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AS II - Test 2 > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

where is sympathetic chain wrt vertebral column?

A

lateral to vertebral column

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2
Q

which side of the mediastinum is the SVC on?

A

superior vena cava is on right side

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3
Q

Describe the course of the esophagus

A
  • originates at C6
  • pass from neck to superior mediastinum
  • posterior to trachea
  • into inferior (posterior) medastintum
  • through diaphragm at T10
  • ends at T11

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4
Q
A
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5
Q

descibe borders of anterior mediastinum

A

continuous with superior mediastinum at sternal angle, bottom is diaphragm, anterior is sternum and posterior is pericardium

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6
Q

boundaries of superior mediastinum

A

from plane through jugular notch and T1 vertebra down to

plane though sternal angle and T4/T5 intervertebral disc

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7
Q

where does thoracic aorta begin/end?

A
  • begins at T4/T5 IV disc
  • ends at T12 vertebral level at aortic hiatus (to become abdominal aorta)
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8
Q

contents of anterior mediastinum

A
  • thymus (extends into anterior mediastinum)
  • loose CT and fat
  • lymph vessels and lymph nodes
  • mediastinal branches of internal thoracic vessels
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9
Q

where is thymus

A

root of neck (superior mediastinum and anterior mediastinum)

immediately deep to manubrium

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10
Q

Superior vena cava returns blood from what structures to heart?

A

returns blood from everything superior to diaphragm except heart and lungs

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11
Q

contents of middle mediastinum (13)

A
  1. heart
  2. ascending aorta
  3. inferior portion of SVC
  4. terminal portion of azygous vein
  5. primary bronchi
  6. pulmonary trunk
  7. R and L pulmonary arteries
  8. pulmonary veins
  9. phrenic nerves
  10. pericardiacophrenic vessels
  11. cardiac plexus
  12. IVC
  13. lymph nodes
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12
Q

what is azygos sytem of veins?

A
  • longitudinal veins that receive blood from the body wall and mediastinal viscera
  • forms collateral pathways between IVC and SVC
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13
Q

thoracic duct drains lymph from where?

A

from all of body except right upper quadrant

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14
Q

When the aortic arch is ascending where is it in relation to other structures?

A

aortic arch ascends anterior to right pulmonary artery and trachea, then goes posterior

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15
Q

Trachea and esophagus orginate at what vertebral level?

A

C6

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16
Q

describe path of hemiazygos & accessory hemiazygous veins

A

normally empty into azygous vein but path is variable

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17
Q

What occurs at the indicated spots?

A
18
Q

Label A-D

A

A. Sympathetic chain

B. Greater splanchnic nerve

C. Lesser splanchnic nerve

D. Least splanchnic nerve

19
Q

branches of aortic arch

A
  • brachiocephalic trunk (1st branch)
    • right common corotid artery
    • right subclavian artery
  • left common carotid artery (2nd brach)
  • left subclavian artery (3rd branch)
20
Q

describe path of azygos veins

A
  • originates around L1
  • enters thorax @ posterior mediastinum via aortic hiatus
  • ascends to the right of thoracic duct
  • arches over root of right lung to join SVC
21
Q

at what level does the superior vena cava pass into the mediastinum and where does it terminate?

A

into mediastinum at sternal angle and terminates at level of 3rd costal cartilage

22
Q

inferior mediastinum boundaries

A

from plane through sternal angle and T4/T5 intervertebral disc down to

diaphragm

further subdivided into anterior, middle, posterior mediastunum

23
Q

describe path of left recurrent laryngeal nerve

A
  • arises from left vagus nerve
  • passes around aortic arch before ascending between trachea and esophagus to reach larynx
24
Q

significant branches of thoracic aorta (6)

A
  1. posterior intercostal arteries
  2. esophageal arteries
  3. bronchial arteries
  4. mediastinal branches
  5. pericardial branches
  6. superior phrenic arteries
25
Q

describe path of thoracic duct

A
  • starts at cisterna chyli (~T12)
  • ascends through posterior mediastinum posterior to esophagus between descending thoracic aorta and azygous vein
  • goes left and enters superior mediastinum
  • ends at junction of left subclavian vein and left IJV (internal jugular vein)
26
Q

describe path of right vagus nerve

A
  • enters superior mediastinum posterior to brachiocephalic vein
  • descends posterior to superior vena cava and along right margin of trachea
  • passes posterior to root of lung in posterior mediastinum
  • branches into pulmonary plexus and inferiorly to esophageal plexus and posterior vagal trunk
27
Q

which 3 thoracic splanchnic nerves course in posterior mediastinum and where are they formed?

A
  1. Greater splanchnic nerve (formed from T5-T9)
  2. Lesser splanchnic nerve (formed from T10-T11)
  3. Least Splanchnic nerve (formed from T12)
28
Q

Whats the smallest subdivision of the mediastinum?

A

anterior (inferior) mediastinum

29
Q

where is thoracic aorta wrt esophagus?

A

thoracic aorta is mostly to the LEFT of the esophagus

30
Q

what are the great veins and what part of the mediastinum are they in?

A
  • right and left brachiocephalic veins
  • superior vena cava

all in superior mediastinum

31
Q

Describe left vagus nerve path

A
  • enters superior mediastinum posterior to left brachiocephalic vein
  • passes anterior to aortic arch and posterior to root of lung in posterior mediastinum
    • gives off left recurrent laryngial nerve
  • branches into pulmonary plexus, inferiorly to esophageal plexus and anterior vagal trunk
32
Q

what joins to form left and right brachiocephalic veins and where do they join?

A

union of internal jugular veins and subclavian veins

occurs posterior to sternoclavicular joint

33
Q

what nerve supplys motor innervation to diaphragm?

A

phrenic nerve

34
Q

what are the great arteries and what section of the mediastinum are they part of?

A
  • arch of aorta (and proximal portion of its major branches)
  • brachiocephalic trunk
  • left common carotid
  • left subclavian

all in superior mediastinum

35
Q

what is the aortic arch continuous with on both sides?

A

continuous with ascending aorta

then continuous with descending thoracic aorta (posterior to root of left lung)

36
Q

what is the primary lymphoid organ?

A

thymus

37
Q

what unites to form superior vena cava and where does this occur?

A

left and right brachiocephalic veins join at level of 1st costal cartilage

38
Q

phrenic nerve supplies sensory branches to what?

A

pericardium, mediastinal pleura, diaphragm

39
Q

describe path of pericardiacophrenic vessels

A
  • travel with phrenic nerves
  • 3 structures
  • pass anterior to root of lung and descend through the middle mediastinum between fibrous pericardium and medastinal pleura
40
Q

describe path of phrenic nerve

A
  • originates in neck (C3,4,5)
  • pass anterior to subclavian artery and posterior to subclavian vein
  • enter superior mediastinum
41
Q

where does trachea end

A

ends at sternal angle (before inferior mediastinum)

42
Q

where does arch of aorta start?

A

begins at level of sternal angle, posterior to 2nd right sternocostal joint (not covered by pericardium)

AS II - Test 2 (6 decks)

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