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OS 205 > Mediastinum > Flashcards

Mediastinum Flashcards

0
Q

Three divisions of the thoracic cavity

A

Right and left pulmonary cavity, and mediastinum

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1
Q

It is the central compartment of the thoracic cavity

A

Mediastinum

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2
Q

Tissue that unites the visceral structures of the mediastinum?

A

Loose connective tissue, fat

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3
Q

Superior border of mediastinum?

A

Superior thoracic aperture

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4
Q

Inferior border of mediastinum?

A

Diaphragm

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5
Q

Anterior border of mediastinum

A

Sternum and costal cartilages

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6
Q

Posterior border of mediastinum?

A

Bodies of thoracic vertebrae

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7
Q

Boundaries of the thoracic inlet?

A

Manubrium, 1st rib, anterior surface of body of T1

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8
Q

Effect of an enlargement in the mediastinum on the surrounding structures?

A

It pushes on the other surrounding structures

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9
Q

Procedure which allows surgeons to view or biopsy mediastinal lymph nodes?

A

Mediastinoscopy

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10
Q

Where is the endoscope inserted when you want to perform mediastinoscopy?

A

Through root of the neck, superior to jugular notch

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11
Q

List three possible causes of mediastinum widening

A

Head on trauma
Malignant lymphoma
Hypertrophy of heart due to congestive heart failure

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12
Q

The portion of interpleural space which lies behind the manubrium and anterior to the upper 4 thoracic vertebrae?

A

Superior mediastinum

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13
Q

Superior boundary of superior mediastinum?

A

Superior thoracic aperture (trans)

Oblique plane of 1st rib (SIM)

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14
Q

Inferior boundary of superior mediastinum?

A

Transverse thoracic plane (trans)

Horizontal plane through sternal angle (SIM)

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15
Q

The plane that passes through the angle of Louis passes through the IV disc between which vertebrae?

A

T4-T5 (trans and moore)

T3-T4 (SIM)

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16
Q

Lateral border of the superior mediastinum?

A

Mediastinal pleura (parietal pleura)

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17
Q

Anterior border of the superior mediastinum?

A

Manubrium of sternum

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18
Q

Posterior border of superior mediastinum

A

T1-T4

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19
Q

Muscles in the superior mediastinum?

A

Origin of sternohyoid and sternothyroid

Lower end of longus colli

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20
Q

Primary lymphoid organ important in thr development and maintenance of immune system located in the inferior neck and anterior superior mediastinum?

A

Thymus gland

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21
Q

Structure anterior to the thymus?

A

Manubrium

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22
Q

Structure posterior to the thymus

A

Fibrous pericardium

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23
Q

In what stage of life does the thymus gland diminish in size?

A

After puberty

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24
Q

The thymus gland is largely replaced by what after puberty?

A

Fat

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25
Q

Arterial supply of the superior mediastinum?

A

Anterior intercostal artery

Anterior mediastinal branches of internal thoracic arteries

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26
Q

Venous drainage of the superior mediastinum?

A

Left brachiocephalic vein
Internal thoracic vein
Inferior thyroid vein

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27
Q

Lymphatic drainage of the superior mediastinum?

A

Parasternal lymph nodes
Brachiocephalic lymph nodes
Tracheobronchial lymph nodes

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28
Q

Great vessel formed from the union of the internal jugular vein and subclavian vein

A

Brachiocephalic vein

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29
Q

Which brachiocephalic vein is longer? Left or right?

A

Left (by more than 2x)

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30
Q

Where does the thoracic duct enter the venous system?

A

Union of left internal jugular vein and left subclavian vein

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31
Q

The brachiocephalic veins are found behind what joint?

A

Sternoclavicular joint

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32
Q

Great vessel formed by the union of left and right brachiocephalic veins?

A

Superior vena cava

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33
Q

The superior vena cava is located in the left or right parasternal border?

A

Right

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34
Q

The superior vena cava begins at the level of which costal cartilage? Ends at what level?

