from sympathetic chain obliquely from posterior/superior to anterior/inferior
Pass through diaphragm to enter abdominal cavity = little splits, where their Preganglionic Fibers will synapse in several ganglia on the aorta (prevertebral ganglia), brining sns innervation to abdominopelvic viscera

43
Q

Name and describe the thoracic splanchnic nerve s

A

Greater= usually only see this one, colllects from t5-9 (sympathetic Fibers from nerve)
Lesser = t11
Least = t12

44
Q

What are vagal trunks

A

Psns = along esophagus, has vagal trunks
Through esophageal hiatus, now will form mesh work of plexuses with sympathetic nerve Fibers

ANAT 214 (34 decks)

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