POSTERIOR MEDIASTINUM Flashcards

1
Q

Boundaries of the posterior mediastinum

A
  • Heart
  • T4/T5 disc
  • T5-T12
  • Diaphragm
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2
Q

Contents of the posterior mediastinum

A
  • Thoracic aorta
  • Esophagus
  • Azygos venous system
  • Vagus nerve plexus
  • Sympathetic trunk
  • Thoracic duct
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3
Q

Where does the thoracic (descending) aorta start and end?

A

starts at T4/T5 vertebral disc junction, ends/enters abdomen at T12

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4
Q

What are the branches of the thoracic (descending) aorta? (What are the main 2?)

A

Posterior I/C aa & Esophageal aa = main 2
Others: Bronchial aa, Mediastinal aa, Pericardial aa

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5
Q

Where does the esophagus start and end?

A

begins in neck – has cervical/thoracic/abdominal parts, enters abdomen through diaphragm at T10

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6
Q

In the superior mediastinum what structures are anterior to the esophagus?

A

trachea, L recurrent laryngeal nerve

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7
Q

In the superior mediastinum what structures are posterior to the esophagus?

A

vertebral column

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8
Q

In the posterior mediastinum what structures are anterior to the esophagus?

A

vagus nerve plexus

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9
Q

In the posterior mediastinum what structures are posterior to the esophagus?

A

thoracic duct, aorta, hemiazygos veins

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10
Q

In the posterior mediastinum what structures are to the R of the esophagus?

A

azygos vein

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11
Q

L recurrent laryngeal nerve travels

A

between trachea and esophagus and back up to larynx

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12
Q

Azygos venous system is formed in the ____ and enters the thorax at what vertebral level?

A

abdomen, T12

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13
Q

The azygos venous system anastomoses with the ____ in the ______

A

IVC, abdomen

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14
Q

Azygos vein system consists of what 2 parts?

A

azygos and hemiazygos vein

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15
Q

azygos vein tributaries

A

R posterior I/C veins, bronchial, esophageal, hemiazygos veins

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16
Q

azygos veins into the _____ at _____

A

SVC, T4

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17
Q

hemiazygos vein drains

A

L posterior I/C veins

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18
Q

What side is the azygos and hemiazygos veins associated with on the body?

A

azygos = R, hemiazygos = L

19
Q

Accessory hemiazygos veins drains the

A

upper L posterior I/C veins

20
Q

the azygos venous system drains structures of the

A

thorax

21
Q

The main drainage of the azygos venous system is the ______ which drains the ______. Why is this the main drainage?

A

azygos vein, posterior thoracic cage
- main drainage because hemiazygos drains into azygos

22
Q

Where does the thoracic duct start and end?

A

starts at cisterna chyli at T12, ends at junction of L IJV + L subclavian with L brachiocephalic vein

23
Q

What structures run between the thoracic duct?

A

azygos vein and aorta

24
Q

What structures are anterior to the thoracic duct?

A

esophagus

25
Q

The function of the thoracic duct is to drain what 3 things?

A
  • All lymphatics below diaphragm
  • L side of thorax
  • L upper limb/head and neck  via tributaries that end at thoracic duct
26
Q

The thoracic duct carries ____ and drains into the _________

A

lymphatic fluid, brachiocephalic

27
Q

Compression of the thoracic duct would lead to what?

A

swelling in thoracic cage

28
Q

What is the cistern chili?

A

structure located at the junction of diaphragm separating thorax from abdomen

29
Q

Above the diaphragm the thoracic duct drains everything on the

A

L

30
Q

Below the diaphragm the thoracic duct drains everything on the

A

R and L

31
Q

R lymphatic duct opens at

A

junction of R IJV + R subclavian with R brachiocephalic vein

32
Q

Function of the R lymphatic drain is the drain what 2 things?

A
  • R side of thorax
  • R upper limb/head and neck (via tributaries that end at R lymphatic duct)
33
Q

Blockage of the lymphatic system lead to swelling of tissues _____ to blockage

A

distal

34
Q

The sympathetic trunk is a ______ that runs…

A

chain of ganglia that run parallel to vertebral column on both sides (“beads on a chain”)

35
Q

Sympathetic trunk supplies ____ innervation to the

A

sympathetic - cardiac, pulmonary, and esophageal plexuses

36
Q

In the thorax, the sympathetic trunk gives rise to

A

greater, lesser, and least splanchnic nerves (T5-T12)

37
Q

The sympathetic trunk, in the thorax, gives rise to innervation at what vertebral levels?

A

T5-T12

38
Q

Sympathetic trunk is an anatomical landmark for

A

nerve fibers exiting spinal cord to get to muscles in he thoracic region/upper limbs

39
Q

Splanchnic Nerves

A

faint nerves extending off of ganglia that penetrate through diaphragm to get to GI tract

40
Q

splanchnic nerves originate in the

A

thorax

41
Q

What are the 3 diaphragmatic apertures and where are they located?

A

Vena caval hiatus - T8
Esophageal Hiatus - T10
Aortic Hiatus - T12

42
Q

What structures pass through at the venal caval hiatus?

A

IVC

43
Q

What structures pass through at the esophageal hiatus?

A

esophagus, Vagus nerves

44
Q

What structures pass through at the aortic hiatus?

A

aorta, thoracic duct, azygos vein, (possibly sympathetic splanchnic nerves)