mediastinum Flashcards
what is the mediastinum?
o Central compartment of the thoracic cavity located between the lungs
what border the mediastinum superiorly?
thoracic inlet
what border the mediastinum inferiorly?
diaphragm
what divides the inferior and superior mediastinum?
imaginary line drawn from the sternal angle to posterior thoracic wall between TIV/V vertebrae
what compartments is the inferior mediastinum broken down into?
- Anterior
- Middle
- Posterior
what borders the anterior mediastinum anteriorly?
sternum
what borders the anterior mediastinum posteriorly?
fibrous pericardium
what borders the anterior mediastinum superiorly?
imaginary line between the sternal angle and TIV/TV
what borders the anterior mediastinum inferiorly?
diaphragm
what is contained within the anterior mediastinum?
lymph node
loose connective tissue
thymus gland
what is the thymus gland
• Lymphoid organ involved in the development of the immune system
is the thymus gland greater in adults or in children?
• Larger in children, begins to shrink during puberty and gets replaced by adipose tissue
what borders the superior mediastinum superiorly?
thoracic inlet
what borders the superior mediastinum inferiorly?
imaginary lines between the sternal angle and TIV/V
anteriorly: Manubrium
what borders the superior mediastinum anteriorly?
Manubrium
what borders the superior mediastinum posteriorly?
thoracic vertebral column
what organs are contained within the superior mediastinum?
trachea
esophagus
thymus (sometimes)
what arteries are contained within the superior mediastinum?
aortic arch
brachiocephalic trink
L. cartoid A.
what veins and lymph vessels are contained within the superior mediastinum?
SVC
brachiocephalic veins
thoracic duct
what nerves are contained within the superior mediastinum?
vagus N.
recurrent laryngeal N
phrenic N.
where are the vagus N. found in the superior mediastinum?
between the internal jugular and common cartoid A.
which reccurent laryngeal nerve is typically seen in the superior manubrium?
left one mostly
why is the right recurrent laryngeal N,. not always seen in the superior mediastinum?
because it branches off the vagus N. more superiorly thus dosent always dip into it.
which structure sits anterior to the other? vein or artery and why?
veins sits anterior to Arteries as protection
In relation to the hilum of the lungs where does the phrenic N. pass?
anteriorly
In relation to the hilum of the lungs where does the vagus N. pass?
posteriorly
what borders the middle mediastinum posteriorly?
posterior border of the pericardial sac
what borders the middle mediastinum anteriorly?
anterior border of the pericardial sac
what borders the middle mediastinum superior?
imaginary line between the sternal angle to TIV/TV
what borders the middle mediastinum inferior?
diaphragmn
what organs are contained in the middle mediasternum?
- heart in pericardial sac
- tracheal bifurcation
- pulmonary bronchi
what arteries are contained in the middle mediasternum?
roots of the ascending aorta
pulmonary trunk and A.
what vessels and lymphe vessels are contained in the middle mediasternum?
roots of SVC
pulmonary veins
azygous vein
what nerves are contained in the middle mediasternum?
phrenic N.
where are the primary bronchi in the middle mediastinum?
found along the superior border of the middle mediastinum
what borders the posterior mediastinum inferior?
diaphragm
what borders the posterior mediastinum superior?
imaginary line between the sternal angle to TIV/TV
what borders the posterior mediastinum posteriorly?
posterior thoracic wall & vertebral column
what borders the posterior mediastinum anteriorly?
posterior surface of the pericardium
what organs are contained in the posterior mediastinum?
esophagus
what arteries are contained in the posterior mediastinum?
thoracic aorta
relative to the posterior mediastinum, where does the descending aorta sit?
towards the left of it
what veins and lymphatic vessels are contained in the posterior mediastinum?
From left to right
- hemiazygous vein
- thoracic duct
- azygous vein
what nerves are contained in the posterior mediastinum?
vagus nerve
into what does the thoracic duct drain into?
left venous angle
what is the cisterna chyli?
dilated lymphatic sac which sits to the right of the abdominal aorta (L1/L2)
where do the vagus nerves pass through in the mediastinum?
posterior to the hilum of the lung on their way to the abdomen
what nerve gives rise to the left recurrent laryngeal N?
left vagus N
how does the left recurrent laryngeal N travel?
as it wraps around the arch of the aorta from anterior to posterior near ligamentum arteriosum, ascends to laynx
where does the L. recurrent laryngeal N sit relative to trachea and common cartoid A?
will sit lateral to trachea and medial to common cartoid A
what forms the anterior vagal trunk?
L. recurrent laryngeal N.
where does the anterior vagal trunk travel?
anterior surface of the esophagus and will descend into the thorax and contribute to plexuses
which Vagus N. is more prone to being pinched? why?
left vagal N.
More prone to pinching or injury to it position as it is wrapped around the aorta
which reccurent laryngeal N. comes down lower in the thorax?
Left recurrent laryngeal N.
how does the Right vagus N. transition into the right recurrent laryngeal N.?
it wraps around the right subclavian A from anterior to posterior and Ascends to larynx between the trachea and common carotid A.
what does the right recurrent larygeal N. become once it travels posterior to the esophagus?
posterior vagal trunk
what does impingement of the recurrent laryngeal N. lead to
hoarseness of the voice
what (mediastinal) does the esophagus travel trough
posterior and middle mediastinum
how does the esophagus enter the abdomen? at what level?
T10
what passes through the caval hiatus? at what level?
IVC
T8
what passes through the aortic hiaatus? at what level?
aorta
T12
what form the pulmonary plexus?
anterior: right vagus N
posterior: left vagus N.
where does the thoracic duct ascend?
ascends to the right abdominal aorta and enter throax via aortic hiatus
where is the thoracic duct located?
between azygous vein and thoracic aorta, deep to esophagus
what is the function of the thoracic duct?
Functions to empty into the venous system of the left venous angle
what parts of the body are drained by the thoracic duct?
lower limbs to thorax, then left side of the chest, neck, head and UL
what drains the right side of the head, neck, chest and UL?
right lymphatic duct