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Anatomy - Charis > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

Boundaries of the mediastinum

A

Anterior: Sternum
Posterior: Spinal vertebrae
Superior:Thoracic inlet (superior thoracic aperture)
Inferior: Thoracic outlet (inferior thoracic aperture)

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2
Q

Boundaries of thoracic inlet

A

T1
Rib 1
Manubrium

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3
Q

2 components of periardium

A

Fibrous

Serous

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4
Q

2 components of serous pericardium

A

Parietal

Visceral

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5
Q

What is cardiac tamponade?

A

Build up of fluid in pericardial cavity

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6
Q

What leads to the increased pressure in cardiac tamponade?

A

The fact that the fibrous pericardium doesn’t stretch

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7
Q

What is pericarditis?

A

Inflammation of the pericardial layers

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8
Q

What causes pain in pericarditis and what can result if not treated?

A

Inflamed and thickened layers of pericardium rub against each other
Can lead to cardiac tamponade

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9
Q

At which level does the oesophagus start?

A

C6/7 end of pharynx

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10
Q

At which level does the trachea start?

A

C6 end of larynx

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11
Q

Superior mediastinum structures from anterior to posterior (8)

A 
Thymus
Phrenic nerves - motor + sensory
Great veins 
Main lymphatic trunks
Vagus nerves
Great arteries
Trachea and main brochi
Upper oesophagus
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12
Q

Which veins make up each brachiocephalic vein?

A

Jugular vein

Subclavian vein

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13
Q

Where does the thoracic duct drain?

A

Junction between L jugular and subclavian veins

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14
Q

What is the function of the thoracic duct and what is the exception?

A

Thoracic duct lymph from whole of the body with the exception of the right upper quadrant of the body that is drained by the right lymphatic duct

lymph from lower limbs, pelvis, abdomen & left thoracic wall to blood

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15
Q

What do the brachiocephalic veins drain?

A

Arms and head

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16
Q

Where do the inferior thyroid veins come from?

A

Brachiocephalic veins

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17
Q

At which level does the azygos arise?

A

L1/2 juncton between right subcostal vein and right ascending lumbar vein

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18
Q

What is the function of the azygos?

A

Drain posterior wall of chest and upper abdomen

Drain posterior mediastinal organs

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19
Q

Course of azygos veins and where do they enter?

A

Arch over right lung root at T4

Enter SVC from behind just above the right atrium

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20
Q

Where does the azygos vein pierce the diaphragm to get into the thorax and along with which other structures?

A

T12, aorta, thoracic duct

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21
Q

What is the right superior intercostal vein made up of?

A

A single vessel formed by 2nd, 3rd, 4th IC veins

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22
Q

List 7 tributaries of the azygos vein

A 
Accessory azygos + hemiazygos vein
Right superior intercostal vein
Right Bronchial veins
5-11 posteror IC veins
Esophageal veins
Mediastinal veis
Pericardial veins
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23
Q

Where does the hemiazygos vein arise from?

A

L ascending lumbar vein and L subcostal vein

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24
Q

How does the hemiazygos enter the thorax?

