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MD3001 : Anatomy > Middle mediastinum > Flashcards

Middle mediastinum Flashcards

1
Q

what is the pulmonary circulation?

A

right heart pumps deoxygenated blood to the lungs

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2
Q

what is pressure of pulmonary circulation?

A

12-16mmhg

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3
Q

whats the systemic circulation

A

left heart pumps oxygenated blood throughout the body

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4
Q

whats the pressure in the systemic circulation?

A

70-120mmHg

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5
Q

whats the boundaries of the mediastinum?

A

two pleural sacs
sternum
CC
thoracic vertebrae

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6
Q

where lies the plane which halfs the mediastinum into supeurior and inferior mediastinum

A

plane passes through sternal angle and T4/5

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7
Q

why is mediastinum important?

A

its highly mobile region allowing volume and pressure changes

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8
Q

what does the middle mediastinum contain

A 
heart 
pericardium
origins of great vessels - aorta, pulmonary trunk and venacava 
smaller vessels (pulmonary veins)
phrenic nerves and the vagus nerve
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9
Q

right side of the mediastinum

A

related to right atrium and veins

superior VC
arch of azygous
IVC

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10
Q

left side of the mediastinum

A

related to left ventricle

left common carotid
left subclavian
arch of aorta
thoracic aorta

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11
Q

whats the pericardium

A

fibro-serous sac that encloses heart and roots of the great vessels

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12
Q

functions of pericardium

A

anchors heart to surrounding tissues without compormising cardiac movement

prvents overfilling of the heart

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13
Q

what are the 2 layers of the pericardium?

A 
fibrous pericardium (external)
serous pericardium (internal)
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14
Q

fibrous pericardium?

A

external

fuses with adventitia of great vessels

posteriorly =- attached by pericardiovertebral ligaments to the 5th - 8th thoracic vertebrae

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15
Q

anterior attachments of fibrous pericardium

A

anteriorly - attached by sternopericardial ligament to body of sternum and 3rd - 6th costal cartilages

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16
Q

posterior attachments of the fibrous pericardium

A

attached by pericardiovertebral ligaments to the 5th - 8th thoracic vertebrae

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17
Q

inferior attachments of the fibrous pericardium

A

blends with central tendon of the diaphragm (pericardiophrenic ligament)

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18
Q

serous pericardium layers

A

2 layers - parietal and visceral

parietal - lines inner aspect of fibrous pericardium and reflected around roots of great vessels and continues as the visceral layer

visceral layer (around organ) = also known as the epicardium which is attached to the muscles of the walls of the heart

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19
Q

where is the pericardial cavity

A

between parietal and visceral layers of serous pericardium

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20
Q

whats the pericardial fluid made from and what does it do?

A

pericardial fluid is 10-15mL of fluid which is produced by the serous pericardium and reduces friction during contraction of the heart

21
Q

when are the two sinuses formed and how?

A

during embryological development

the heart tube folds and invaginates into the serous pericardium (within fibrous sac) and forms two sinuses

22
Q

whats the oblique sinus

A

also known as Haller’s cul de sac

potential space behind the left atrium

23
Q

whats the transverse sinus

A

also known as sinus of theile
space between the atrial and venous ends of the heart

seperates Aorta and PT from SVC - posterior to ascending aorta and PT and anterior to SVC
superior to LA and pulmonary veins

24
Q

arterial supple to the pericardium

A

supplied by the pericardiacophrenic artery and the musculophrenic artery

(subclavian artery > internal thoracic artery > pericardo and musculophrenic)

25
Q

thoracic aorta is suppled by

A

bronchial arteries
esophageal arteries
superier phrenic arteries

26
Q

visceral layer (epicardium) suppled by

A

coronary artery

27
Q

venous drainage of the pericardium

A

azygos vein drains to the SVC

and the pericardiocophrenic vein which drains to internal thoracic vein which drains to brachiocephalic vein

28
Q

lymphatic drainage of the pericardium

A

tracheobroncial lymph nodes

29
Q

nerve supply of pericardium

A

phrenic nerve - sensory fibres

vagus nerve - vasomotor fibres

cardiopulmonary splanchnic nerves (sympathertic)

30
Q

whats the phrenic nerve

A

branch of the cervical plexus
arising from ventral rami of C3,4,5 - keeps the diaphragm alive
found in the neck

31
Q

where does phrenic nerve enter superior mediastinum

A

between venous and arterial planes (subclavian artery and vein) behind clavicle

32
Q

where does phrenic nerve travel in inferior mediastinum

A

passes anterior to root of lung
accompanied by pericardiacophrenic artery and vein

lies on either side of the ehart between the fibrous percardium and the pariteal pleura of the lungs

33
Q

pathway of left phrenic nerve

A

crosses aortic arch
anterior to root of left lung
over left ventricle

34
Q

pathway of right phrenic nerve

A

adjacent to SVC then IVC

through caval opening

35
Q

what does phrenic nerve supply

A

sole motor supply to diaphragm

sensory fibres to parietal pleura, peritoneum and pleura related to central tendon of diaphragm refered pain

36
Q

refered pain of phrenic nerve?

A

structure with sensory supply via phrenic (pleura, peritoneum and pleura of tendon of diaphragm) can cause refered pain inlateral neck, supraclavicular and shoulder tip due to the supraclavicular nerves C3 and 4 suplying skin over shoulder c4 dermatome

37
Q

phrenic nerve injury

A 
cardiac surgery - snstillation of saline slush for myocardial preservation 
thoracic surgery
lung tumors
mediastinal tumours
polio
latrogenic
38
Q

apex of the heart

A

left 5th intercostal space and 8-10cm left of midline

more superior and lateral in children

39
Q

base of the heart

A

left atrium and pulmonary veins (small portion of the right atrium)

40
Q

where is base of heart fixed

A

posteriorly to pericardium at level of t6(5) - T9(8) vertebrae

the oblique pericardial sinus lies posterior to this

(left atrium is related to the osophagus)

41
Q

surfaces of heart - sternocostal

A

anterior

right ventricle and small portion of right atrium

42
Q

surfaces of the heart - diaphragmatic

A

inferior

left ventricle and small portion of right ventricle
sits on central tendon of diaphragm
seperated from base of heart by the coronary sinus

43
Q

right margin of the heart

A

right pulmonary surface

44
Q

left margin of heart

A

left pulmonary surface

45
Q

inferior margin

A

between anterior and diaphragmatic surfaces

46
Q

obtuse margin

A

between anterior and left pulmonary surfaces

47
Q

what runs in the anterior interventricular sulcus

A

divides ventricles

anterior interventricular artery
great cardiac vein (anterior interventricular vein)

this is to the RIGHT of the apex of the heart

48
Q

what runs in the coronary sulcus

A

seperates atria from ventricles

right coronary artery
left circumflex artery
small cardiac vein
coronary sinus

49
Q

what runs in the posterior interventricular sulcus

A

posterior interventricular artery

middle cardiac vein (posterior interventricular vein)

MD3001 : Anatomy (3 decks)

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