Posterior Mediastinum and the Neck (CVR) Flashcards

1
Q

What does the Posterior mediastinum contain (6 structures)

A
  • descending (thoracic) aorta
  • azygos veins
  • oesophagus
  • thoracic duct
  • sympathetic trunk and splanchnic nerves
  • posterior intercostal vessels and nerves
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2
Q

What arteries does the Descending aorta give rise to (5) PBOPP

A

Posterior intercostal arteries
Bronchial arteries of the lung
Oesophageal branches
Pericardial branches
Phrenic branches

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3
Q

What Level does the aorta pass through the diaphraghm

A

T12

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4
Q

Where do the azygos veins arise from and Vertabrae level

A

Arise from diaphragm at level L1/L2

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5
Q

Where do the azygos veins drain blood from

A

Posterior thoracic wall

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6
Q

Where do the Azygos veins drain into

A

Superior Vena cava

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7
Q

Where does the azygos vein lie?

A

Right side of the vertebral bodies

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8
Q

What shorter vein runs on the left side of the vertebral bodies?

A

Hemiazygos

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9
Q

what three veins does the azygos system receive blood from? (PBO)

A

Posterior intercostal veins
Bronchial veins
Oesophageal veins

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10
Q

Where does the oesophagus lie in the posterior mediastinum?

A

Right of the aorta

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11
Q

Where is the oesophageal hiatus and what level is it at

A

In the diaphragm and at the level of T10

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12
Q

Where does the Thoracic duct lie

A

Between azygos vein and aorta

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13
Q

What structure does lymph from the lower limbs, pelvis and abdomen flow to that gives rise to the thoracic duct?

A

Cisterna chyli

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14
Q

Where does the the thoracic duct receive lymph from in the thorax?

A

Intercostal spaces and lymph nodes

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15
Q

Where does the Thoracic duct terminate?

A

Opens into venous system at the junction between left internal jugular vein and left subclavian vein

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16
Q

What is the right side of the head and neck and the right upper limb drained by?

A

Lymphatic duct

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17
Q

What are sympathetic trunks?
Where do they lie?

A

Thin, longitudinal fibre tracts interspersed with ganglia
Lie on posterior thoracic wall

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18
Q

What are the ganglia in the sympathetic trunks referred to as? Where do the trunks extend from and to?

A

Paravertebral ganglia
Skull base to coccyx

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19
Q

Where do the cell bodies of the Preganglionic sympathetic neurones lie?

A

T1-L2/3

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20
Q

What does the Sympathetic trunk allow?

A

Sympathetic fibres arising from T1-L2/3 to be distributed to all parts of the body

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21
Q

When a Sympathetic fibre leaves the Spinal cord What does it enter?

A

Sympathetic trunk

22
Q

What are the three things a sympathetic fibre can do at the Sympathetic trunk?

A

Synapse in the ganglion at level of entry
Ascends or descends in trunk before synapsing
Travels through a ganglion without synapsing

23
Q

What does this show? What fibres does this form?

A

Axon not synapsing in the sympathetic trunk
Abdominopelvic splanchnic nerves

24
Q

Which Splanchnic nerves involve a synapse within the sympathetic trunk? What levels?

A

Cardiopulmonary splanchnic nerves
(C4-T5)

25
What does the posterior intercostal space contain?
Intercostal muscles Posterior intercostal artery Posterior intercostal nerve Posterior intercostal vein
26
Where does the posterior intercostal artery branch from
Descending aorta
27
Sympathetic fibres to thoracic viscera?
Cardiopulmonary splanchnic nerves (T1-T5)
28
What innervates the sinoatrial node ?
Cardiac plexus Para and sympathetic
29
What innervates the bronchi? type of innervation
Pulmonary plexus Parasympathetic and sympathetic
30
What innervates the Oesophagus?
Oesophageal plexus
31
Where can cardiac pain be felt?
Central chest Left side of neck and left arm
32
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)
33
What separates the Anterior and Posterior triangles of the neck?
Sternocleidomastoid
34
Name a-d
Mandible Anterior triangle Sternocleidomastoid Clavicle
35
Name e-g
e- Trapezius f- Posterior triangle g- Mastoid process
36
Anterior, posterior and superior boundaries of the anterior triangle?
Anterior- midline Posterior- Anterior sternoceidomastoid Superior- mandible
37
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
38
What innervates the Infrahyoid muscles? From where?
Ansa cervicalis C1-C3
39
What does the posterior triangle contain?
part of Subclavian artery and vein External jugular vein CN11 Phrenic Brachial plexus roots Cervical plexus
40
4 supra hyoids?
Mylohyoid Stylohyoid Geniohyoid Digastric
41
Function of the Infrahyoid?
Draw hyoid bone inferiorly during swallowing
42
Two superficial infrahyoids?
Sternohyoid - Sternum Omohyoid- Scapula
43
Two deep infrahyoid muscles?
Sternothyroid and thyrohyoid
44
name a-e
a- External carotid b- Superior thyroid artery c- Inferior thyroid artery d- Thyrocervical trunk e- Right subclavian artery
45
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
46
WHere does the Common carotid bifurcate?
C4
47
What are the Left and right inferior thyroid arteries a branch of?
Thyrocervical trunk
48
What arteries supply the PT
Inferior thyroid arteries
49
What supplies the platysma?
CN7
50
Where does the Vagus nerve run between the bifurcation?
Between the common carotid artery and The internal jugular vein
51