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Anatomy > Quiz 3 - Mediastinum > Flashcards

Quiz 3 - Mediastinum Flashcards

1
Q

three compartments of the thoracic cavity

A

2 pleural cavities and a central region called the mediastinum

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2
Q

borders of the mediastinum

A

superior: superior thoracic aperture
inferior: diaphragm

anterior: sternum
posterior: thoracic vertebrae

lateral: pulmonary cavities/lungs

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3
Q

transverse thoracic plane

A

-divides the mediastinum into superior and inferior portions by an imaginary line that passes thru the sternal angle anteriorly and the T4/T5 disc posteriorly

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4
Q

subdivisions of the inferior portion of the mediastinum

A
  • anterior
  • middle
  • posterior

*it is divided into these parts by the pericardium! (membrane surrounding the heart)

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5
Q

thymus

A
  • one of the most anterior structures in the mediastinum
  • anterior to the great vessels and pericardium
  • lymphoid organs involved with immune system T cell development
  • primarily active in childhood but then undergoes “involution” and becomes mostly fat
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6
Q

major organ within the mediastinum

A

the heart, which is surrounded by the percardium

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7
Q

pericardium has both ______ and _____ layers

A

fibrous and serous

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8
Q

fibrous pericardium

A
  • tough outer layer
  • does not stretch
  • fused to the diaphragm
  • continuous with the tunica adventitia of the great vessels
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9
Q

serous pericardium

A
  • 2 layers
  • visceral serous: applied to surface of heart (deepest of the layers); also known as the epicardium
  • parietal serous: lines the internal surface of the fibrous pericardium
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10
Q

where are the visceral and parietal layers continuous?

A

-near the origins of the great vessels

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11
Q

superior limit of the pericardium

A

transverse thoracic plane

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12
Q

epicardium

A
  • visceral layer of serous pericardium

- outer layer of the heart wall

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13
Q

great vessels

A
  • the large arteries and veins that are attached to the heart
  • include: ascending aorta, pulmonary trunk, SVC, IVC, and pulmonary veins
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14
Q

superior vena cava (SVC)

A
  • formed by the convergence of the left and right brachiocephalic veins
  • enters right atrium of heart

**note that the right brachiocephalic vein is formed when the subclavian vein merges with the internal jugular vein

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15
Q

inferior vena cava (IVC)

A
  • enters right atrium

- carries deoxy blood from lower half of the body by passing thru the diaphragm at the T8 level

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16
Q

aorta

A
  • largest artery in the body
  • arises from the left ventricle
  • travels thru the thorax (where it has 3 parts) and abdomen
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17
Q

3 parts of aorta in the abdomen

A
  1. ascending aorta
  2. aortic arch
  3. descending thoracic aorta
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18
Q

ascending aorta

A
  • arises from the left ventricle
  • immediately gives off the right and left coronary arteries
  • ends at the transverse thoracic plane
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19
Q

aortic arch

A
  • passes posterior to the left heart
  • gives off three branches: braciocephalic trunk (which gives rise to the right common carotid and the right subclavian arteries), the left common carotid, and the left subclavian arteries
  • becomes the descending aorta at the T4/T5 disc
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20
Q

aortic arch begins and ends at…?

A

-transverse thoracic plane

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21
Q

thoracic (descending) aorta

A
  • begins at the transverse thoracic plane
  • descends on the anterolateral aspect of the vertebral column on the left side of the body
  • gives off numerous branches
  • major branches: broncial arteries, esophageal arteries, and posterior intercostal arteries
  • passes posterior to the diaphragm at the T12 level, where it becomes the abdominal aorta
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22
Q

pulmonary trunk (aka main pulmonary artery)

A
  • arises from the right ventricle

- bifurcates into the right and left pulmonary arteries

23
Q

right pulmonary artery

A

-posterior to the ascending aorta and SVC as it travels towards the right lung

24
Q

left pulmonary artery

A

-travels anterior to the thoracic aorta

25
Q

ductus arteriosus

A
  • a channel that exists during fetal circulation between the pulmonary trunk and the aortic arch
  • allows blood to bypass non-functioning lungs in the fetus
26
Q

at birth, the ductus arteriosus closes and becomes fibrous, leaving a remnant called ________

A

-the ligamentum arteriosum, located in the mediastinum

27
Q

area between the aortic arch and the pulmonary vessels

A

-aortopulmonary window

28
Q

how many pulmonary veins are there?

A

4

-carry oxygenated blood from lungs to left atrium

29
Q

trachea

A
  • found posterior to the great vessels in the midline

- bifurcates into the primary (main) bronchi at T4

30
Q

tracheobronchial lymph nodes

A

-found at the tracheal bifurcation

31
Q

paratracheal lymph nodes

A

-found along the lateral aspect of the trachea

32
Q

esophagus

A
  • located directly posterior to the trachea
  • continuous with the pharynx superiorly and the stomach inferiorly
  • exits the thoracic cavity thru a hole in the diaphragm (the esophageal hiatus) at T10
33
Q

unlike the trachea, the esophagus is found in _____

A

-both the superior and inferior mediastina

34
Q

primary structures remaining in the posterior mediastinum after removing the esophagus and thoracic aorta

A
  • azygos system of veins
  • thoracic duct
  • components of the autonomic system (sympathetic trunks)
35
Q

azygos venous system

A
  • posterior mediastinum
  • receives drainage from the thoracic wall (primarily from posterior intercostal veins) as well as from veins of the viscera (e.g. esophageal and mediastinal veins)
  • variations normal and common
36
Q

azygos vein typically travels where?

