Mediastinum Flashcards
0
Q
Three divisions of the thoracic cavity
A
Right and left pulmonary cavity, and mediastinum
1
Q
It is the central compartment of the thoracic cavity
A
Mediastinum
2
Q
Tissue that unites the visceral structures of the mediastinum?
A
Loose connective tissue, fat
3
Q
Superior border of mediastinum?
A
Superior thoracic aperture
4
Q
Inferior border of mediastinum?
A
Diaphragm
5
Q
Anterior border of mediastinum
A
Sternum and costal cartilages
6
Q
Posterior border of mediastinum?
A
Bodies of thoracic vertebrae
7
Q
Boundaries of the thoracic inlet?
A
Manubrium, 1st rib, anterior surface of body of T1
8
Q
Effect of an enlargement in the mediastinum on the surrounding structures?
A
It pushes on the other surrounding structures
9
Q
Procedure which allows surgeons to view or biopsy mediastinal lymph nodes?
A
Mediastinoscopy
10
Q
Where is the endoscope inserted when you want to perform mediastinoscopy?
A
Through root of the neck, superior to jugular notch
11
Q
List three possible causes of mediastinum widening
A
Head on trauma
Malignant lymphoma
Hypertrophy of heart due to congestive heart failure
12
Q
The portion of interpleural space which lies behind the manubrium and anterior to the upper 4 thoracic vertebrae?
A
Superior mediastinum
13
Q
Superior boundary of superior mediastinum?
A
Superior thoracic aperture (trans)
Oblique plane of 1st rib (SIM)
14
Q
Inferior boundary of superior mediastinum?
A
Transverse thoracic plane (trans)
Horizontal plane through sternal angle (SIM)
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)
16
Q
Lateral border of the superior mediastinum?
A
Mediastinal pleura (parietal pleura)
17
Q
Anterior border of the superior mediastinum?
A
Manubrium of sternum
18
Q
Posterior border of superior mediastinum
A
T1-T4
19
Q
Muscles in the superior mediastinum?
A
Origin of sternohyoid and sternothyroid
Lower end of longus colli
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
21
Q
Structure anterior to the thymus?
A
Manubrium
22
Q
Structure posterior to the thymus
A
Fibrous pericardium
23
Q
In what stage of life does the thymus gland diminish in size?
A
After puberty
24
The thymus gland is largely replaced by what after puberty?
Fat
25
Arterial supply of the superior mediastinum?
Anterior intercostal artery
| Anterior mediastinal branches of internal thoracic arteries
26
Venous drainage of the superior mediastinum?
Left brachiocephalic vein
Internal thoracic vein
Inferior thyroid vein
27
Lymphatic drainage of the superior mediastinum?
Parasternal lymph nodes
Brachiocephalic lymph nodes
Tracheobronchial lymph nodes
28
Great vessel formed from the union of the internal jugular vein and subclavian vein
Brachiocephalic vein
29
Which brachiocephalic vein is longer? Left or right?
Left (by more than 2x)
30
Where does the thoracic duct enter the venous system?
Union of left internal jugular vein and left subclavian vein
31
The brachiocephalic veins are found behind what joint?
Sternoclavicular joint
32
Great vessel formed by the union of left and right brachiocephalic veins?
Superior vena cava
33
The superior vena cava is located in the left or right parasternal border?
Right
34
The superior vena cava begins at the level of which costal cartilage? Ends at what level?
Begins at 1st, ends at 3rd
35
Heart chamber where superior vena cava leads into?
Right atrium
36
The superior vena cava is _____ to the trachea? (Anatomic direction)
Anterolateral
37
The superior vena cava is _____ to the ascending aorta? (Anatomic direction)
Posterolateral
38
This nerve is between the superior vena cava and the mediastinal pleura?
Right phrenic nerve
39
The ascending aorta is located in what area of the mediastinum
Inferior mediastinum
40
The ascending aorta begins in this structure
Aortic orifice
41
The only branches of the ascending aorta
Coronary arteries
42
Curved continuation of the ascending aorta?
Arch of the aorta
43
Three branches of the arch of the aorta
Brachiocephalic artery, left common carotid artery, left subclavian artery
44
Beginning of the course of the arch of the aorta?
Sternal angle of louis, t4
45
The arch of the aorta ascends anterior to which other blood vessel?
Right pulmonary artery
46
Trace the course of the arch of the aorta from anterior to the tracheal bifurcation?
Arches superoposteriorly, then to the left, then inferiorly
47
Where is the apex of the arch of the aorta located?
