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anatomy > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

What are the boundaries of the mediastinum?

A

superior: thoracic inlet and root of neck
inferior: diaphragm
anterior: sternum
posterior: vertebral column

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2
Q

What are the divisions of the mediastinum?

A

superior and inferior

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3
Q

what are the subdivisions of the inferior mediastinum?

A

middle: pericardium and heart
anterior: space between pericardium and sternum
posterior: space between pericardium and lower thoracic vertebrae

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4
Q

what are the boundaries of the superior mediastinum?

A

anterior: manubrium
posterior: first thoracic vertebrae
superior : root of the neck
inferior: is continuous with three compartments of inferior mediastinum

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5
Q

What are the contents of the superior mediastinum?6

A

the great vessels, trachea, esophagus, thoracic duct, vagus, phrenic nerves

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6
Q

What two veins joint to form the superior vena cava?

A

the right and left brachiocephalic vein

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7
Q

where is the right brachiocephalic vein formed?

A

at root of neck:

right subclavian and right internal jugular veing

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8
Q

where is left brachiocephalic vein formed

A

at root of neck

left subclavian and left internal jugular vein

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9
Q

what does superior vena cava contain?

A

venous flow from head, neck, both upper limpb

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10
Q

what is the anterior mediastinum?

A

space between pericardium and sternum

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11
Q

what are the boundaries and contents of middle mediastinum?

A

pericardium and heart

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12
Q

What are the boundaries and contents of posterior mediastinum?

A

space between pericardium and lower thoracic vertebrae

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13
Q

What is the aorta? What three branches is it divided into?

A

It is the main arterial trunk from the heart. It is divided into:

  1. Ascending aorta
  2. Arch of the aorta
  3. Descending aorta
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14
Q

Where does the ascending aorta lie? With what does it lie?

A

The ascending aorta lies in the fibrous pericardium. It is enclosed with the pulmonary trunk in a sheath of serous pericardium.

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15
Q

What are the three branches of the arch of the aorta? Where does each pass?

A

The three branches of the arch of the aorta are:

  1. Brachiocephalic artery – passes upward, to the RIGHT of the trachea, DIVIDES into the right subclavian artery and the right common carotid artery
  2. Left common carotid artery – runs upward, to the LEFT of the trachea and enters NECK
  3. Left subclavian artery – runs upward, along LEFT side of trachea and esophagus to enter NECK; arches over the APEX of LEFT LUNG
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16
Q

where does thoracic aorta begin and end

A

The thoracic aorta begins at the lower border of the fourth thoracic vertebra where it is continuous with the aortic arch, and ends in front of the lower border of the twelfth thoracic vertebra, at

17
Q

What does the azygos venous system consist of?

A

It consists of

  1. The main azygos vein
  2. The hemiazygos vein
  3. Accessory hemiazygos
18
Q

From where does the azygos system drain?

A

The azygos system drains from:

  1. The posterior parts of intercostal spa
  2. The posterior abdominal wall
  3. Pericardium
  4. Diaphragm
  5. Bronchi
  6. Esophagus
19
Q

What is the origin of the azygos vein? What are its tributaries? How does it travel?

A

The azygos vein has a variable origin and numerous tributaries. It ascends through the aortic opening in the diaphragm on the right side of the aorta to the level of the 5th thoracic vertebra. It arches above the root of the right lung and empties into the posterior surface of the superior vena cava.

20
Q

What is the origin of the hemiazygos vein? How does it travel?

A

The hemiazygos vein arises on the left side by the junction of the left subcostal and ascending lumbar veins; it ascends on the LEFT side of the vertebral column, POSTERIOR to the thoracic aorta to the level of T9, then crosses to the RIGHT to join the azygos vein.

21
Q

What is the origin of the accessory hemiazygos vein? How does it travel?

A

The accessory hemiazygos vein descends on the LEFT side of the vertebral column, crossews over at the 7th thoracic vertebra to join the azygos vein; can join the hemiazygos vein.

22
Q

What are the main nerves of the thorax? How do they travel?

A

The main nerves of the thorax are the:

  1. Right vagus nerve – descends in the thorax, passes behind the root of the right lung to form the pulmonary plexus, then onto the POSTERIOR surface of the esophagus to form the esophageal plexus, and descends through the esophageal opening of the diaphragm behind the esophagus to reach the POSTERIOR stomach.
  2. Left vagus nerve – descends in the thorax between the left common carotid and left subclavian arteries, crosses the left side of the aortic arch, turns behind the root of the left lung and forms the pulmonary plexus, then onto the ANTERIOR surface of the esophagus to form the esophageal plexus, and descends through the esophageal opening of the diaphragm in front of the esophagus to the ANTERIOR stomach
23
Q

Which vagus nerve supplies the lungs and the esophagus?

A

Both vagi do

24
Q

What does the right vagus give off? The left vagus?

A

The right vagus gives off cardiac branches.

The left vagus gives off the left recurrent laryngeal nerve

25
Q

Where do phrenic nerves arise?

A

They arise from the ventral rami of cervical nerves 3,4,5

26
Q

What kind of fibers do they possess?

A

Both efferent and efferent fibers

27
Q

What are the phrenic nerves the sole nerve supply to?

A

The diaphragm

28
Q

Where do the phrenic nerves travel?

A
  1. Right phrenic nerve – descends in the thorax on the RIGHT side of the superior vena cava, passes in FRONT of the root of the right lung, travels on the RIGHT side of the pericardium, descends on RIGHT of inferior vena cava to pass through the caval opening in the diaphragm and supplies the central peritoneum
  2. Left phrenic nerve – descends in the thorax on the LEFT side of the LEFT subclavian artery, crosses the LEFT side of the aortic arch, passes in front of the root of the left lung, travels on the LEFT side of the pericardium, descends to pierce the diaphragm and supply the central peritoneum
29
Q

general contents of mediastinum

A

esophagus, thoracic duct, thymus, heart and large blood vessels, trachea, vagus and phrenic nerves, sympathetic trunks

30
Q

What are the two branches of the pulmonary trunk? How do they project?

A

The pulmonary divides into the:

  1. Right pulmonary artery: projects to the RIGHT, posterior to the ascending aorta and superior vena cava to enter the root of the RIGHT lung
  2. Left pulmonary artery: projects to the LEFT, anterior to the descending aorta to enter the root of the LEFT lung
31
Q

What does esophagus consist of?

A

Esophagus consists of

  1. An outer connective tissue sheath
  2. A muscular layer of external longitudinal and internal circular fibers (striated upper 2/3, smooth lower 1/3)
  3. Submucosal layer containing mucous glands
  4. Mucosal layer of stratified epithelium
32
Q

What is the arterial supply of the esophagus?

A

The arterial supply of the esophagus is via the inferior thyroid artery, branches of the descending thoracic aorta and the left gastric artery

33
Q

What is the venous drainage of the esophagus?

A

To the inferior thyroid, azygos and left gastric veins.

34
Q

What are three locations for possible esophageal impingement?

A
  1. Superior impingement at pharynx
  2. Middle impingement at aortic arch, left bronchus
  3. Inferior impingement through diaphragm at T10
35
Q

What is the purpose of the thoracic duct?

A

It conveys to the blood all lymph from

  1. The lower limbs
  2. Pelvic cavity
  3. Abdominal cavity
  4. Left thorax
  5. Left arm
  6. Left side of the head and neck

anatomy (12 decks)

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