A

-on the anterolateral aspect of the vertebral column on the right side of the body

37
Q

accessory hemiazygos and hemiazygos veins travel where?

A
  • anterolateral aspect of vertebral column on the LEFT side of the body
  • drain into the azygos vein via branches that cross the midline
38
Q

azygos vein drainage

A

superiorly: into SVC
inferiorly: connections with IVC in abdomen

-serves as a collateral channel if IVC blocked

39
Q

thoracic duct

A
  • largest lymphatic vessel in the body; receives lymph from the entire lower half of the body and ULQ and returns fluid to the venous system
  • begins in upper abdomen as a dilation called the cisterna chyli
  • in the mediastinum, it travels on the anterior aspect of the vertebral column, just to the right of the thoracic aorta, and to the left of the azygos vein
  • terminates by merging with the venous system at the junction of the left internal jugular and left subclavian veins
40
Q

lymph from RUQ

A

-drains into the right lymphatic duct

41
Q

sympathetic trunks

A
  • extend from the base of the skull to the coccyx
  • in the thorax, they travel just lateral to the vertebral column anterior to the ribs
  • various branches leave the sympathetic chain ganglia in the thorax
42
Q

white and gray rami communicantes

A
  • connect the sympathetic trunks to the spinal nerves

- emerge from the posterolateral parts of the ganglia

43
Q

cardiac nerves

A
  • emerge from the anteromedial parts of the cervical and upper thoracic sympathetic ganglia
  • contain post-ganglionic sympathetic neurons that innervate the viscera of the thorax (not just the heart!) by traveling thru the thoracic visceral plexus
44
Q

visceral nerves in the thorax (like the cardiac nerves) are distributed to their targets by traveling through a plexus that surrounds the thoracic viscera. what are the three major subdivisions of this visceral plexus?

A
  1. cardiac plexus: found on the superficial and deep aspects of the aortic arch
  2. pulmonary plexus: surrounds the tracheal bifurcation and primary bronchi
  3. esophageal plexus: surrounds the esophagus
45
Q

thoracic splanchnic nerves

A
  • emerge from the anteromedial parts of the T5-T12 sympathetic ganglia
  • contain pre-ganglionic sympathetic neurons that innervate viscera in the abdominal and pelvic cavities
  • just traveling thru the thoracic without innervating anything

there are 3:

  1. greater splanchnic: T5-T9
  2. lesser splanchnic: T10-T11
  3. least splanchnic: T12
46
Q

phrenic nerves

A
  • originate C3-C5 ventral rami
  • enter mediastinum thru the superior thoracic aperture, travel ANTERIOR to the roots of the lungs and descend to the diaphragm along the lateral aspects of the pericardium
  • provide somatic motor fibers to the diaphragm
  • convey somatic sensations from the central part of the diaphragm, fibrous and parietal serous pericardium, mediastinal pleura, and the central part of the diaphragmatic pleura
47
Q

pericardiacophrenic vessels

A

-travels with the phrenic nerve and provide blood to the pericardium and diaphragm

48
Q

vagus nerves

A
  • arise from the brainstem
  • travel in the neck near the carotid arteries
  • enter the thorax via the thoracic aperture
  • POSTERIOR to root of lung (unlike phrenic nerves!) before entering the esophageal plexus
49
Q

right vagus nerve

A
  • travels along the lateral aspect of the trachea
  • POSTERIOR to root of lung (unlike phrenic nerves!)
  • enters esophageal plexus on the posterior part of the esophagus
50
Q

left vagus nerve

A
  • travels on the anterolateral surface of the aortic arch
  • is in contact with the aortic arch
  • POSTERIOR to root of lung (unlike phrenic nerves!)
  • enters esophageal plexus on the anterior part of the esophagus
51
Q

branches of the vagus nerves into visceral plexuses that innervate heart, bronchial tree, and esophagus

A
  • contain parasympathetic neurons and visceral afferent neurons
  • parasympathetic neurons decrease HR, constrict bronchial tree, stimulate peristalsis and the secretion of mucous in the esophagus.
  • afferent neurons convey sensations of stretch from the lungs, pain from the heart, and participate in visceral reflexes
52
Q

after traveling through the esophageal plexus, the vagus nerves do what?

A

-regroup as the anterior and posterior vagal trunks that travel through the diaphragm with the esophagus

53
Q

left recurrent pharyngeal nerve

A
  • branch of the vagus nerve that arises near the arch of the aorta
  • travels thru the aortopulmonary window posterior to the ligamentum arteriosum, and ascends back into the neck along the lateral aspect of the trachea
  • innervates portions of the larynx (e.g. somatic efferent fibers to muscles of the larynx)

***compression of this nerve by an aortic aneurysm or other mass can produce hoarseness of the voice!!!

54
Q

right recurrent laryngeal nerve

A
  • travels around the right subclavian artery in the neck

- is NOT in the mediastinum!!!

Anatomy (13 decks)

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