Posterior Mediastinum Flashcards
Where does the thoracic duct begin?
Cisterna chyli at L1-L2
Where does the thoracic duct end?
flows into the venous side of the circulation
at the LEFT VENOUS ANGLE
Notch at left internal jugular vein and left subclavian vein
What does the right lymphatic trunk drain?
Right arm
right side of head
right side of upper abdomen
What does the thoracic duct drain?
The rest of the body that isn’t drained by the right lymphatic duct
Where does the esophagus deviate?
Deviates left and passes through diaphragm at T10
anterior to aorta
What structures lie behind the pericardium?
sympathetic chain
Posterior veins on the right side drain into what?
Azygos vein
Posterior veins on the left side drain into what?
Hemi-azygos / accessory hemiazygos
What does the hemiazygos and accessory hemiazygos vein drain into?
azygos vein
What does the right superior intercostal vein drain?
2nd 3rd and 4th intercostal space – empty into azygos
what does the left superior intercostal vein drain?
1st - 4th intercostal space – drains into accessory hemiazygos / maybe hemiazygos
What does the right supreme intercostal vein drain?
1st intercostal space
What does the supreme intercostal vein drain into?
brachiocephalic
Where does the right lymphatic duct end?
empties in the junction of the right subclavian vein and right jugular vein
Right venous angle
When does the thoracic duct cross over to the left side of the body?
Around T4 - T5
What is the cisterna chyli formed by?
Left and right lumbar trunks
and intestinal trunk
When does the thoracic duct enter through aortic hiatus?
T12
Explain the drainage of lymph nodes in the lungs
pulmonary nodes –> bronchopulmonary (hilar) nodes –> inferior tracheobronchial (carinal) nodes –> superior tracheobronchial nodes –> tracheal nodes –> flows in to circulation
What lymph nodes are found where the carina is located?
Inferior tracheobronchial (carinal) nodes
Where does the esophagus descend from?
Superior mediastinum
Where is the esophagus located?
Posterior and to the right of aortic arch
Behind pericardium, left atrium, and left main bronchus
Explain if the right or left vagal trunk are posterior or anterior to the esophagus
Right vagal trunk is posterior
Left vagal trunk is anterior
What is the 1st intercostal space supplied w/ blood by?
subclavian artery
How are intercostal spaces supplied with blood?
Internal thoracic arteries give rise to the anterior intercostal arteries that connect with the posterior intercostal arteries
What does the posterior intercostal arteries originate from?
Descending aorta
What are complications of aortic dissections?
Arterial branch obstructions (stroke, heart attack, abdominal pain) –
Rupture and extravasation (hemopericardium, hemothorax) –
What is a Stanford A aortic dissection
Ascending portion of aortic arch is involved
Surgical innervation needed
What is a Stanford B aortic dissection
Descending aorta involved treated medcially (blood pressure control)
What is a true lumen and how can you it is a true lumen?
Surrounded by calcifications
smaller than false lumen
How can you see a false lumen?
Delayed enhancement
larger than true lumen
outer curve of the arch
usually origin of the left renal artery
What do you call blood in the pericardial sac?
Hemopericardium
What do you call blood in the thorax?
Hemothorax
What do you call blood in mediastinum?
Hemomediastinum
What are arterioles?
terminal vessels of arterial system
control blood flow to capillary networks
site of the greatest resistance to blood flow
responsible for maintaining blood pressure
Do arterioles have internal elastic membrane?
NO
Where are continuous capillaries found?
in muscle, connective and nerve tissues and exocrine glands
Where are fenestrated capillaries found?
kidney, intestine, and endocrine glands
Where are sinusoidal capillaries found?
liver, bone marrow, spleen
