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OS 205 > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

What are the boundaries of the mediastinum?

A 
Superior: Thoracic inlet
Inferior: Diaphragm
Lateral: L. and R. pleural cavities
Anterior: Sternum and CCs
Posterior: T1 - T12
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2
Q

Primary divisions of the mediastinum and their borders:

A
  1. Superior mediastinum
    (Separated by the transverse thoracic plane = T4/T5 to Sternal Angle)
  2. Inferior mediastinum
    a. Anterior (anterior to pericardial sac, posterior to body of sternum)
    b. Middle (bounded by pericardial sac)
    c. Posterior (anterior to T5 - T12), posterior to pericardial sac and diaphragm)
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3
Q

What connects the neck and the chest?

A

Superior mediastinum

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4
Q

What are the contents of the superior mediastinum?

A
  • Thymus
  • Great vessels (Brachiocephalic veins, SVC, aortic arch, brachiocephalic trunk, left common carotid artery, left subclavian artery, vagus nerve, phrenic nerve, cardiac plexus of nerves
  • Trachea, Esophagus, left recurrent laryngeal nerve
  • Thoracic duct and lymphatic trunks
  • Level VII group of lymph nodes
  • Parathyroid (ectopic)

Anterior to Posterior:
Thymus -> Veins -> Arteries -> Airway -> Alimentary Tract -> Lymphatic Trunks

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5
Q

From which pharyngeal arches did the parathyroid and thymus come from?

A

3rd and 4th Pharyngeal arch

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6
Q

Primary lymphoid organ located in the inferior part of the neck and anterior part of the mediastinum where T-lymphocytes mature.

A

Thymus

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7
Q

What is the blood supply of the thymus?

A

Anterior intercostal and anterior mediastinal branches of internal thoracic arteries

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8
Q

Enlarged thymus leading to obliteration of superior and anterior mediastinum. Motor issue wherein eyelids are nonfunctional in the afternoon.

A

Myasthenia gravis

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9
Q

Returns blood from all structures superior to the diaphragm except lungs and heart

A

Superior Vena Cava

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10
Q

Formed by the union of the internal jugular veins and subclavian veins at the level of the _____________.
Ends and enters right atrium at level of the ____________.

A

1st right costal cartilage

3rd right costal cartilage

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11
Q

Squeezing of the SVC due to a tumor causing an enlarged head and prominent veins in neck

A

SVC Syndrome

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12
Q

Remnant of the fetal ductus arteriosus

A

Ligamentum arteriosum

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13
Q

What lies above the plane of the sternal angle of Louis (2nd rib)?

A

Arch of the aorta

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14
Q

Where does the arch of aorta become the thoracic aorta?

A

After it passes the 2nd left rib

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15
Q

First and largest branch of the arch of aorta:

A

Brachiocephalic trunk

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16
Q

Brachiocephalic trunk divides into:

A
  • Right common carotid artery

- Right subclavian artery

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17
Q

What arches around the right main bronchus?

A

Azygos vein

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18
Q

Phrenic nerve arises from:

A

C3, C4, and C5 of the cervical plexus

19
Q

Phrenic nerve motor and sensory supply:

A 
Motor: Diaphragm
Sensory: 
- 1/3 of diaphragm (superior and inferior)
- Pericardium
- Mediastinal pleura
20
Q

Extent of Trachea

A

C6 - T4 (Sternal Angle) then it bifurcates into right and left bronchi

21
Q

Entrance of esophagus to diaphragm

A

Esophageal hiatus

22
Q

Constrictions of the esophagus

A

15 - 23 - 40 cm from upper incisors

23
Q

Where does the thoracic duct drain into?

A

Junction between IJV and subclavian vein

24
Q

Anterior mediastinum boundaries

A

Superior: Superior mediastinum / sternal angle
Inferior: Diaphragm
Anterior: Body of sternum and transversus thorasis muscle
Posterior: Pericardium

25
Q

What are the contents of the anterior mediastinum?

A

Fat, areolar tissue

Thymus

26
Q

What are the content of the middle mediastinum?

A

Pulmonary veins, Pulmonary artery, Aorta, SVC and IVC

27
Q

Base of the heart is fixed to the pericardial wall at the level of:

A

T5 - T8 / T6 - T9 (when standing)

28
Q

Heart cannot expand because of pericardial sac being filled with fluid

A

Cardiac tamponade

29
Q

Pain in the parietal pericardium can be felt in the neck due to which nerve?

A

Phrenic Nerve (C3 - C5)

30
Q

Tough external layer which protects the heart against sudden overfilling

A

Fibrous pericardium

31
Q

What are the attachments of the fibrous pericardium?

A

Superior: Tunica adventitia of great vessels
Inferior: Pericardiocophrenic ligament
Anterior: Sternopericardial ligament
Posterior: Posterior mediastinum

32
Q

Composed of mesothelium, a single layer of flattened cells lining the fibrous pericardium and external surface of the heart

A

Serous pericardium

33
Q

Layer of the serous pericardium that forms the epicardium, the outermost layer of the heart.

A

Visceral layer of the serous pericardium

34
Q

Separates the two groups of great vessels (important during surgery): Pulmonary artery and aorta separated from SVC, IVC, and pulmonary veins

A

Transverse pericardial sinus

35
Q

Arterial and venous supply of the fibrous and serous pericardium:

A

Pericardiophrenic artery and vein

36
Q

Where does the descending aorta terminate?

A

T12

37
Q

Bronchial arteries, esophageal artery, and the posterior intercostal arteries are branches of:

A

Thoracic Descending Aorta

38
Q

Level of esophageal hiatus:

A

T10

39
Q

What ascends in the posterior mediastinum between the thoracic aorta and azygos vein?

A

Thoracic Duct

40
Q

What receives lymph from the esophagus, posterior aspect of the pericardium and diaphragm, and the middle posterior intercostal spaces?

A

Posterior mediastinal lymph nodes

41
Q

What drains the back, thoracoabdominal walls, and mediastinal viscera?

A

Azygos system of veins

42
Q

What receives blood from the 4th - 8th ICS?

A

Accessory hemiazygos vein

43
Q

What receives blood from the inferior 3 posterior intercostal veins, the inferior esophageal veins, and several small mediastinal veins?

A

Hemiazygos vein

OS 205 (4 decks)

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