Session 5 - The Superior and Posterior Mediastinum

Question 1

What is the thoracic duct and where does it join the vascular system?

Answer 1

The thoracic duct is the main lymphatic channel draining lymph from the lower half of
the body and the bowel back to the blood stream

Question 2

Why is the bowel component of the thoracic duct important?

Answer 2

Only route of fat absorption

into the lymphatics

Question 3

What structures are supplied by the three splanchnic nerves and where does a patient
appreciate pain felt by these nerves?

Answer 3

Greater splanchnic nerve; fore gut, epigastrium.

Lesser splanchnic nerve: midgut, round the umbilicus.

Least splanchnic nerve, hind gut, suprapubic area.

Question 4

What structure lies immediately behind the trachea in the upper thorax and the left atria
in the lower thorax?

Answer 4

The oesophagus

Question 5

What structures drain blood into the azygous system?

Answer 5

Lateral and Posterior chest wall

Lateral and posterior abdominal wall

Question 6

Why is the left recurrent laryngeal nerve at risk from thoracic disease but not the right?

Answer 6

Left passes into the thorax, round the aortic arch and back into the neck

Question 7

Where do the sympathetic nerves attach to the central nervous system?

Answer 7

T 1-12

L 1-2

Question 8

Where does the parasympathetic nervous system attach?

Answer 8

Brainstem

S 2-4

Question 9

What happens if the sympathetic nerves to the head and neck are damaged?

Answer 9

No sweat on face
Eye lid droop
Pupil constrict
Slightly withdrawn eyeball - Horner’s syndrome