Posterior Mediastinum and the Neck (CVR) Flashcards
What does the Posterior mediastinum contain (6 structures)
- descending (thoracic) aorta
- azygos veins
- oesophagus
- thoracic duct
- sympathetic trunk and splanchnic nerves
- posterior intercostal vessels and nerves
What arteries does the Descending aorta give rise to (5) PBOPP
Posterior intercostal arteries
Bronchial arteries of the lung
Oesophageal branches
Pericardial branches
Phrenic branches
What Level does the aorta pass through the diaphraghm
T12
Where do the azygos veins arise from and Vertabrae level
Arise from diaphragm at level L1/L2
Where do the azygos veins drain blood from
Posterior thoracic wall
Where do the Azygos veins drain into
Superior Vena cava
Where does the azygos vein lie?
Right side of the vertebral bodies
What shorter vein runs on the left side of the vertebral bodies?
Hemiazygos
what three veins does the azygos system receive blood from? (PBO)
Posterior intercostal veins
Bronchial veins
Oesophageal veins
Where does the oesophagus lie in the posterior mediastinum?
Right of the aorta
Where is the oesophageal hiatus and what level is it at
In the diaphragm and at the level of T10
Where does the Thoracic duct lie
Between azygos vein and aorta
What structure does lymph from the lower limbs, pelvis and abdomen flow to that gives rise to the thoracic duct?
Cisterna chyli
Where does the the thoracic duct receive lymph from in the thorax?
Intercostal spaces and lymph nodes
Where does the Thoracic duct terminate?
Opens into venous system at the junction between left internal jugular vein and left subclavian vein
What is the right side of the head and neck and the right upper limb drained by?
Lymphatic duct
What are sympathetic trunks?
Where do they lie?
Thin, longitudinal fibre tracts interspersed with ganglia
Lie on posterior thoracic wall
What are the ganglia in the sympathetic trunks referred to as? Where do the trunks extend from and to?
Paravertebral ganglia
Skull base to coccyx
Where do the cell bodies of the Preganglionic sympathetic neurones lie?
T1-L2/3
What does the Sympathetic trunk allow?
Sympathetic fibres arising from T1-L2/3 to be distributed to all parts of the body
When a Sympathetic fibre leaves the Spinal cord What does it enter?
Sympathetic trunk
What are the three things a sympathetic fibre can do at the Sympathetic trunk?
Synapse in the ganglion at level of entry
Ascends or descends in trunk before synapsing
Travels through a ganglion without synapsing
What does this show? What fibres does this form?
Axon not synapsing in the sympathetic trunk
Abdominopelvic splanchnic nerves
Which Splanchnic nerves involve a synapse within the sympathetic trunk? What levels?
Cardiopulmonary splanchnic nerves
(C4-T5)
What does the posterior intercostal space contain?
Intercostal muscles
Posterior intercostal artery
Posterior intercostal nerve
Posterior intercostal vein
Where does the posterior intercostal artery branch from
Descending aorta
Sympathetic fibres to thoracic viscera?
Cardiopulmonary splanchnic nerves (T1-T5)
What innervates the sinoatrial node ?
Cardiac plexus
Para and sympathetic
What innervates the bronchi? type of innervation
Pulmonary plexus
Parasympathetic and sympathetic
What innervates the Oesophagus?
Oesophageal plexus
Where can cardiac pain be felt?
Central chest
Left side of neck and left arm
Why does myocardic ischaemia cause referred pain?
Cardiac splanchnic nerves T1-T5 have visceral fibres that provide sensation for chest wall, neck and arm (Aswell as heart)
What separates the Anterior and Posterior triangles of the neck?
Sternocleidomastoid
Name a-d
Mandible
Anterior triangle
Sternocleidomastoid
Clavicle
Name e-g
e- Trapezius
f- Posterior triangle
g- Mastoid process
Anterior, posterior and superior boundaries of the anterior triangle?
Anterior- midline
Posterior- Anterior sternoceidomastoid
Superior- mandible
Structures in the anterior triangle
Trachea
Larynx
Thyroid
Suprahyoid muscles
Infrahyoid muscles
Internal jugular
Common carotid artery
Branches of CN 7,9,11,12
Ansa cervicalis
What innervates the Infrahyoid muscles? From where?
Ansa cervicalis
C1-C3
What does the posterior triangle contain?
part of Subclavian artery and vein
External jugular vein
CN11
Phrenic
Brachial plexus roots
Cervical plexus
4 supra hyoids?
Mylohyoid
Stylohyoid
Geniohyoid
Digastric
Function of the Infrahyoid?
Draw hyoid bone inferiorly during swallowing
Two superficial infrahyoids?
Sternohyoid - Sternum
Omohyoid- Scapula
Two deep infrahyoid muscles?
Sternothyroid and thyrohyoid
name a-e
a- External carotid
b- Superior thyroid artery
c- Inferior thyroid artery
d- Thyrocervical trunk
e- Right subclavian artery
Name f-k
f- Braciocephalic
g- Arch of aorta
h- Left subclavian artery
i- Left common carotid artery
j- Thyroid ima artery
k- THyroid isthmus
WHere does the Common carotid bifurcate?
C4
What are the Left and right inferior thyroid arteries a branch of?
Thyrocervical trunk
What arteries supply the PT
Inferior thyroid arteries
What supplies the platysma?
CN7
Where does the Vagus nerve run between the bifurcation?
Between the common carotid artery and The internal jugular vein
