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Anatomy of thorax > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

Where does the superior mediastinum terminate

A

Superior thoracic aperture

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2
Q

What are the boundaries of the superior mediastinum

A 
Superior-Thoracic inlet
Inferior-Level of sternal angle (T4/5)
Anterior-Manubrium of sternum 
Posterior-Vertebral bodies of T1-4
Lateral-Pleura of lungs
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3
Q

Contents of the superior mediastinum (vessels)

A 
ABC'S
--> Arch of the Aorta
Brachioceophalic aa
left Common Carotid aa
left Subclavian aa
  • -> Superior vena cava;
  • Brachiocephalic vv
  • Left superior intercostal vv
  • Supreme intercostal vv
  • Azygous vv
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4
Q

Where does bifurcation of brachiocephalic aa

A

Sternoclavicular joint

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5
Q

Where do the SVC and IJV join and what do they become

A

Sternoclavicular joint

-Join to become brachiocephalic vein

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6
Q

What nerves are in the superior mediastinum

A 
Left vagus nerve 
Left recurrent laryngeal nerve 
Right vagus nerve 
Phrenic nerve 
Sympathetic trunk
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7
Q

What is the course of the left vagus nerve

A

Enters the superior mediastinum between the left common carotid and left subclavian

-Descends anteriorly to the aortic arch, before travelling posterior to the left bronchus

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8
Q

What is the course of the right vagus nerve

A

Runs parallel to the trachea and passes posteriorly to the superior vena cava and the right primary bronchus

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9
Q

What branch does the right vagus nerve give off

A

Right recurrent laryngeal nerve

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10
Q

What does the right recurrent laryngeal nerve loop around

A

Right subclavian artery

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11
Q

What branch does the left vagus nerve give off

A

Left recurrent laryngeal nerve

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12
Q

What does the left recurrent laryngeal hook around

A

Aortic arch

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13
Q

What does the vagus nerve innervate

A

Parasympathetic innervation to viscera via pulmonary, cardiac and oesophageal plexuses

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14
Q

What do the recurrent laryngeal nerves innervate

A

The muscles of the larynx

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15
Q

What Is the course of the phrenic nerve

A 
Superficial of anterior scalene
Lateral to vagus then great vessels
Passes anterior to hilum of lungs
Right leaves via canal opening od diaphragm at T8
Left pierces diaphragm at heart apex
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16
Q

Where is pain referred to for phrenic nerve

A

Shoulder/upper arm

17
Q

What is the thymus the site of

A

T cell maturation

18
Q

What muscles are found in the superior mediastinum

A

sternohyoid and sternothydoid

19
Q

Where is the anterior mediastinum

A

Between sternum and pericardium

20
Q

What are the contents of the anterior mediastinum

A 
Loose connective tissue 
Fibrous bands
Fat
Lymphatic vessels
Lymph nodes
Internal thoracic vessel branches
THYMUS in children
21
Q

contents of the middle mediastinum

A 
Pericardium
Heart
Ascending aorta
Pulmonary trunk
SVC
Arch of azygos vein 
Main bronchi
Cardiac plexus
Phrenic nerves
22
Q

Contents of posterior mediastinum

A 
thoracic aorta 
Thoracic duct
Azygos + hemiazygos veins
Oesophagus
Oesophageal plexus
Thoracic sympathetic trunks
Thoracic splanchnic nerves
Posterior mediastinal lymph nodes
23
Q

What does the azygos system drain

A
  • Back
  • thoracic-abdominal column
  • Mediastinal viscera
24
Q

Where is the hemiazygos vein

A

Left side of column posterior to aorta as far as T9

25
Q

Where is the accessory hemiazygos vein

A

Left side of column T5-T8

->Crosses over T7-T8 vertebrae

26
Q

What does the thoracic duct drain

A

All body except upper right quadrant

27
Q

Where does the thoracic duct start and where does it enter

A

Cisterna Chyli (L1-L2)

–>Enters junction of IJV and left SCV (left venous angle)

28
Q

What does the sympathetic chain provide

A

Sympathetic innervation to structures

29
Q

Where is the sympathetic chain in the superior thorax

A

Against heads of ribs

30
Q

Where is the sympathetic chain in the middle of the thorax

A

Costovertebral joints

31
Q

Where is the sympathetic chain in the inferior thorax

A

Sides of vertebral bodies

32
Q

What are the 3 splanchnic nerves and their root values

A

Greater- T5-T9/10
Lesser-T10-T11
Least-T12

33
Q

Where are presynaptic fibres found

A

5-12

34
Q

Where does metastasis occur through in a carcinoma of a breast

A

Normally via lymph, but can also go via azygos/hemiazygos

35
Q

What is a potential pathway for a breast carcinoma to spread and why

A

breast- vertebrae - brain and cranium

-Because the lymph vessels, azygos and hemiazygos system run alongside vertebrae and communicate with internal vertebral venous plexuses

Anatomy of thorax (7 decks)

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