Part I. Mediastinum Flashcards
What is the transverse thoracic plane?
A line between sternal angle and T4-T5 IVD
What level is the transverse thoracic plane?
T4-T5 IVD
What is the arterial supply of the thymus?
Internal Thoracic A and Anterior Intercostal A
What is the venous supply of the thymus?
Internal Thoracic V and L Brachiocephalic V
Where does lymph drainage go from the thymus?
Parasternal, Brachiocephalic and Tracheobronchial nodes
Left Brachiocephalic Vein receives lymph via ____ while the Right Brachiocephalic Vein receives lymph via ____
Thoracic Duct
Right Lymphatic Duct
What is the carina?
Internal ridge of tissue located at the tracheal bifurcation
What level is the carina located at?
Level of ~T5
What is key about the carina? (…sensitive area…)
Sensitive area regarding the cough reflex
At what level does the Descending Thoracic Aorta begin?
T4 (continuation of aortic arch)
The Descending Thoracic Aorta passes behind thoracic diaphragm via:
Aortic Hiatus (at T12)
After the Descending Thoracic Aorta passes through the Aortic Hiatus, what does it continue inferior as?
Abdominal Aorta
What structures pass through the aortic hiatus?
Descending Thoracic Aorta
Thoracic Duct
Azygos V
The Descending Thoracic Aorta has three vascular planes. One of them is the Unpaired Anterior Visceral Branches. What is an example of this?
Esophageal aa. (2-5)
The Descending Thoracic Aorta has three vascular planes. One of them is the Paired Lateral Visceral Branches. What is an example of this?
Bronchial aa.
The Descending Thoracic Aorta has three vascular planes. One of them is the Paired Parietal Visceral Branches. What is an example of this?
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
That is the start and end of the esophagus?
Pharynx to stomach
What level is the trachea?
T1-T4
What is the superior border of the superior mediastinum?
Superior thoracic aperture
What is the inferior border of the superior mediastinum?
Transverse thoracic plane (line between sternal angle and T4-T5 IVD)
What is the superior border of the Mediastinum?
Superior thoracic aperture
What is the inferior border of the Mediastinum?
Thoracic diaphragm
What is the anterior border of the Mediastinum?
Sternum and costal cartilages
What is the posterior border of the Mediastinum?
Bodies of thoracic vertebrae
What is the lateral border of the Mediastinum?
Mediastinal pleura
Where is the arch of the aorta located ina supine position?
Superior to transverse thoracic plane
Where is the arch of the aorta in standing/sitting?
at the transverse thoracic plane
Where is the tracheal bifurcation in supine?
at the transverse thoracic plane
Where is the tracheal bifurcation in standing/sitting?
Inferior to transverse thoracic plane
Where is the inferior aspect of the heart in supine?
Xiphisternal junction and T9 vertebral body
Where is the inferior aspect of the heart in standing/sitting?
Middle of xiphoid process and T9/T10 IVD
What is the superior border of the inferior mediastinum?
Transverse thoracic plane
What is the inferior border of the inferior mediastinum?
Thoracic diaphragm
What is the inferior mediastinum divided into?
Anterior, middle, posterior parts
What is the ligament that connects pericardium to the diaphragm?
Pericardiophrenic ligaments
What anchors the pericardium anteriorly to the sternum?
Sternopericardial ligament
What anchors the pericardium superior?
Base of the great vessels
What anchors the pericardium posteriorly?
Loose connective tissue
What is the pericardial cavity?
Potential space between visceral and parietal layers of serous pericardium
What sinus is posterior to Ascending Aorta and Pulmonary Trunk and anterior to Superior Vena Cava?
Transverse pericardial sinus
What sinus is posterior to base of hear and inferior to Pulmonary vvs?
Oblique pericardial sinus
What artery travels with Phrenic N?
Pericardiacophrenic A
What does the Pericardiacophrenic A supply?
supply Thoracic Diaphragm and Pericardium
What N innervates pericardium and diaphragm?
Phrenic N
Where is pericardial pain felt?
Retrosternally… often refers to C3 C4 C5
What kind of tissue is the outer layer of the pericardium?
fibrous, made of dense connective tissue
What kind of tissue is the inner layer of the pericardium?
serous, made of mesothelium
What layer of the pericardium is continuous with the visceral pericardium and reflects onto heart and great vessels?
serous layer
What is the histological term for visceral pericardium?
epicardium
The potential space between visceral and parietal pericardium is called what? What does it contain?
pericardial cavity, contains fluid to reduce friction
The condition of inflammation of the pericardium? What are the clinical symptoms?
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
Pericardial effusion (fluid accumulation) could result in what?
Cardiac tamponade
What is cardiac insufficiency?
failure of heart valve to close fully. Most common in mitral valve and will cause systolic murmur
What is cardiac prolapse?
cardiac valve pushes back into atrium causing a leak and a mid systolic click
What is cardiac stenosis?
failure of a valve to open fully. Most common in aortic semilunar valves and cane be replace surgically
What is coronary artery disease?
blood flow through the coronary arteries is reduced, compromising function of the heart.
What are two common causes of coronary artery disease
embolus and atherosclerosis
What are the three most common coronary arteries to occlude?
anterior interventricular artery 40-50% of the time
Right coronary artery 30-40% of the time
circumflex artery 15-20% of the time
Insufficient blood flow to myocardium, resulting in necrosis and fibrous scar tissue formation is called what?
myocardial infarction
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?
angiography
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?
angioplasty
May be combined with thrombokinase to break up clot and/or a stent to maintain luminal potency.
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?
coronary bypass graft
great saphenous vein, radial artery are commonly used or the internal thoracic can be diverted to the heart