Posterior mediastinum Flashcards

1
Q

What are the following boundaries of the posterior mediastinum?
- anterior
- posterior
- superior
- inferior

A

anterior = heart and pericardium
posterior = T5-T12
superiorly = angle of louis
inferiorly = diaphragm

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2
Q

What are the contents of the posterior mediastinum

A

DATES
Descending thoracic aorta
Azygous vein
Thoracic duct
Esophagus
Sympathetic trunk chain

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3
Q

What are the two branches of the descending thoracic aorta

A

parietal and visceral branches

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4
Q

What is included in the parietal branches of the descending thoracic aorta

A

posterior intercostal arteries
subcostal artery
superior phrenic arteries

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5
Q

What is included in the visceral branches of the descending thoracic aorta

A

pericardial, bronchial, esophageal and mediastinal branches

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6
Q

What is the function of the azygous vein

A

drains blood from the body wall and moves it to the superior vena cava

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7
Q

What is the difference between the accessory azygous and hemiazygous vein

A

both drain blood but hemiazygous only drains blood up to T9 and accessory only drains blood up to T8

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8
Q

Describe the function of the thoracic duct

A

begins at the cisterna chyli and drains the abdominal viscera, pelvis and lower limbs. Runs from LII to the root of the neck and lymph is drained into the venous system and is emptied into the junction of the left subclavian and left internal jugular vein

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9
Q

What arteries supply the oesophagus

A

oeseophageal arteries from the aorta
bronchial arteries
ascending branches of the gastric arteries

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10
Q

What veins are associated with the oesophagus

A

small vessels returning to the azygous vein, hemiazygous vein and oesophageal branches to the left gastric veins

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11
Q

What do the right and left vagus nerves go on to form

A

forms the oesophageal plexus. then goes on to form:
- anterior vagal trunk (mainly from fibres from the left vagus nerve)
- posterior vagal trunk (mainly from fibres from the right vagus nerve)

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12
Q

What is the sympathetic trunk

A

2 parallel chains, each with 11/12 ganglia

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13
Q

State the differences between the first 5 ganglion of the sympathetic trunk and the posterior 7

A

first 5 = postganglionic sympathetic fibres, supply the thoracic viscera
posterior 7 = preganglionic sympathetic fibres, supply abdominal and pelvic nerves. also contains the splanchnic nerves

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14
Q

What are the 3 types of splanchnic nerves

A

greater, lesser and least

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15
Q

Where is the greater splanchnic nerve and what is its role

A

from T5 -> T 9/10
ends in the celiac ganglion
provides sympathetic innervation to the abdominal viscera

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16
Q

What are the 3 hiatus’

A

caval, oesophageal and thoracic aorta

17
Q

What is the caval hiatus and what T level

A

T8
- IVC
- terminal branches of right phrenic nerve

18
Q

What is the oesophageal hiatus and what T level

A

T10
oesophagus
right and left vagus nerves
oesophageal branches of left gastric arteries/veins

19
Q

What is the thoracic aorta and what T level

A

T12
aorta
thoracic duct
azygous vein

20
Q

What is the thoracic aorta hiatus also known as

A

the median arcuate ligament -> a type of crus where the diaphragm thickens around the hiatus

21
Q

What occurs when the phrenic nerve stops working

A

paralysis of the diaphragm

22
Q

What type of muscle is the diaphragm

A

skeletal because you can control your breathing

23
Q

What stage of respiration needs energy

A

inspiration because the diaphragm is actively pushed down

24
Q

How can you differentiate between a CT above and below the sternal angle

A

above = trachea has not bifurcated

25
Q

How can you identify the pulomonary trunk in a CT

A

Y shaped

26
Q

What is the structure of the right hilum

A

bronchus superior
pulmonary vein inferior
pumonary artery in the middle

27
Q

What is the blood supply to the SA node

A

nodal arery from RCA

28
Q

What is the blood supply to the AV node

A

nodal artery from RCA

29
Q

What is the blood supply to the AV bundle of his

A

mainly yhe LAD artery

30
Q

Where do the ostia of the coronary arteries lie

A

the openings for the R+L coronary arteries lie just above the aortic valve

31
Q

What is an angioplasty

A

using a balloon to stretch open a narrowed artery

32
Q

What is a stent

A

metal tube used to keep vessels open

33
Q

Describe the vessels between the right brachial artery and the right coronary artery

A

right brachial artery
right axillary artery
brachiocephalic trunk
arch of aorta
ascending aorta
right aortic sinus
right coronary sinus
right coronary artery