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Gross III > Part I. Mediastinum > Flashcards

Part I. Mediastinum Flashcards

1
Q

What is the transverse thoracic plane?

A

A line between sternal angle and T4-T5 IVD

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2
Q

What level is the transverse thoracic plane?

A

T4-T5 IVD

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3
Q

What is the arterial supply of the thymus?

A

Internal Thoracic A and Anterior Intercostal A

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4
Q

What is the venous supply of the thymus?

A

Internal Thoracic V and L Brachiocephalic V

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5
Q

Where does lymph drainage go from the thymus?

A

Parasternal, Brachiocephalic and Tracheobronchial nodes

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6
Q

Left Brachiocephalic Vein receives lymph via ____ while the Right Brachiocephalic Vein receives lymph via ____

A

Thoracic Duct

Right Lymphatic Duct

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7
Q

What is the carina?

A

Internal ridge of tissue located at the tracheal bifurcation

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8
Q

What level is the carina located at?

A

Level of ~T5

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9
Q

What is key about the carina? (…sensitive area…)

A

Sensitive area regarding the cough reflex

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10
Q

At what level does the Descending Thoracic Aorta begin?

A

T4 (continuation of aortic arch)

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11
Q

The Descending Thoracic Aorta passes behind thoracic diaphragm via:

A

Aortic Hiatus (at T12)

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12
Q

After the Descending Thoracic Aorta passes through the Aortic Hiatus, what does it continue inferior as?

A

Abdominal Aorta

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13
Q

What structures pass through the aortic hiatus?

A

Descending Thoracic Aorta
Thoracic Duct
Azygos V

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14
Q

The Descending Thoracic Aorta has three vascular planes. One of them is the Unpaired Anterior Visceral Branches. What is an example of this?

A

Esophageal aa. (2-5)

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15
Q

The Descending Thoracic Aorta has three vascular planes. One of them is the Paired Lateral Visceral Branches. What is an example of this?

A

Bronchial aa.

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16
Q

The Descending Thoracic Aorta has three vascular planes. One of them is the Paired Parietal Visceral Branches. What is an example of this?

A

Posterior intercostal aa. (9 pair)

Subcostal aa. (1 pair) remember this is an intercostal artery, but it’s below the 12th rib so its just sub-costal

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17
Q

That is the start and end of the esophagus?

A

Pharynx to stomach

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18
Q

What level is the trachea?

A

T1-T4

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19
Q

What is the superior border of the superior mediastinum?

A

Superior thoracic aperture

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20
Q

What is the inferior border of the superior mediastinum?

A

Transverse thoracic plane (line between sternal angle and T4-T5 IVD)

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21
Q

What is the superior border of the Mediastinum?

A

Superior thoracic aperture

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22
Q

What is the inferior border of the Mediastinum?

A

Thoracic diaphragm

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23
Q

What is the anterior border of the Mediastinum?

A

Sternum and costal cartilages

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24
Q

What is the posterior border of the Mediastinum?

A

Bodies of thoracic vertebrae

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25
Q

What is the lateral border of the Mediastinum?

A

Mediastinal pleura

26
Q

Where is the arch of the aorta located ina supine position?

A

Superior to transverse thoracic plane

27
Q

Where is the arch of the aorta in standing/sitting?

A

at the transverse thoracic plane

28
Q

Where is the tracheal bifurcation in supine?

A

at the transverse thoracic plane

29
Q

Where is the tracheal bifurcation in standing/sitting?

A

Inferior to transverse thoracic plane

30
Q

Where is the inferior aspect of the heart in supine?

A

Xiphisternal junction and T9 vertebral body

31
Q

Where is the inferior aspect of the heart in standing/sitting?

A

Middle of xiphoid process and T9/T10 IVD

32
Q

What is the superior border of the inferior mediastinum?

A

Transverse thoracic plane

33
Q

What is the inferior border of the inferior mediastinum?

A

Thoracic diaphragm

34
Q

What is the inferior mediastinum divided into?

A

Anterior, middle, posterior parts

35
Q

What is the ligament that connects pericardium to the diaphragm?

A

Pericardiophrenic ligaments

36
Q

What anchors the pericardium anteriorly to the sternum?

A

Sternopericardial ligament

37
Q

What anchors the pericardium superior?

A

Base of the great vessels

38
Q

What anchors the pericardium posteriorly?

A

Loose connective tissue

39
Q

What is the pericardial cavity?

A

Potential space between visceral and parietal layers of serous pericardium

40
Q

What sinus is posterior to Ascending Aorta and Pulmonary Trunk and anterior to Superior Vena Cava?

A

Transverse pericardial sinus

41
Q

What sinus is posterior to base of hear and inferior to Pulmonary vvs?

A

Oblique pericardial sinus

42
Q

What artery travels with Phrenic N?

A

Pericardiacophrenic A

43
Q

What does the Pericardiacophrenic A supply?

A

supply Thoracic Diaphragm and Pericardium

44
Q

What N innervates pericardium and diaphragm?

A

Phrenic N

45
Q

Where is pericardial pain felt?

A

Retrosternally… often refers to C3 C4 C5

46
Q

What kind of tissue is the outer layer of the pericardium?

A

fibrous, made of dense connective tissue

47
Q

What kind of tissue is the inner layer of the pericardium?

A

serous, made of mesothelium

48
Q

What layer of the pericardium is continuous with the visceral pericardium and reflects onto heart and great vessels?

A

serous layer

49
Q

What is the histological term for visceral pericardium?

A

epicardium

50
Q

The potential space between visceral and parietal pericardium is called what? What does it contain?

A

pericardial cavity, contains fluid to reduce friction

51
Q

The condition of inflammation of the pericardium? What are the clinical symptoms?

A

pericarditis

  • audible sounds heard with stethoscope due to roughened serous layer
  • causes chest pain and possibly pericardial effusion (fluid accumulation) which could impair cardiac function
52
Q

Pericardial effusion (fluid accumulation) could result in what?

A

Cardiac tamponade

53
Q

What is cardiac insufficiency?

A

failure of heart valve to close fully. Most common in mitral valve and will cause systolic murmur

54
Q

What is cardiac prolapse?

A

cardiac valve pushes back into atrium causing a leak and a mid systolic click

55
Q

What is cardiac stenosis?

A

failure of a valve to open fully. Most common in aortic semilunar valves and cane be replace surgically

56
Q

What is coronary artery disease?

A

blood flow through the coronary arteries is reduced, compromising function of the heart.

57
Q

What are two common causes of coronary artery disease

A

embolus and atherosclerosis

58
Q

What are the three most common coronary arteries to occlude?

A

anterior interventricular artery 40-50% of the time
Right coronary artery 30-40% of the time
circumflex artery 15-20% of the time

59
Q

Insufficient blood flow to myocardium, resulting in necrosis and fibrous scar tissue formation is called what?

A

myocardial infarction

60
Q

A catheter is fed through the aorta via femoral artery to narrowed coronary artery and radiopaque fluid is released to visualize the narrowing. What is this called?

A

angiography

61
Q

A catheter is fed through the aorta via the femoral artery to a narrowed coronary artery and a balloon is inflated which pushes atherosclerotic plaque open. What is this called? What other procedures can be combined with this?

A

angioplasty

May be combined with thrombokinase to break up clot and/or a stent to maintain luminal potency.

62
Q

A donor vessel is sewn from the ascending aorta to point distal of coronary artery occlusion. What is this called? What are the common donor vessels?

A

coronary bypass graft

great saphenous vein, radial artery are commonly used or the internal thoracic can be diverted to the heart

Gross III (20 decks)

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