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mediastinum Flashcards

1
Q

what is the thoracic cavity split into?

A

2 pleural cavities

the mediastinum

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2
Q

what forms the superior boundary of the mediastinum?

A

thoracic inlet

T1 and the first rib

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3
Q

what forms the inferior boundary of the mediastinum?

A

diaphragm

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4
Q

what forms the anterior boundary of the mediastinum?

A

sternum and costal cartilages

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5
Q

what forms the posterior boundary of the mediastinum?

A

thoracic vertebrae

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6
Q

how can the mediastinum be divided?

A

into the inferior and superior mediastinum

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7
Q

how can the inferior mediastinum be divided?

A

anterior
middle
posterior

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8
Q

why is the mediastinum highly mobile?

A

contains hollow/air-filled structures which are going to move
has connective tissue which allows for movement of internal organs

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9
Q

what are other names for the manubriosternal joint?

A

the sternal angle

angle of Louis

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10
Q

which rib inserts into the sternum at the sternal angle?

A

rib 2

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11
Q

what is the transthoracic plane?

A

the straight horizontal line drawn through the sternal angle

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12
Q

what line separates mediastinum into the inferior and superior section?

A

transthoracic plane

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13
Q

what intervertebral disc does the transthoracic plane go through?

A

T4/T5

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14
Q

what position is a person assumed to be in when describing the structures of the mediastinum?

A

supine

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15
Q

in the supine position, where is the arch of the aorta?

A

superior to the transthoracic plane

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16
Q

in the supine position, where is the carina?

A

transected by the transthoracic plane

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17
Q

what is the carina?

A

the bifurcation of the trachea into the left and right main bronchi

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18
Q

at what spinal level does the carina occur?

A

T5/6

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19
Q

at what spinal level does the central tendon lie?

A

T9

the level of the xiphisternal junction

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20
Q

in the standing position, where is the arch of the aorta?

A

transected by the transthoracic plane

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21
Q

in the standing position, where does the carina lie?

A

inferior to the transthoracic plane

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22
Q

where does the heart sit in the mediastinum?

A

on the diaphragm

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23
Q

what are the contents of the superior mediastinum?

A 
thymus gland
brachiocephalic vein, SVC and aortic arch
phrenic, vagus and laryngeal nerves
trachea
oesophagus
thoracic duct and lymphatic trunk
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24
Q

what are the contents of the anterior mediastinum?

A

thymus gland

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25
what are the contents of the middle mediastinum?
pericardium and the heart
26
what are the contents of the posterior mediastinum?
``` primary bronchi oesophagus descending aorta thoracic duct azygos and hemiazygos veins ```
27
what spinal levels does the trachea stretch between?
C6 to T4
28
name a specialisation of the trachea?
U shaped cartilage rings
29
at what spinal level does the carina occur?
T4/5
30
what spinal levels does the oesophagus span between?
C6 to T10
31
what direction does the oesophagus incline to and why?
the left to go to the stomach
32
what is the oesophagus posterior to?
the trachea
33
what is the cisterna chyli?
the most inferior part of the thoracic duct
34
describe the passage of the thoracic duct through the body
starts as the cisterna chyli in the abdomen ascends through the diaphragm runs to the left of the oesophagus into the root of the neck
35
what spinal level is the neck?
C6
36
what spinal level is the thoracic inlet?
T1/T2
37
what spinal level is the transthoracic plane?
T4/T5
38
what spinal level is the diaphragm?
T10
39
what happens to the thymus gland in adults?
gets fatty
40
what are the layers of the pericardium?
tough outer fibrous | inner serous membrane - parietal and visceral
41
what does the outer fibrous pericardium attach to?
the greater vessels | central tendon of the diaphragm
42
what is the function of the fibrous pericardium?
stops overexpansion protective attaches to diaphragm
43
what is cardiac tamponade?
when fluid builds up in the pericardial cavity and compresses the heart
44
which ventricle is more anterior?
right ventricle
45
where is the apex of the heart?
5th intercostal space at the midclavicular line
46
which ventricle forms the apex of the heart?
the left ventricle
47
what arteries supply the thoracic wall?
internal intercostal arteries
48
where do the posterior intercostal arteries branch from?
1 and 2 branch from the costocervical trunk | lower 9 from the descending aorta
49
what is the costocervical trunk?
a branch of the subclavian arteries
50
where do the anterior intercostal arteries branch from?
the internal intercostal arteries
51
where do the internal thoracic arteries run?
anteriorly either side of the sternum
52
what are neurovascular bundles made up of?
intercostal vein, artery and nerve
53
where do neurovascular bundles lie?
underneath the inferior part of the rib
54
what do anterior intercostal arteries branch into?
inferior and superior branch
55
why are collateral branches needed?
to ensure that blood reaches all of the intercostal space
56
define thoracentesis
sampling or removal of excess fluid around the lungs
57
how should a needle be inserted in thoracentesis?
9th intercostal space in midclavicular line to avoid inferior border of the lung
58
are the azygos veins on the left or right?
right
59
what do the right posterior intercostal veins drain into?
the azygos vein
60
what do the left posterior intercostal veins drain into?
hemiazygos vein
61
what vessel does the azygos vein feed into?
superior vena cava
62
where does the vagus enter the mediastinum?
lateral to the common carotid artery
63
where does the right laryngeal nerve split from the vagus?
at the subclavian artery
64
where does the right phrenic nerve enter the mediastinum?
between the right subclavian vein and artery
65
where does the left laryngeal go after its split from the vagus?
under and posterior to the aorta to form a motor neurone to the larynx
66
where does the left phrenic nerve enter the mediastinum?
between the left subclavian vein and artery
67
where does the left phrenic nerve go after it has entered the mediastinum?
passes aorta anteriorly and runs over the left of the heart
68
what does the vagus nerve innervate?
oesophagus heart bronchi passes through stomach to some of the enteric nervous system
69
what does the laryngeal nerve control?
vocalisation and breathing
70
what does the phrenic nerve innervate?
motor innervation to the diaphragm | sensory innervation to the pericardium and mediastinum pleura
71
which part of the heart does the phrenic nerve mainly innervate?
the left
72
describe the role of the phrenic nerve in a heart attack
ventricular muscle is affected phrenic nerve sends signals to C3-C5 dermatomes pain felt in arm and shoulders so its easier for the body to associate with pain
73
what happens if the phrenic nerve is paralysed?
diaphragm cant contract on one side and draw air inside

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