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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
Q

what are the contents of the middle mediastinum?

A

pericardium and the heart

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26
Q

what are the contents of the posterior mediastinum?

A 
primary bronchi
oesophagus
descending aorta
thoracic duct
azygos and hemiazygos veins
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27
Q

what spinal levels does the trachea stretch between?

A

C6 to T4

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28
Q

name a specialisation of the trachea?

A

U shaped cartilage rings

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29
Q

at what spinal level does the carina occur?

A

T4/5

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30
Q

what spinal levels does the oesophagus span between?

A

C6 to T10

31
Q

what direction does the oesophagus incline to and why?

A

the left to go to the stomach

32
Q

what is the oesophagus posterior to?

A

the trachea

33
Q

what is the cisterna chyli?

A

the most inferior part of the thoracic duct

34
Q

describe the passage of the thoracic duct through the body

A

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
Q

what spinal level is the neck?

A

C6

36
Q

what spinal level is the thoracic inlet?

A

T1/T2

37
Q

what spinal level is the transthoracic plane?

A

T4/T5

38
Q

what spinal level is the diaphragm?

A

T10

39
Q

what happens to the thymus gland in adults?

A

gets fatty

40
Q

what are the layers of the pericardium?

A

tough outer fibrous

inner serous membrane - parietal and visceral

41
Q

what does the outer fibrous pericardium attach to?

A

the greater vessels

central tendon of the diaphragm

42
Q

what is the function of the fibrous pericardium?

A

stops overexpansion
protective
attaches to diaphragm

43
Q

what is cardiac tamponade?

A

when fluid builds up in the pericardial cavity and compresses the heart

44
Q

which ventricle is more anterior?

A

right ventricle

45
Q

where is the apex of the heart?

A

5th intercostal space at the midclavicular line

46
Q

which ventricle forms the apex of the heart?

A

the left ventricle

47
Q

what arteries supply the thoracic wall?

A

internal intercostal arteries

48
Q

where do the posterior intercostal arteries branch from?

A

1 and 2 branch from the costocervical trunk

lower 9 from the descending aorta

49
Q

what is the costocervical trunk?

A

a branch of the subclavian arteries

50
Q

where do the anterior intercostal arteries branch from?

A

the internal intercostal arteries

51
Q

where do the internal thoracic arteries run?

A

anteriorly either side of the sternum

52
Q

what are neurovascular bundles made up of?

A

intercostal vein, artery and nerve

53
Q

where do neurovascular bundles lie?

A

underneath the inferior part of the rib

54
Q

what do anterior intercostal arteries branch into?

A

inferior and superior branch

55
Q

why are collateral branches needed?

A

to ensure that blood reaches all of the intercostal space

56
Q

define thoracentesis

A

sampling or removal of excess fluid around the lungs

57
Q

how should a needle be inserted in thoracentesis?

A

9th intercostal space in midclavicular line to avoid inferior border of the lung

58
Q

are the azygos veins on the left or right?

A

right

59
Q

what do the right posterior intercostal veins drain into?

A

the azygos vein

60
Q

what do the left posterior intercostal veins drain into?

A

hemiazygos vein

61
Q

what vessel does the azygos vein feed into?

A

superior vena cava

62
Q

where does the vagus enter the mediastinum?

A

lateral to the common carotid artery

63
Q

where does the right laryngeal nerve split from the vagus?

A

at the subclavian artery

64
Q

where does the right phrenic nerve enter the mediastinum?

A

between the right subclavian vein and artery

65
Q

where does the left laryngeal go after its split from the vagus?

A

under and posterior to the aorta to form a motor neurone to the larynx

66
Q

where does the left phrenic nerve enter the mediastinum?

A

between the left subclavian vein and artery

67
Q

where does the left phrenic nerve go after it has entered the mediastinum?

A

passes aorta anteriorly and runs over the left of the heart

68
Q

what does the vagus nerve innervate?

A

oesophagus
heart
bronchi
passes through stomach to some of the enteric nervous system

69
Q

what does the laryngeal nerve control?

A

vocalisation and breathing

70
Q

what does the phrenic nerve innervate?

A

motor innervation to the diaphragm

sensory innervation to the pericardium and mediastinum pleura

71
Q

which part of the heart does the phrenic nerve mainly innervate?

A

the left

72
Q

describe the role of the phrenic nerve in a heart attack

A

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
Q

what happens if the phrenic nerve is paralysed?

A

diaphragm cant contract on one side and draw air inside

c (25 decks)

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