Mediastinum Flashcards

1
Q

Mediastinum Definition

A

space btw the two pleural sacs

contains all structures of thorax except for lungs and pleura

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2
Q

Superior Border

A

Thoracic Inlet

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3
Q

Inferior Border

A

Diaphragm

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4
Q

Anterior Border

A

Sternum and Costal Cartilages

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5
Q

Posterior Border

A

Thoracic Vertebrae

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6
Q

Division

A

Superior - all above sternal angle

Inferior - all below sternal angle

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7
Q

Inferior is divided into…

A

Anterior
Middle
Posterior

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8
Q

Superior Division Borders

A

Superior to sternal angle

Level of T4-T5

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9
Q

Structures in Superior Division

A
Thymus
Brachiocephalic Veins
SVC
Aortic arch and branches
Vagus
Left recurrent laryngeal nerve
Phrenic
Trachea
Thoracic Duct
Esophagus
Sympathetic Chain
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10
Q

Thymus

A

Superior mediastinum
Infancy and chilhood is posterior to manubrium
Adulthood it is mainly adipose tissue, only 10% is functioning

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11
Q

Brachiocephalic Veins

A

Superior Mediastinum
Form from union of internal jugular veins with subclavian
Left is twice as long as right

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12
Q

Branches from Aortic Arch

A

superior mediastinum
Brachiocephalic artery
Left CC
Left Subclavian

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13
Q

Inferior mediastinum Border

A

Inferior to sternal angle

T4-T5 through T12 vertebrae

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14
Q

Anterior Mediastinum Borders

A
Anteriorly = sternum and transversus thoracis
Posteriorly = pericardium
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15
Q

Anterior Mediastinum Structures

A
Remains of thymus
Loose CT
Fat
Lymph nodes
Vessels
Branches of internal thoracic artery
Sternopericardial ligament
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16
Q

Middle Mediastinal Borders

A

Anteriorly - body of sternum, 2nd-6th costal cartilages

Posteriorly - 5th-8th thoracic vertebrae

17
Q

Middle Mediastinal Structures

A
Heart
Pericardium
Phrenic 
Primary bronchi
Origins of great vessels
Nerves
Lymphatics
18
Q

What are the great vessels in middle mediastinum

A

Superior and Inferior Vena Cava
Ascending Aorta
Pulmonary Arteries and Veins

19
Q

Lymphatics - Middle Mediastinum

A

Subepicardial lymph nodes
Lymph vessels - join to form single vessel
Drain into inferior tracheobronchial lymph nodes

20
Q

Posterior Mediastinum Borders

A

Anteriorly - pericardium and diaphragm

Posteriorly - T5 to T12 vertebrae

21
Q

Posterior Mediastinum Structures

A
Thoracic Aorta 
Thoracic Duct
Azygos System
Esophagus
Nerves 
Lymphatics
22
Q

Thoracic Aorta Branches - Posterior

A

Bronchial - 1 R, 2L
Esophageal - usually 2 branches
Mediastinal - to lymph nodes and other tissues
Pericardial - to pericardium
Posterior intercostals - 3rd - 11th spaces
Subcostal - under 12 rib
Superior phrenic - last branch, superior surface of diaphragm

23
Q

Thoracic Duct - Posterior

A

Cisterna chyli - expanded end of duct at 12th vertebrae
Passes through aortic hiatus
Duck btw two gooses (esophagus and azygos)
Ascends on right side, crosses over btw T4-T6
Empties into union of left internal jugular vein and left subclavian vein

24
Q

Azygos system - Posterior

A

Connects inferior cava to superior vena cava

25
Q

Azygos Vein - P

A

Drains right side of thoracic and abdominal wall
Union of right subcostal and right ascending lumbar vein
Ascends posterior thoracic wall within post mediastinum
Arches over root of right lung into SVC

26
Q

Hemiazygos Vein - P

A

Union of left subcostal and left ascending lumbar vein
Drains left 9th-11th IC spaces
Ascends to cross over to azygos at T9

27
Q

Accessory Hemiazygos Vein - P

A

Descends the left side of thoracic vertebral column
Drains left 4th-8th IC spaces
Crosses over to azygos at T7 or T8

28
Q

Right and Left Superior Intercostal Veins - P

A

Right - drains into Azygos

Left - drains into left brachiocephalic vein

29
Q

Esophagus - P

A

Aortic Constriction
Bronchial Constriction
Diaphragmatic Constriction

30
Q

Nerves - P

A

Esophageal Plexus - Vagus
Aortic Plexus - Autonomic Nerves
Thoracic Splanchnic Nerves - Greater, Lesser, Least

31
Q

Greater Splanchnic - P

A

Via sympathetic chain ganglia T5-T9

32
Q

Lesser Splanchnic - P

A

Via sympathetic chain ganglia T10 - T11

33
Q

Least Splanchnic - P

A

Via sympathetic chain ganglia T12

34
Q

Lymphatics - P

A

Posterior mediastinal lymph nodes
Intercostal lymph nodes
Diaphragmatic lymph nodes