A

Begins at 1st, ends at 3rd

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35
Q

Heart chamber where superior vena cava leads into?

A

Right atrium

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36
Q

The superior vena cava is _____ to the trachea? (Anatomic direction)

A

Anterolateral

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37
Q

The superior vena cava is _____ to the ascending aorta? (Anatomic direction)

A

Posterolateral

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38
Q

This nerve is between the superior vena cava and the mediastinal pleura?

A

Right phrenic nerve

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39
Q

The ascending aorta is located in what area of the mediastinum

A

Inferior mediastinum

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40
Q

The ascending aorta begins in this structure

A

Aortic orifice

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41
Q

The only branches of the ascending aorta

A

Coronary arteries

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42
Q

Curved continuation of the ascending aorta?

A

Arch of the aorta

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43
Q

Three branches of the arch of the aorta

A

Brachiocephalic artery, left common carotid artery, left subclavian artery

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44
Q

Beginning of the course of the arch of the aorta?

A

Sternal angle of louis, t4

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45
Q

The arch of the aorta ascends anterior to which other blood vessel?

A

Right pulmonary artery

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46
Q

Trace the course of the arch of the aorta from anterior to the tracheal bifurcation?

A

Arches superoposteriorly, then to the left, then inferiorly

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47
Q

Where is the apex of the arch of the aorta located?

A

Left side of trachea and esophagus

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48
Q

The descending portion of the arch passes posterior to the root of which lung?

A

Left

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49
Q

The arch of the aorta continues onward as what vessel at the level of the 2nd sternocostal joint

A

Thoracic aorta

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50
Q

Which vessel occupies the corresponding position of the arch of the aorta on the right side?

A

Arch of azygos vein

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51
Q

Structure that passes from root of left pulmonary artery to inferior surface of arch of aorta

A

Ligamentum arteriosum

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52
Q

The ligamentum arteriosum is a remnant of this fetal structure

A

Ductus arteriosus

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53
Q

Ligation of ligamentum arteriosum can lead to this

A

Voice hoarseness

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54
Q

Largest branch of the aortic arch

A

Brachiocephalic trunk

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55
Q

Structures anterior to brachiocephalic trunk

A

Manubrium, left brachiocephalic vein

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56
Q

Structure posterior to brachiocephalic trunk

A

Trachea

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57
Q

Direction of the course of the brachiocepalic trunk?

A

Superolaterally

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58
Q

Brachiocephalic trunk enters neck behind this structure?

A

Sternoclavicular joint

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59
Q

2nd branch of the aortic arch

A

Left common carotid artery

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60
Q

3rd branch of the aortic arch

A

Left subclavian artery

61
Q

The left common carotid artery is slightly posterior and to the left of this artery?

A

Brachiocephalic trunk

62
Q

Relationship of trachea and left common carotid

A

Left common carotid is first anterior to trachea, then gains left side

63
Q

The left common carotid artery enters the neck posterior to which structure?

A

Left sternoclavicular joint

64
Q

Branch of aortic arch with no branches in superior mediastinum

A

Left subclavian artery

65
Q

Relationship of left subclavian artery to left common carotid artery

A

Left subclavian is posterior and lateral to common carotid

66
Q

Relationship of left subclavian and trachea

A

Left subclavian is lateral to trachea

67
Q

The left subclavian artery enters root of neck posterior to which structure?

A

Left sternoclavicular joint

68
Q

Entrance of the vagus nerves in the superior mediastinum

A

Posterior to sternoclavicular joint and brachiocephalic vein

69
Q

The right vagus nerve gives off what branch anterior to the right subclavian artery?

A

Right recurrent laryngeal nerve

70
Q

Where does the right vagus nerve break up to contribute to the right pulmonary plexus?

A

Posterior to the right brachiocephalic vein, superior vena cava, and root of right lung

71
Q

Where does the left vagus nerve enter the superior mediastinum?

