Mediastinum Flashcards
Layers of Superior Mediastinum
Posterior--->Anterior Digestive Layer Respiratory Layer Arterial Layer Venous Layer Glandular Layer
The L vagus nerve enters the superior mediastinum with the L carotid artery. The n passes anterior to the ______ _____ and gives off the left recurrent which passes _____ the ____ ____ immediately distal to the ______ _____. The L vagus continues inferiorly to reach the ______.
The L vagus nerve enters the superior mediastinum with the L carotid artery. The n passes anterior to the AORTIC ARCH and gives off the left recurrent which passes under the AORTIC ARCH immediately distal to the LIGAMENTUM ARTERIOSUM. The L vagus continues inferiorly to reach the ESOPHAGUS.
The R recurrent nerve passes under the _____ _____ artery and courses upward to the ______. This nerve is never in the mediastinum. It continues downward to the _____ surface of the esophagus.
The R recurrent nerve passes under the RIGHT SUBCLAVIAN artery and courses upward to the LARYNX. This nerve is never in the mediastinum. It continues downward to the POSTERIOR surface of the esophagus.
The descending aorta enters the _____ mediastinum to the ______ of the esophagus and gradually moves ______ the esophagus as they descend. In the inferior part of the region, the aorta is _____ to the esophagus.
The descending aorta enters the POSTERIOR mediastinum to the LEFT of the esophagus and gradually moves BEHIND the esophagus as they descend. In the inferior part of the region, the aorta is POSTERIOR to the esophagus.
The thoracic duct drains at the jct of the _____ Subclavian vein and the _____ _____ jugular vein.
The thoracic duct drains at the jct of the LEFT Subclavian vein and the LEFT INTERNAL jugular vein.
Diaphragm is innervated by ____ nerves from SC levels C_-_.
3 Levels of Origin:
_____- 2 crurua, each crus takes it’s origin from the bodies of the upper 2 or 3 ______ _____ ______.
_____- muscle fibers arising from the inner surfaces of the lower _ ribs
____- muscle fibers arising from the inner surface of the _____ _____
Diaphragm is innervated by ____ nerves from SC levels C_-_.
3 Levels of Origin:
LUMBAR- 2 crurua, each crus takes it’s origin from the bodies of the upper 2 or 3 LUMBAR VERTEBRAL BODIES.
COSTAL- muscle fibers arising from the inner surfaces of the lower SIX ribs
STERNAL- muscle fibers arising from the inner surface of the XIPHOID PROCESS
Hiatuses in Diaphragm:
-Caval: level of T_, within ____ ____ to the _ of the midline. Transmits ___ and some branches of __ ____ nerve.
- Esophageal: level of T__, within muscle of ____ crus to the ___ of the midline. Transmits the esophagus and _____/_____ ______ nerves. The skeletal muscle of the ___ crus serves as a ______ for the esophagus.
- Aortic: level of T__. Behind the ____ in the ______. Transmits aorta, ______ vein, and _______ _____.
- Sternocostal: at level of T__. Between the muscle of the sternal origin and costal origin. Transmits the ______ ______ vessels.
Hiatuses in Diaphragm:
-Caval: level of T8, within CENTRAL TENDON to the R of the midline. Transmits IVC and and some branches of R PHRENIC nerve.
- Esophageal: level of T10, within muscle of RIGHT crus to the LEFT of the midline. Transmits the esophagus and ANTERIOR/POSTERIOR VAGAL nerves. The skeletal muscle of the RIGHT crus serves as a SPHINCTER for the esophagus.
- Aortic: level of T12. Behind the CRURA in the MIDLINE. Transmits aorta, AZYGOS vein, and THORACIC DUCT.
- Sternocostal: at level of T10. Between the muscle of the sternal origin and costal origin. Transmits the SUPERIOR EPIGASTRIC vessels.
Structures that pass through diaphragm without a specific hiatus
Sympathetic trunk, thoracic splanchnic nerves, hemiazygos vein, most branches of phrenic nerves.
Accessory respiratory muscles
Scalenes, pec major, minor, serratus anterior and posterior
Referred pain for diaphragm
C3-5
