Mediastinum Flashcards
Passage of fluid from pericardial capillaries into the pericardial cavity
Pericardial effusion
The heart becomes compressed (unable to expand and fill fully) and ineffective
Chronically inflamed and thickened pericardium may actually calcify and hamper cardiac efficiency
Inflammation of the pericardium
Symptoms?
Pericarditis
Chest pain
Inadequacy of a heart (that fails to pump out blood) at the same rate that it receives it (maintaining blood circulation)
Congestive heart failure
The resulting friction from pericarditis which sounds like the rustle of silk when listening with a stethoscope is called?
Pericardial friction rub
Excess pericardial fluid does not allow the heart to expand fully, limiting the inflow of blood to the ventricles
TRUE or FALSE
The level of the viscera relative to the subdivisions of the mediastinum does not depend on the position of the person
False
Supine position: abdominal viscera push the mediastinal structures superiorly
Standing/erect: soft structures (pericardium and contents, heart and great vessels, abdominal viscera) sag inferiorly (GRAVITY)
What is the surgical significance of the transverse pericardial sinus?
STOP the circulation of blood-by passing a surgical clamp-placing and tightening a ligature-inserting tubes of a coronary bypass machine-placing a digit through the transverse sinus
What for? Cardiac surgery. Because patients are put on cardiopulmonary bypass.
What do you call the phenomenon when excess pericardial fluid does not allow the heart to expand fully because heart volume is increasingly compromised by fluid outside the heart but inside the pericardial cavity?
Hint 1: Stab wounds could lead to blood entering the pericardial cavity (hemopericardium)
Hint 2: Veins of the face and neck become engorged because of the backup of blood beginning at the SVC
Cardiac tamponade
Perforation of a weakened area of heart muscle following a heart attack is called?
Hint: Hemopericardium would lead to this
Myocardial infarction (MI)
This is done to relieve cardiac tamponade
Drainage of fluid from the pericardial cavity
Where is the wide-bore needle inserted?
Pericardiocentensis
Left 5th or 6th intercostal space near the sternum
How is this possible? “Bare area” of the pericardium – cardiac notch in the left lung, shallower notch in the left pleural sac
Pericardial sac is reached also by entering the infrasternal angle and passing the needle superoposteriorly
Danger: Puncturing the internal thoracic artery
Where is the pericardiophremic artery and vein?
Memory Aid: Peri-cardio-phrenic
Peri (around) Cardio (the heart) ~ pericardium
Which travels with the PHRENIC nerve to the diaphragm (parallel)
FYI: Medial to the INTERNAL THORACIC ARTERY (differemt branch)
Terminal branch of the internal thoracic artery
Musculophrenic artery (found near the diaphragm)
Primary source of sensory fibers of the pericardium
Pain sensations conveyed by this are referred to the skin of the ipsilateral supraclavicular region (top of shoulder on the same side)
Phrenic nerve
Function of sympathetic trunks?
Vasomotor
What type of lymphocyte does the thymus produce?
T
TRUE or FALSE
There is no right thoracic duct
True