A

Between left common carotid artery and left subclavian artery

72
Q

When the left vagus nerve reaches the aortic arch, the left vagus nerve diverges posteriorly from what nerve?

A

Left phrenic nerve

73
Q

Where does the left vagus nerve give off the left recurrent laryngeal nerve?

A

Inferior border of the aortic arch

74
Q

The groove where the recurrent laryngeal nerves ascend to the larynx

A

Tracheoesophageal groove

75
Q

Structures which is motor innervated by phrenic nerve

A

Diaphragm

76
Q

Structures sensory innervated by phrenic nerve

A

Diaphragm, pericardium, mediastinal pleura

77
Q

Where does the phrenic nerve enter the superior mediastinum?

A

Between subclavian artery and origin of brachiocephalic vein

78
Q

The phrenic nerve passes (anterior/posterior) to the roots of the lungs

A

Anterior

79
Q

The vagus nerves pass (anterior/posterior) to the root of the lungs?

A

Posterior

80
Q

Which phrenic nerve runs along the fibrous pericardium of the heart?

A

Left

81
Q

Where does the right phrenic nerve pierce the diaphragm

A

Near the caval opening

82
Q

Where does the left phrenic nerve pierce the diaphragm

A

Left of the pericardium

83
Q

It is formed by both sympathetic and parasympathetic nerve fibers en route to the heart

A

Cardiac plexus

85
Q

Location of the deep part of the cardiac plexus

A

Between aortic arch and bifurcation of trachea

86
Q

The fibers of the cardiac plexus are distributed to which parts of the heart?

A

Along coronary vessels and components of heart conducting system

87
Q

Which is more posterior? Esophagus or trachea

A

Esophagus

88
Q

Which is more anterior? Esophagus or trachea

A

Trachea

89
Q

The trachea inclines a little to which side of the median plane?

A

Right

90
Q

On what level does the trachea divide into right and left main bronchi?

A

Level of the sternal angle of louis

91
Q

Fibromuscular tube which extends from pharynx to stomach

A

Esophagus

92
Q

Location of the superficial part of the cardiac plexus

A

Beneath the arch of aorta, in front of pulmonary artery

93
Q

The esophagus generally inclines to which side? Left or right?

A

Left

94
Q

The esophagus is usually flattened in what direction?

A

Anteroposteriorly

95
Q

The esophagus is compressed anteriorly by which structure?

A

Root of left lung

96
Q

The esophagus passes through the diaphragm in which structure?

A

Esophageal hiatus

97
Q

Smallest subdivision of mediastinum

A

Anterior mediastinum

98
Q

Anterior border of anterior mediastinum?

A

Body of sternum and transverse thoracic muscles

99
Q

Posterior border of anterior mediastinum

A

Pericardium

100
Q

Superior border of anterior mediastinum

A

Transverse thoracic plane

101
Q

Inferior border of anterior mediastinum

A

Diaphragm

102
Q

Anterior border of posterior mediastinum

A

Pericardium and part of diaphragm

103
Q

Posterior border of posterior mediastinum

A

Anterior surface of body of T5 to T12

104
Q

Superior border of posterior mediastinum

A

Transverse thoracic plane

105
Q

Inferior border of posterior mediastinum

A

Diaphragm

106
Q

Lateral border of posterior mediastinum

A

Parietal pleura

107
Q

Continuation of the arch of the aorta

A

Thoracic aorta

108
Q

Nerve network surrounding the thoracic aorta

A

Thoracic aortic plexus

109
Q

The thoracic aorta descends on the levels of which thoracic vertebrae

A

Inferior of T4 to T12

110
Q

The thoracic aorta enters the diaphragm through what structure?