A

L crus of diaphragm or through aortic hiatus

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25
At which level does the hemiazygos enter the azygos?
T9 | crosses vertebral column posterior to thoraci duct, esophagus, thoracic aorta
26
List 3 tributaries of the azygos vein
Lowest 4-5 posterior IC veins Esophageal veins Mediastinal veins
27
Where does the accessory hemiazygos enter the azygos vein?
T8
28
Where does the thoracic duct begin from and where does it end?
T12 as a continuation of the cysterna chili L1 including cysterna chili lecture: Begins below diaphragm at cisterna chyli Starts between oesophagus and aorta on right Ends at C7
29
Course of thoracic duct from T12-T5 | Course of thoracic duct from T5-C7
Midline + posterior T5 crosses the midline to the left and enters the superior mediastinum To the left of the oesophagus
30
Where does the aortic arch end/where does the descending aorta begin?
T4
31
Where do the coronary arteries arise from and at which level?
Ascending aorta R coronary artery - R aortic sinus L coronary artery - L aortic sinus at the level of the ascending aorta
32
List the 3 branches of the aortic arch
Brachiocephalic artery Left common carotid artery Left subclavian artery
33
What is the ligamentum arteriosum and what is its function?
Remnant of the ductus arteriosus allows blood to bypass the lungs during development (lungs are inactive in the womb) Connects pulmonary trunk with arch of the aorta
34
Phrenic nerve - motor innervation to
Diaphragm
35
Phrenic nerve - sensory innervation to
Pericardium Mediastinal pleura (parietal) Peritoneum of central diaphragm Central tendon of diaphragm
36
Vessels supplying the phrenic nerve?
pericardiacophrenic vessels
37
Course of R phrenic nerve
``` Lateral to the right vagus nerve Lateral and slightly posterior to the beginning of the right brachiocephalic vein Right side of SVC Enters middle mediastinum Right side of pericardial sac Within fibrous pericardium Anterior to the root of the right lung Leaves thorax by passing through diaphragm at T8 with IVC ```
38
To which organs do vagus nerves give their branches?
Esophagus, Heart, Lungs
39
Course of L vagus nerve
Posterior to L brachiocephalic vein between the L common carotid and the L subclavian arteries Lateral to common carotids Anterior to aortic arch (!) Posterior to lung roots forms a plexus following oesophagus into the abdomen
40
Course of R vagus nerve
Lies between R brachiocephalic vein + R brachiocephalic trunk Lies on the trachea Descends in posterior direction Towards the trachea Crosses the lateral surface of the trachea Passes posteriorly to the root of the right lung to reach the oseophagus Just before the oesophagus it is crossed by the archof the azygos vein
41
What does the R recurrent laryngeal nerve recurs around?
R Subclavian artery
42
What does the L recurrent laryngeal nerve recurs around?
Ligamentum arteriosum and arch of the aorta
43
Where do sympathetic trunks lie?
On each side of the posterior mediastinum
44
From which spinal nerves do the sympathetic trunks receive branches from?
T1-L2
45
Where do nerves to body wall synapse?
In ganglia of trunks
46
Where do nerves to viscera (internal organs) synapse?
In local ganglia (close to the organ of interest)
47
What is the splanchnic nerve?
Fibres from lower T5-T12 that reach the abdomen in bundles
48
2 functions of the sympathetic trunks?
1. Distribute sympathetic nerves to smooth muscle and glands throughout the body (visceral efferents) 2. Bring pain fibres back to CNS from viscera (visceral afferents)
49
Contents of posterior mediastinum (7)
``` Oesophagus Descending aorta Thoracic duct Azygos venous system Posterior mediastinal lymph nodes Thoracic sympathetic trunks Splanchnic nerves ```
50
Course of esophagus
``` Begins at C7 (end of pharynx) Enters superior mediastinum and then makes its way to posterior mediastinum At T7: Deviates to the left Inclines anteriorly to pass in front of the descending thoracic aorta Progressively anterior to aorta below T7 T10 Passes through the diaphragm (+CN10) T11 ends at stomach ```
51
Where are the constrictions of the oesophagus?
1. Junction between pharynx and oesophagus 2. Where oesophagus is crossed by the arch of the aorta 3. Where the oesophagus is compressed by the L main bronchus 4. At esophageal hiatus (diaphragm)
52
Branches to chest and abdomen Sympathetic/Parasympathetic?
Parasympathetic
53
Recurrent laryngeal nerve Sympathetic/Parasympathetic?
Sympathetic | Supplies skeletal muscles of larynx
54
What is the mediastinum?
Is a thick midline partition that separates the two pleural cavities.
55
How is the SVC formed?
By asymmetric union of right and left brachiocephalic veins
56
Where does the trachea lie?
Behind + between the brachiocephalic and L common carotid arteries
57
Distribution of common carotid arteries
Divide to internal and external carotids high in neck
58
What do the subclavian arteries supply?
Vertebral arteries
59
What do the carotid arteries supply?
Head and neck
60
In a horizontal section through TIII why can't you see the R current laryngeal nerve?
It's much higher up | RIGHT Recurrent Laryngeal nerve HIGHER than LEFT Recurrent Laryngeal nerve. So LEFT Recurrent Laryngeal nerve is longer.
61
Which nerve is more anterior Vagus or recurrent laryngeal nerve?
Vagus
62
What vertebral level separates superior + inferior mediastinum?
T4/5
63
Which structure is the ligamentum arteriosum closely associated with?
Left recurrent laryngeal nerve
64
What can cardiac tamponade lead to?
Biventricular failure
65
What is a pericaridal effusion?
is where excess fluid builds up between the parietal and visceral layers of the serous pericardium
66
At which vertebral level does the R bachiocephalic trunk bifurcate?
T1-Sternoclavicular joint
67
At which vertebral level does the aortic arch end?
T4-Sternal angle
68
At which vertebral level do the two brachiocephalic veins join?
T3 | Posterior to the lower edge of the 1st CC

Anatomy - Charis (4 decks)

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