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SPOM > Mediastinum and Lungs > Flashcards

Mediastinum and Lungs Flashcards

1
Q

Mediastinum?

A
  • area between two pleural sacs
  • superior
  • Inferior has three divisions (middle, anterior, posterior)
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2
Q

Superior Mediastinum? contents?

A
  • sternal angle to T4

- contains trachea, esophagus, and important neural structures

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3
Q

Inferior mediastinum? Contents?

A
  1. Middle
    - heart and pericardium
  2. Anterior
    - posterior to sternum and anterior to pericardium
    - sternopericardial ligaments
    - lymph nodes (cancer)
    - thymus gland
    - thyroid gland (can descend to substernal)
  3. Posterior
    - anterior to vertebral bodies and posterior to pericardium
    - esophagus, thoracic duct, Vagus nerve
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4
Q

Esophagus location?

A
  • extends lower end of pharynx to stomach
  • midline structure
  • no adventitia
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5
Q

Esophagus function?

A
  • distensible: will accommodate anything that can be swallowed
  • superior part: striated muscle for voluntary initiation of swallowing
  • inferior part: smooth muscle for autonomic control of swallowing
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6
Q

Esophagus innervation?

A

-Vagus nerve runs behind it

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7
Q

Left recurrent laryngeal nerve? Clinical significance?

A
  • branch of Vagus nerve goes back up and wraps around Aorta
  • hoarse voice could be caused by Aortic aneurysm (very rare)
  • put on differential
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8
Q

Varicose veins of esophagus?

A
  • anastomosis of veins with left gastric veins
  • associated with portal hypertension
  • blood backs up into these veins of hepatic portal system
  • can cause acid reflux and bleeding
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9
Q

Thoracic Duct path? Function?

A
  • Starts in abdomen as dilated lymph duct called Cisterna Chyli
  • goes through aortic opening and travels in posterior mediastinum
  • enters at junction of left Internal Jugular vein and Left Subclavian vein
  • Function: receives lymph from most of the body including left side of head and neck
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10
Q

Trachea structure?

A
  • midline, mobile
  • 16-20 C shaped bars of hyaline cartilage on anterior side
  • elastic fibers on posterior side
  • enclosed by fibrous muscle covering
  • divides T5/T6
  • 10 cm in length
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11
Q

Carina of Trachea?

A
  • ridge down midline of trachea
  • anterior posterior ridge where trachea branches
  • richly innervated by Vagus nerve
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12
Q

If someone swallows something, where will it most likely go?

A
  • right main stem bronchi

- larger and more midline with trachea

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13
Q

What supplies the main bronchi with blood?

A
  • bronchial arteries
  • supply non-respiratory areas of lungs and visceral pleura with oxygenated blood
  • from Aorta
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14
Q

When someone get’s ear cleaned out, why would they cough?

A
  • external ear: Auricular Temporal nerve
  • connected with Vagus nerve to larynx and trachea
  • Vagus nerve wanders everywhere (esophagus, cardiac plexus to slow HR, abdomen)
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15
Q

Function of lungs?

A

-gas exchange: O2 in, CO2 out

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16
Q

How are lungs attached?

A
  • attached to heart and trachea by root and pulmonary ligaments
  • double fold of mediastinal pleura
  • root of hilum (bronchi, artery, vein, autonomic nerve fibers)
17
Q

Left lung lobes?

A
  • Superior and inferior lobes separated by an oblique fissure
  • Clinical: pneumonias can be specific to one lobe
  • has lingula
18
Q

Right lung lobes?

A
  • horizontal fissure separates superior and middle lobes

- oblique fissure separates inferior from middle and superior lobes

19
Q

Lung Pleura?

A
  1. Parietal pleura
    - lines chest cavity
    - diaphragmatic
    - mediastinal (Phrenic N.)
    - costal (Intercostal N.)
    - apical
  2. Visceral pleura
    - rests on lungs
    - sends projections inwards
    - no sensory innervation
20
Q

Parietal pleura innervation and blood supply?

A
  • Phrenic N. (sensory and motor)
  • Intercostal N.
  • Intercostal arteries
21
Q

Visceral pleura blood supply and innervation?

A
  • Bronchial arteries

- no sensory innervation

22
Q

Pleural cavity where pleural effusions occur?

A
  • between parietal and visceral pleura
  • fluid accumulates here
  • Pleurocentesis: removal of fluid from pleural cavity (stick needle superior to rib into pleural cavity)
23
Q

Costal endothoracic fascia?

A
  • thin layer of fascia separates costal pleura from ribs

- thickened superiorly over apex of lungs (simpson’s fascia)

24
Q

Costomediastinal recess?

A
  • only on left side
  • goes over bare area of heart
  • where lingual of lung extends to pericardium
25
Q

Costodiaphagmatic recess?

A
  • found on both right and left sides
  • surrounds area of diaphragm
  • during deep respiration lung extends inferiorly into recess
  • when taking fluid from lungs, tell patient not to take deep breath
26
Q

Cupola?

A

suprapleural membrane over apex of lungs

27
Q

Hilar lympadenopathy?

A

swollen lymph nodes around hilum

28
Q

Bronchopulmonary segments?

A
  • third order branch
  • largest within lobe
  • 10 segments each lung
  • separated by septa from visceral pleura
  • pulmonary veins are intersegmental
  • pulmonary arteries accompany bronchi
  • pneumonia can occur in segments and not spread to others
29
Q

Ventilation?

A

moving air inward via muscles of respiration

30
Q

Diffusion in alveoli? Thickened membrane?

A
  • O2 and CO2 diffuse through alveolar membrane
  • CO2 takes less effort to diffuse

Pulmonary Fibrosis

  • if alveolar membrane thickens, patients cannot get enough O2
  • treat with O2 tank
31
Q

Expiration?

A

passive process that allows air to flow in and out of lungs by elastic fibers

32
Q

Pulmonary artery?

A
  • bring deoxygenated blood from right ventricle to lungs

- elastic

33
Q

Pulmonary veins?

A
  • bring oxygenated blood from lungs back to heart
  • enter left atrium
  • no valves
  • 4 veins
34
Q

Bronchial arteries?

A
  • come off Aorta

- supply non respiratory areas of lungs with blood

35
Q

Bronchial veins?

A

-drain from lungs to azygous, hemiazygous, or intercostal veins

36
Q

Azygous vein?

A

drains into superior vena cava

37
Q

Lymph drainage of hilum?

A
  • pulmonary nodes

- tracheobronchial nodes

38
Q

Lung innervation?

A

autonomic

39
Q

Diameter of lungs after Inspiration?

A
  1. vertical diameter: contraction of diaphragm
  2. AP diameter: shape of ribs, intercostals
  3. Transverse diameter: shape of ribs, intercostals

SPOM (17 decks)

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