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ANAT241 module 4 > Mediastinum II > Flashcards

Mediastinum II Flashcards

1
Q

what are the major divisions of the mediastinum?

A

Superior
Inferior (anterior, middle, posterior)

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2
Q

what is in the superficial division of the mediastinum?

A

Internal thoracic aorta
Thymus
Superior vena cava
Parasternal lymphatics

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3
Q

what is in the middle layer of the mediastinum?

A

Arch of the aorta
Pulmonary trunk
Vagus nerve
Phrenic nerve

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4
Q

what is in the deep layer of the mediastinum?

A

Trachea
Esophagus
Recurrent laryngeal n.
Thoracic duct
Azygos vein
Sympathetic trunk

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5
Q

what is contained in the superior mediastinum?

A

-Thymus, thoracic duct
- Internal thoracic blood vessels, great vessels of the heart, ligamentum arteriosum, azygous veins
- Vagus nerve, phrenic nerve, recurrent laryngeal nerve, sympathetic trunk
- Trachea
- Esophagus

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6
Q

what are the 3 layers of the superior mediastinum?

A

-superficial
-middle
-Deep

*different on the left and right

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7
Q

what is contained in the superficial layer of the superior mediastinum?

A

Internal thoracic arteries and veins
- inferior anterior mediastinum
Thymus
Superior vena cava and major branches
Parasternal lymphatics

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8
Q

what are the features of the thymus?

A

Immediately posterior to sternum
Bi-lobar

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9
Q

what is the role of the thymus?

A

Early development of the immune system
- T-cells multiply, differentiate into specialised immune cells, prevent autoimmunity

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10
Q

what are the features of the thymus in children?

A

Root of the neck
- as far superiorly as thyroid cartilage
Inferior anterior mediastinum
- 4th costal cartilage

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11
Q

what are the features of the thymus in adults?

A

-Atrophies after puberty
- Mostly fatty tissue

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12
Q

what happens if the left BCV is distended?

A

it can extend above the superior media stinum
- becomes vulnerable to suprasternal incisions

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13
Q

what are the features of the left and right brachiocephalic veins?

A

-Subclavian vein and internal jugular vein
- Posterior to medial ends of clavicles

The left BCV is longer than the right
- has to pass anterior to the branches of the aorta

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14
Q

what do the brachiocephalic veins drain?

A

Drainage of the upper limb, head and neck

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15
Q

what is contained within the middle layer of the superior mediastinum?

A
  • Aortic arch and major branches (pulmonary trunk and pulmonary arteries (middle mediastinum))
  • Ligamentum arteriosum
  • Vagus nerve
    -phrenic nerve
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16
Q

what are the features of the arch of the aorta?

A
  • Emerges from pericardial sac as ascending aorta
  • Sternal angle=arch

Course
- Superior (mid-manubrium), posterilateral (left)

3 main branches

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17
Q

what are the ABC’s of the Aorta?

A

Arch
Brachiocephilic arch
left Common carotid artery
left Subclavian artery

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18
Q

what are the features of the Pulmonary trunk and arteries?

A
  • (middle mediastinum)
  • Emerges: left of arch
  • Passes: posterior to superior vena cava and arch of aorta
19
Q

where does the vagus nerve emerge from?

A

10th cranial nerve - brainstem

20
Q

what is the role of the vagus nerve?

A

Parasympathetic innervation to thoracic and abdominal organs

21
Q

where is the vagus nerve?

A

Lateral to trachea
Left: lateral to arch of aorta

22
Q

where does the phrenic nerve arise from?

A

C3, C4, and C5

23
Q

what does the vagus nerve innervate?

A

Esophageal plexus, cardiac plexus, pulmonary plexus

24
Q

what does the phrenic nerve innervate?

A

Diaphragm, pericardium (parietal serous and fibrous) and pleura

25
Q

where is the phrenic nerve?

A

-behind the subclavian vein, in front of the lung root
- Lies as lateral as possible- in contact with mediastinal pleura
- on the lateral aspect of the great vessles

26
Q

what is contained within the deep layer of the superior mediastinum?

A

Trachea
Esophagus
Left recurrent laryngeal nerve (vagus)
Thoracic duct
Azygos vein
Sympathetic trunks

27
Q

what is the function of the lower esophageal sphincter?

A

Controls entrace into the stomach

28
Q

what are the narrowings of the esophagus?

A
  • Upper esophageal sphincter (C6, cricoid)
  • Aortic arch
  • Left main bronchus
  • Esophageal hiatus (diaphragm)
29
Q

where does the esophagus run?

A

Joins the pharynx to the stomach
- Cervical (skeletal muscle), thoracic, abdominal (smooth muscle)

30
Q

what is posterior to the esophagus?

A

Vertebral bodies

31
Q

what is anterior to the esophagus?

A

Trachea

32
Q

what is right to the esophagus?

A

Azygos vein

33
Q

what is left to the esophagus?

A

Arch of the aorta

34
Q

what is the recurrent laryngeal nerve?

A

Branch of the vagus nerve
There are left and right

35
Q

what are the features of the left recurrent laryngeal nerve?

A

-superior mediastinum
-ligamentum arteriosum
-Arch of the aorta

36
Q

what are the features of the right recurrent laryngeal nerve?

A

-neck region
-right subclavian artery

37
Q

what does the recurrent laryngeal nerve innervate?

A

Trachea
Esophagus
Larynx

38
Q

what can happen to the left recurrent laryngeal nerve?

A

It is susceptible to compression as it passes under the aortic arch

the symptoms: vocal cord paralysis, hoarsenees of voice

39
Q

where is the thoracic duct?

A

Posterior infeior mediastinum
- Cisterna chyli (T12)
- Between aorta and azygous vein
- Moves to the left (alongside aorta) behind esophagus

40
Q

what is the role of the thoracic duct?

A

Drains into left brachiocephalic vein
- junction between the internal jugular vein and left subclavian vein

Drains body of lymph
- except right upper limb, right half of thorax, head and heck = right lymphatic duct

41
Q

what are the features of the Azygos vein?

A
  • Right laternal aspect of vertebral bodies
  • Venous drainage: posterior thoracic wall (upper lumbar region)- posterior intercostal veins
    -Superior aspect is located within superior mediastinum
42
Q

where does the azygos vein enter?

A

Superior vena cava

43
Q

what is the sympathetic trunk of the nervous system?

A

-Parallel chains of nerves
- Lateral to vertebral column (neck of ribs)

-Sympathetic innervation thoracic and abdominal viscera
Superior mediastinum (pulmonary, esophageal, cardiac plexuses)

ANAT241 module 4 (5 decks)

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