Left side of trachea and esophagus
48
The descending portion of the arch passes posterior to the root of which lung?
Left
49
The arch of the aorta continues onward as what vessel at the level of the 2nd sternocostal joint
Thoracic aorta
50
Which vessel occupies the corresponding position of the arch of the aorta on the right side?
Arch of azygos vein
51
Structure that passes from root of left pulmonary artery to inferior surface of arch of aorta
Ligamentum arteriosum
52
The ligamentum arteriosum is a remnant of this fetal structure
Ductus arteriosus
53
Ligation of ligamentum arteriosum can lead to this
Voice hoarseness
54
Largest branch of the aortic arch
Brachiocephalic trunk
55
Structures anterior to brachiocephalic trunk
Manubrium, left brachiocephalic vein
56
Structure posterior to brachiocephalic trunk
Trachea
57
Direction of the course of the brachiocepalic trunk?
Superolaterally
58
Brachiocephalic trunk enters neck behind this structure?
Sternoclavicular joint
59
2nd branch of the aortic arch
Left common carotid artery
60
3rd branch of the aortic arch
Left subclavian artery
61
The left common carotid artery is slightly posterior and to the left of this artery?
Brachiocephalic trunk
62
Relationship of trachea and left common carotid
Left common carotid is first anterior to trachea, then gains left side
63
The left common carotid artery enters the neck posterior to which structure?
Left sternoclavicular joint
64
Branch of aortic arch with no branches in superior mediastinum
Left subclavian artery
65
Relationship of left subclavian artery to left common carotid artery
Left subclavian is posterior and lateral to common carotid
66
Relationship of left subclavian and trachea
Left subclavian is lateral to trachea
67
The left subclavian artery enters root of neck posterior to which structure?
Left sternoclavicular joint
68
Entrance of the vagus nerves in the superior mediastinum
Posterior to sternoclavicular joint and brachiocephalic vein
69
The right vagus nerve gives off what branch anterior to the right subclavian artery?
Right recurrent laryngeal nerve
70
Where does the right vagus nerve break up to contribute to the right pulmonary plexus?
Posterior to the right brachiocephalic vein, superior vena cava, and root of right lung
71
Where does the left vagus nerve enter the superior mediastinum?
Between left common carotid artery and left subclavian artery
72
When the left vagus nerve reaches the aortic arch, the left vagus nerve diverges posteriorly from what nerve?
Left phrenic nerve
73
Where does the left vagus nerve give off the left recurrent laryngeal nerve?
Inferior border of the aortic arch
74
The groove where the recurrent laryngeal nerves ascend to the larynx
Tracheoesophageal groove
75
Structures which is motor innervated by phrenic nerve
Diaphragm
76
Structures sensory innervated by phrenic nerve
Diaphragm, pericardium, mediastinal pleura
77
Where does the phrenic nerve enter the superior mediastinum?
Between subclavian artery and origin of brachiocephalic vein
78
The phrenic nerve passes (anterior/posterior) to the roots of the lungs
Anterior
79
The vagus nerves pass (anterior/posterior) to the root of the lungs?
Posterior
80
Which phrenic nerve runs along the fibrous pericardium of the heart?
Left
81
Where does the right phrenic nerve pierce the diaphragm
Near the caval opening
82
Where does the left phrenic nerve pierce the diaphragm
Left of the pericardium
83
It is formed by both sympathetic and parasympathetic nerve fibers en route to the heart
Cardiac plexus
85
Location of the deep part of the cardiac plexus
Between aortic arch and bifurcation of trachea
86
The fibers of the cardiac plexus are distributed to which parts of the heart?
Along coronary vessels and components of heart conducting system
87
Which is more posterior? Esophagus or trachea
Esophagus
88
Which is more anterior? Esophagus or trachea
Trachea
89
The trachea inclines a little to which side of the median plane?
Right
90
On what level does the trachea divide into right and left main bronchi?
Level of the sternal angle of louis
91
Fibromuscular tube which extends from pharynx to stomach
Esophagus
92
Location of the superficial part of the cardiac plexus
Beneath the arch of aorta, in front of pulmonary artery
93
The esophagus generally inclines to which side? Left or right?
Left
94
The esophagus is usually flattened in what direction?
Anteroposteriorly
95
The esophagus is compressed anteriorly by which structure?
Root of left lung
96
The esophagus passes through the diaphragm in which structure?
Esophageal hiatus
97
Smallest subdivision of mediastinum
Anterior mediastinum
98
Anterior border of anterior mediastinum?
