Mediastinum/Pericardium

Question 1

procedure to view or biopsy mediastinal lymph nodes

Answer 1

mediastinoscopy

Question 2

trauma from hemorrhage of great vessels, hypertrophy of heart (congestive heart failure), or malignant lymphoma in lymph node can cause?

Answer 2

widening of mediastinum

Question 3

how would you expose the superior and inferior vena cavas?

Answer 3

open the pericardial sac

Question 4

what is the surgical significance of the transverse pericardial sinus?

Answer 4

ability to stop or divert blood flow of aorta or pulmonary trunk during surgery due to its location

Question 5

inflammation of pericardium, rough serous pericardium, chronic inflammation can calcify

Answer 5

pericarditis

Question 6

passage of fluid from pericardial capillaries into pericardial cavity, compressing heart

Answer 6

pericardial effusion

Question 7

right cardiac hypertension, venous blood return exceeds cardiac output

Answer 7

non-inflammatory pericardial effusion

Question 8

pericardial effusion causes compression of heart, which leads to decrease in cardiac output

Answer 8

cardiac tamponade

Question 9

blood in pericardial cavity from weakened heart muscles (myocardial infarction), bleeding from surgery, or stab wounds; veins of face & neck become engorged (high pressure)

Answer 9

hemopericardium

Question 10

drainage of fluid in pericardial cavity; typical treatment of cardiac tamponade

Answer 10

pericardiocentesis

Question 11

where do you stick a needle for pericardiocentesis?

Answer 11

in left 5th/6th ICS near sternum

Question 12

position of heart is completely reversed so apex is pointing towards right side

Answer 12

dextrocardia

Question 13

dysphagia (difficulting swallowing) might be indicative of?

Answer 13

retroesophageal right subclavian artery (most left sided branch of aorta & crosses posterior to esophagus & can compress it)

Question 14

accessory artery to thyroid gland that may arise from brachiocephalic artery

Answer 14

thyroid irna artery

Question 15

aortic arch that curves over right root of lung?

Answer 15

right arch of aorta

Question 16

vascular ring around esophagus and trachea; can compress these structures

Answer 16

double arch of aorta

Question 17

chest pain that radiates to the back is indicative of?

Answer 17

aneurysm of ascending aorta because it isn’t reinforced by fibrous pericardium; evident on chest film/angiogram

Question 18

aneurysm of ascending aorta, enlargement of mediastinal lymph nodes, or bronchogenic/esophageal carcinoma may cause what common injury?

Answer 18

compression of the left recurrent laryngeal nerve because it winds around arch of aorta and ascends between trachea & esophagus

Question 19

chylothorax; lymph escaping into thoracic cavity

Answer 19

laceration of thoracic duct

Question 20

how would blood get back to the heart if the superior vena cava is obstructed?

Answer 20

azygos vein will drain into abdominal wall veins and then into inferior vena cava into right atrium

Question 21

if the azygous system receives all blood via inferior vena cava (except of that from liver) this is indicative of?

Answer 21

IVC obstruction

Question 22

visualization of aorta with radioplaque contrast material

Answer 22

aortic angiography