Posterior mediastinum

Question 1

Describe the azygos system of veins

Answer 1

Runs posterior to the heart on the right hand side. Is made by the ascending lumbar veins and the right subcostal veins inferiorly and the right intercostal vein superiorly.

On the right hand side, the hemiazygos (inferior) and the accessory hemiazygos vein (superior) join the azygos at about T8/T9

Question 2

Describe the pathway of the thoracic duct

Answer 2

In the lumbar region, the cisterna chyli moves up the abdomen as the thoracic duct in the midline.
It crosses to the left at about T5, and drains into the left subclavian by the junction of the left subclavian and the left internal jugular.

Question 3

What supplies the oesophagus?

Answer 3

Arterial: Aorta and left gastric
Venous: Left gastric and azygos system
Nerve: P/S vagus, Sympathetic trunk

Question 4

What are the three depressions in the oesophagus?
(sup -> inf)
difficulty swalowing

Answer 4

1- where the aortic arch comes out of the heart (aortic aneurysm)
2- where the left main bronchus is (a lung cancer)
3- oesophageal hiatus (diaphragm/left and right crus)

Question 5

TREE DIAGRAM

Answer 5

pg 74 pls

Question 6

What is coarctation?

Answer 6

Narrowing of aorta (something to do with ductus arteriosus)

Question 7

How is coarctation bypassed? assuming it is after the three main branches of the aortic arch

Answer 7

1- increased blood flow to internal thoracic, thus inreased blood flow to anterior intercostals, thus increased flow to the posterior intercostals (due to anastomoses).

2- increased blood flow to internal thoracic down to superior epigastric, to inferior epigastric, to external iliac to femoral