Body of sternum and transverse thoracic muscles
99
Posterior border of anterior mediastinum
Pericardium
100
Superior border of anterior mediastinum
Transverse thoracic plane
101
Inferior border of anterior mediastinum
Diaphragm
102
Anterior border of posterior mediastinum
Pericardium and part of diaphragm
103
Posterior border of posterior mediastinum
Anterior surface of body of T5 to T12
104
Superior border of posterior mediastinum
Transverse thoracic plane
105
Inferior border of posterior mediastinum
Diaphragm
106
Lateral border of posterior mediastinum
Parietal pleura
107
Continuation of the arch of the aorta
Thoracic aorta
108
Nerve network surrounding the thoracic aorta
Thoracic aortic plexus
109
The thoracic aorta descends on the levels of which thoracic vertebrae
Inferior of T4 to T12
110
The thoracic aorta enters the diaphragm through what structure?
Aortic hiatus
111
The other two vessels accompanying the thoracic aorta in the aortic hiatus
Thoracic duct snd azygos vein
112
Anteromedial unpaired branches of the thoracic aorta
Esophageal arteries
113
Lateral paired visceral branches of the thoracic aorta
Bronchial artery
114
Posterolateral paired segmental parietal branches of the thoracic aorta
Posterior intercostal and subcostal artery
115
Only part of the alimentary canal without a serosa
Esophagus
116
The esophagus passes through which side of the aorta
Posterior and to the right
117
The esophageal hiatus is at the level of which thoracic vertebra?
T10
118
The constrictions of the esophagus are caused by compressive forces by which structures?
Arch of aorta
Left main bronchus
Diaphragm
119
Largest lymphatic channel in the body
Thoracic duct
120
The thoracic duct originates from which structure in the abdomen
Chyle cistern
121
Structure to the left of the thoracic duct in the posterior mediastinum?
Thoracic aorta
122
Structure to the right of the thoracic duct in the posterior mediastinum?
Azygos vein
123
Structure to the anterior of the thoracic duct in the posterior mediastinum?
Esophagus
124
Clinical condition where lymph and chyle enter pleural cavity
Chylothorax
125
Large vein running paravertebrally anterior to the thoracic vertebra
Azygos vein
126
The azygos vein forms a collateral pathway between what vessels?
Superior and inferior vena cava
127
Vein which arises on the left side by junction of left subcostal and ascending lumbar veins
Hemiazygos vein
128
The sympathetic trunks and associated ganglia lie against which structures in the superior, middle, and inferior thorax?
S - head of rib
M - costovertebral joints
I - vertebral body
129
Anterior branches of the sympathetic trunk on each side of the vertebra
Splanchnic nerves
130
Fibroserous membrane that covers the heart and the beginning of its great vessels
Pericardium
131
Tough external layer of pericardium
Fibrous pericardium
132
Site of continuity of pericardium and central tendon of diaphragm
Pericardiacophrenic ligament
133
Fibrous pericardium continues superiorly with what structures?
Tunica adventitia of great vessels and pretracheal layer of deep cervical fascia
134
Attachment of sternum to pericardium
Sternopericardial ligament
135
Function of the fibrous pericardium
Tethers heart in place and protect heart against overfilling
136
Layer of pericardium composed mainly of mesothelium
Serous pericardium
137
Layer of serous pericardium fused to the fibrous pericardium
Parietal layer
138
Layer of serous pericardium which makes up the epicardium
Visceral layer
139
Space between parietal and visceral layer
Pericardial cavity
140
Most external of 3 layers of heart wall
Epicardium
141
Function of the fluid in pericardial cavity
Contains fluid which enable heart to move and beat in frictionless environment
142
Transversely running passage in the pericardial sac between the origins of the afferent and efferent great vessels
Transverse pericardial sinus
143
Vessels anterior to the transverse pericardial sinus
Pulmonary trunk and ascending aorta
144
Vessels posterior to the transverse pericardial sinus
Superior vena cava
145
A wide pocket like recess in the pericardial cavity posterior to the base of the heart
Oblique pericardial sinus
146
Several fingers can be inserted in which side of the oblique pericardial sinus
Inferior side
147
Lateral boundary of oblique pericardial sinus
Pulmonary veins and inferior vena cava
148
Main Arterial supply of pericardium
Pericardiacophrenic artery
149
Main Venous drainage of pericardium
Pericardiophrenic veins
150
Sensory innervation of pericardium
Phrenic nerve
151
Vasomotor innervation of pericardium
Sympathetic trunk
152
Function of vagus nerve innervation of pericardium
Unknown
