Mediastinum and Pericardium Flashcards
What are the boundaries of the mediastinum
Superior: superior thoracic aperture
Inferior: thoracic diaphragm
Anterior: sternum and costal cartilage
Posterior: bodies of the thoracic vertebrae
What is contained in the mediastinum
all thoracic contents except lungs and vertebral column
Where is the superior division of the mediastinum found
Between thoracic aperture and T4-5 IVD
What are the contents of the superior division of the mediastinum
aortic arch, tracheal bifurcation
Where is the inferior division of the mediastinum found
between T4-5 IVD and thoracic diapragm
What is found in the inferior division of the mediastinum
pericardium
heart
Great blood vessel
What is the pericardium
double walled sac that encloses the heart and the root of the great vessels
What costal levels is the pericardium located between
2nd and 6th costal cartilages
What is the purpose of the pericardium
restrict excessive heart movement
How does the pericardium anchor to the body
Diaphragm by the pericardiophrenic ligament
Sternum by the sternocardial ligaments
Great vessels superiorly
Posteriorly by loose connective tissue
What are the layers of the parietal pericardium
Fibrous layer
Serous Layer
What is the fibrous pericardium continuous with
Inferiorly: central tendon of diaphragm, and tunica adventitia of inferior vena cava
Superiorly: Tunica adventitia of great vessels
What is the serous layer of percardium continuous with
visceral pericardium at the root of the great vessels
What is the visceral pericardium also known as
epicardium
What does the pericardial cavity contain and what does it do
contains serous fluid and facilitates frictionless movement
Where is the oblique pericardial sinus located
posterior surface of heart inferior to pulmonary vv
-formed by the serous pericardium reflected around the vv
Where is the transverse pericardial sinus
passage posterior to ascending aorta and pulmonary trunk, but anterior to superior vena cava
- used in heart bypass surgery for access to vessels
Where does the pericardiacophrenic a branch from and what does it supply
Branch from internal thoracic
Runs with phrenic n to parietal pericardium and thoracic diaphragm
What does the percardiophrenic vein drain into
drains in to the internal thoracic v or brachiocephalic v
What is the nerve roots for the phrenic nerve
C3-4-5 VPR
What type of innervation does the phrenic nerve provide to
somatic sensory innervation (pain)– for mediastinal pleura
- pain felt directly posterior to sternum
- referred pain to ipsilateral supraclavicular region
What is pericarditis
Inflammation of the serous pericardium
- Roughens the serous layers of the pericardium causing fluid buildup
- may compress the heart and cause cardiac tamponade
What is hemopericardium
Blood accumulation in the pericardial sac
-Causes the veins in neck to become engorged as SVC is compressed
Where is pericardiocentesis performed
5th or 6th intercostal space into the bare area
