Regional Anatomy Of Mediastinum Flashcards
What are the sections of the mediastinum?
- superior
- anterior
- middle
- posterior
Where is the aortic pulmonary window located?
- level T4/5
- bound by inferior surface of aortic arch and superior surface of right pulmonary artery
What are the Boundaries of superior mediastinum?
Superior: superior thoracic aperture
Inferior: sternal angle
Anterior: manubrium of sternum
Posterior: vertebral column (T1->T4/5)
What are the boundaries of the anterior mediastinum?
Superior: sternal angle (T4/5)
Inferior: thoracic diaphragm
Anterior: body of sternum
Posterior: fibrous pericardium
What are the boundaries of the middle mediastinum?
Superior: plane passing through sternal angle (T4/5)
Inferior: thoracic diaphragm
Anterior: fibrous pericardium
Posterior: fibrous pericardium, tracheal bifurcation and primary bronchial
What are the boundaries of the posterior mediastinum?
Superior: plane passing through sternal angle (T4/5)
Inferior: thoracic diaphragm
Anterior: fibrous pericardium, tracheal bifurcation and primary bronchi
Posterior: vertebral colum (T4/5-> T12)
What are the blood vessels in the superior mediastinum?
- L & R brachiocephalic veins
- superior half of superior vena cava
- aortic arch and branches
What are the nervous tissue contents in the superior mediastinum?
- L & R phrenic nerves
- L & R vagus nerves
- L recurrent laryngeal nerve
What are the large organs contained in the superior mediastinum?
- thymus
- brachiocephalic lymph nodes
- teaches and associated lymph nodes
- oesophagus
- thoracic duct
What are the blood vessel contents of anterior mediastinum?
- internal thoracic blood vessels
What are the nervous tissue contents of the anterior mediastinum?
- none
What are the large organs contained in the anterior mediastinum?
- thymus (of children)
- parasternal lymph nodes
What are the blood vessels contained in the middle mediastinum?
- great vessels of the heart
- L & R pulmonary arteries and veins
What nervous tissue is contained in the middle mediastinum?
- L & R phrenic nerves
What are the large organs contained in the middle mediastinum?
- heart
- terminal end of trachea and primary bronchi
- bronchotracheal lymph nodes
What blood vessels are contained in the posterior mediastinum?
- descending aorta
- azygous, hemiazygous and accessory azygous veins
What nervous tissue is contained in the posterior mediastinum?
- vagus nerves
What large organs are contained in the posterior mediastinum?
- oesophagus
- thoracic duct
- posterior mediastinal lymph nodes
What and where is the apex of the heart?
- formed by inferolateral part of left ventricle
- lies deep to 5th intercostal space, 7-9 cm to left of midline in adults
- apex site on diaphragm and thus loves when breathing
What and where is the base of the heart?
- formed mostly by left atrium
- opposite to the apex and forms the posterior aspect
- faces vertebra T6-T9
What are the main coronary arteries and what is their origin?
- right and left coronary artery
- anastomoses
- they are the first colatetla branch straight from aorta
What are the bifurcations of the right coronary artery?
- right marginal artery
- posterior interventricular artery
What are the branches of the left coronary artery?
- anterior interventricular artery
- circumflex artery
- left marginal artery
What are the two main anastomoses?
- Circumflex artery and right coronary artery
2. Posterior interventricular artery and anterior interventricular artery
What are the three main variations in coronary artery positioning?
- Anastomoses changes position
- No right coronary artery
- No left coronary artery
What are the tributes of the coronary sinus?
- great cardiac vein
- middle cardiac vein
- posterior vein of left ventricle
- small cardiac vein
What is the origin of the left recurrent laryngeal nerve?
Starts when vagus nerve loops through aortic window and innervates the larynx/pharynx
What is the origin of the right recurrent laryngeal nerve?
Starts after VAN complex of the neck and loops around right subclavian artery
What vertebral level is the oesophageal hiatus?
T10
What vertebral level is the caval foramen?
T8
What vertebral level is the aortic hiatus?
T12
What is the location difference between the left and right pulmonary arteries?
Left is more superior and passes superior to left superior secondary bronchus whereas right passes between the right superior and middle secondary bronchi
Where does the descending aorta lie? How does this change with age?
Immediately anterior to vertebral bodies
- as we age the vertebral discs change and thus cause change to the aorta
Where does the thoracic duct course?
Posterior to oesophagus