A

Aortic hiatus

111
Q

The other two vessels accompanying the thoracic aorta in the aortic hiatus

A

Thoracic duct snd azygos vein

112
Q

Anteromedial unpaired branches of the thoracic aorta

A

Esophageal arteries

113
Q

Lateral paired visceral branches of the thoracic aorta

A

Bronchial artery

114
Q

Posterolateral paired segmental parietal branches of the thoracic aorta

A

Posterior intercostal and subcostal artery

115
Q

Only part of the alimentary canal without a serosa

A

Esophagus

116
Q

The esophagus passes through which side of the aorta

A

Posterior and to the right

117
Q

The esophageal hiatus is at the level of which thoracic vertebra?

A

T10

118
Q

The constrictions of the esophagus are caused by compressive forces by which structures?

A

Arch of aorta
Left main bronchus
Diaphragm

119
Q

Largest lymphatic channel in the body

A

Thoracic duct

120
Q

The thoracic duct originates from which structure in the abdomen

A

Chyle cistern

121
Q

Structure to the left of the thoracic duct in the posterior mediastinum?

A

Thoracic aorta

122
Q

Structure to the right of the thoracic duct in the posterior mediastinum?

A

Azygos vein

123
Q

Structure to the anterior of the thoracic duct in the posterior mediastinum?

A

Esophagus

124
Q

Clinical condition where lymph and chyle enter pleural cavity

A

Chylothorax

125
Q

Large vein running paravertebrally anterior to the thoracic vertebra

A

Azygos vein

126
Q

The azygos vein forms a collateral pathway between what vessels?

A

Superior and inferior vena cava

127
Q

Vein which arises on the left side by junction of left subcostal and ascending lumbar veins

A

Hemiazygos vein

128
Q

The sympathetic trunks and associated ganglia lie against which structures in the superior, middle, and inferior thorax?

A

S - head of rib
M - costovertebral joints
I - vertebral body

129
Q

Anterior branches of the sympathetic trunk on each side of the vertebra

A

Splanchnic nerves

130
Q

Fibroserous membrane that covers the heart and the beginning of its great vessels

A

Pericardium

131
Q

Tough external layer of pericardium

A

Fibrous pericardium

132
Q

Site of continuity of pericardium and central tendon of diaphragm

A

Pericardiacophrenic ligament

133
Q

Fibrous pericardium continues superiorly with what structures?

A

Tunica adventitia of great vessels and pretracheal layer of deep cervical fascia

134
Q

Attachment of sternum to pericardium

A

Sternopericardial ligament

135
Q

Function of the fibrous pericardium

A

Tethers heart in place and protect heart against overfilling

136
Q

Layer of pericardium composed mainly of mesothelium

A

Serous pericardium

137
Q

Layer of serous pericardium fused to the fibrous pericardium

A

Parietal layer

138
Q

Layer of serous pericardium which makes up the epicardium

A

Visceral layer

139
Q

Space between parietal and visceral layer

A

Pericardial cavity

140
Q

Most external of 3 layers of heart wall

A

Epicardium

141
Q

Function of the fluid in pericardial cavity

A

Contains fluid which enable heart to move and beat in frictionless environment

142
Q

Transversely running passage in the pericardial sac between the origins of the afferent and efferent great vessels

A

Transverse pericardial sinus

143
Q

Vessels anterior to the transverse pericardial sinus

A

Pulmonary trunk and ascending aorta

144
Q

Vessels posterior to the transverse pericardial sinus

A

Superior vena cava

145
Q

A wide pocket like recess in the pericardial cavity posterior to the base of the heart

A

Oblique pericardial sinus

146
Q

Several fingers can be inserted in which side of the oblique pericardial sinus

A

Inferior side

147
Q

Lateral boundary of oblique pericardial sinus

A

Pulmonary veins and inferior vena cava

148
Q

Main Arterial supply of pericardium

A

Pericardiacophrenic artery

149
Q

Main Venous drainage of pericardium

A

Pericardiophrenic veins

150
Q

Sensory innervation of pericardium

A

Phrenic nerve

151
Q

Vasomotor innervation of pericardium

A

Sympathetic trunk

152
Q

Function of vagus nerve innervation of pericardium

A

Unknown

OS 205 (4 decks)

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