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Block 3 > SFP: Superior And Posterior Mediastinum > Flashcards

SFP: Superior And Posterior Mediastinum Flashcards

1
Q

What divides the superior mediastinum from the inferior mediastinum?

A

The line between the sternal angle and the disc between T4 and T5.

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2
Q

What divides the inferior mediastinum and into what parts?

A

The pericardium divides the inferior mediastinum into anterior, posterior, and middle.

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3
Q

Where is the thymus located in the mediastinum?

A

It is the most anterior structure in the superior mediastinum and extends into the anterior mediastinum.

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4
Q

Which venous structures are found in the superior mediastinum?

A
  • Superior vena cava
  • Inferior vena cava
  • Right brachiocephalic vein
  • Left brachiocephalic vein
  • Internal jugular vein
  • Subclavian vein
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5
Q

The superior vena cava is associated with which rib?

A

3rd rib.

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6
Q

The inferior vena cava is associated with which rib?

A

6th rib.

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7
Q

What are some tributaries of the brachiocephalic veins?

A
  • Inferior thyroid vein
  • Internal thoracic vein
  • Pericardiophrenic vein
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8
Q

Which arterial structures are located in the superior mediastinum?

A
  • Aortic arch
  • Brachiocephalic trunk
  • Left common carotid artery
  • Left subclavian artery
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9
Q

What non-vascular structures are seen in the superior mediastinum?

A
  • Trachea
  • Esophagus
  • Thoracic duct
  • Phrenic nerve
  • Vagus nerve
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10
Q

What are azygous veins?

A

Veins found in the superior mediastinum with variation in location, often found between the 5th and 6th rib.

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11
Q

Describe the left superior intercostal vein.

A

It drains the upper left intercostal spaces 2, 3, and 4, traveling between the vagus and phrenic nerves.

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12
Q

What are the 3 parts of the thoracic aorta?

A

Ascending, aortic arch, and descending

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13
Q

Describe the ascending aorta

A

Found in the middle mediastinum, covered by the pericardium, begins at the aortic valve, branches into 2 coronary arteries

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14
Q

Describe the aortic arch

A

Found in the superior mediastinum, has 3 branches, not covered by the pericardium

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15
Q

Describe the descending aorta

A

Found in the posterior mediastinum, has many branches, ends at the aortic hiatus in the diaphragm

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16
Q

Describe circulation in adults

A

Blood enters the right atrium via superior and inferior vena cava, goes to right ventricle, pumped to lungs, returns oxygenated blood to left atrium, passes to left ventricle, then out to the system

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17
Q

Describe fetal circulation

A

Deoxygenated blood enters through superior vena cava; oxygenated blood via inferior vena cava to right atria/ventricle, can pass through foramen ovale to left atrium, pumped to aorta and ductus arteriosus where it mixes with deoxygenated blood

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18
Q

Where is the foramen ovale?

A

Between the right and left atria

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19
Q

Where is the ductus arteriosus located?

A

Between the pulmonary trunk and aortic arch

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20
Q

What do we call the ductus arteriosus once it is closed?

A

Ligamentum arteriosum

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21
Q

What is the condition called when the ductus arteriosus remains open?

A

Patent ductus arteriosus

22
Q

Describe the placement of the left recurrent laryngeal nerve

A

Passes under the aortic arch posterior to the ligamentum arteriosum, connects to the left vagus nerve

23
Q

What type of muscle is found in the esophagus?

A

Skeletal muscle proximally, smooth muscle distally

24
Q

What are the 4 constrictions of the esophagus?

A
  • Cricopharyngeal (C6)
  • Aortic (aortic arch; T4)
  • Root of left lung (TS)
  • Hiatal (at diaphragm; 10)

The constrictions are anatomical narrowing points along the esophagus.

25
Q

What is the arterial supply for the upper third of the esophagus?

A

Inferior thyroid artery

Drained by the inferior thyroid vein.

26
Q

What is the arterial supply for the middle third of the esophagus?

A

Esophageal branches of thoracic aorta

Drained by the azygous vein and hemiazygos vein that feeds to the superior vena cava.

27
Q

What is the arterial supply for the bottom third of the esophagus?

A

Esophageal branches of left gastric artery

Drained by the esophageal branch of left gastric vein that feeds to a portal vein.

28
Q

Describe the posterior intercostal nodes.

A

Drain from the posterior thoracic wall and deliver to the thoracic duct and right lymphatic duct

Important for lymphatic drainage in the thoracic region.

29
Q

Describe the parasternal nodes.

A

Drain from the anterior thoracic wall

They play a role in the immune response and drainage of the thoracic cavity.

30
Q

Describe the posterior mediastinal nodes.

A

Drain from diaphragmatic nodes, esophageal nodes, and pericardial nodes

They are part of the lymphatic system in the mediastinum.

31
Q

Describe the broncho mediastinal trunks.

A

Accept flow from posterior mediastinal nodes, parasternal nodes, and paratracheal nodes

They are significant in the drainage of lymphatic fluid from the lungs and surrounding structures.

32
Q

What does the thoracic duct drain to?

A

Left brachiocephalic vein

The broncho mediastinal trunks drain to the thoracic duct.

33
Q

Where is the thoracic duct located?

A

Runs through the aortic hiatus posterior to the esophagus on the left side in the superior mediastinum

It is the main lymphatic vessel in the body.

34
Q

What two nerves does the left superior intercostal separate?

A

Vagus and phrenic

This anatomical relationship is important for understanding nerve function in the thorax.

35
Q

What are the three major innervations of the vagus nerve in the mediastinum?

A
  • Esophageal plexus
  • Cardiac plexus
  • Right and left pulmonary plexus

These plexuses are crucial for autonomic regulation of thoracic organs.

36
Q

Which spinal nerves form the phrenic nerve?

A

C3, C4, C5

The phrenic nerve is essential for diaphragm function and respiration.

37
Q

Where is the phrenic nerve located in the mediastinum?

A

Descends anteriorly to the roots of the lungs between the pericardium and pleura

This positioning is crucial for its role in diaphragm innervation.

38
Q

What does the phrenic nerve distribute to?

A

Mediastinal pleura and dome of diaphragm

This distribution is vital for respiratory function.

39
Q

How does the right phrenic nerve distribute?

A

Passes to the right side of the right brachiocephalic vein/SVC, pericardium, right atrium, IVC, and to the diaphragm

This pathway is important for its role in cardiac and respiratory functions.

40
Q

Describe the left phrenic nerve’s pathway.

A

Passes to the left side of the aortic arch and pericardium to the diaphragm

This pathway allows it to innervate the left side of the diaphragm.

41
Q

Where does the right vagus nerve pass?

A

Anterior to the right subclavian artery

This positioning is important for its function in autonomic control.

42
Q

What is a key feature of the left vagus nerve’s pathway?

A

Passes between left common carotid and subclavian arteries and descends anteriorly to the left side of the aortic arch

This pathway is significant for its role in parasympathetic innervation.

43
Q

What are white rami and grey rami associated with in the sympathetic nervous system?

A

White with preganglionic and ventral roots, grey with postganglionic

This distinction is important for understanding sympathetic nerve pathways.

44
Q

From which spinal levels can the greater splanchnic nerves be found?

A

T5 to T12

These nerves are involved in autonomic innervation of abdominal organs.

45
Q

Do splanchnic nerves synapse in the sympathetic chain?

A

No

Splanchnic nerves directly innervate target organs without synapsing in the chain.

46
Q

Identify the spinal levels where greater splanchnic nerves are located.

A

Greater splanchnic nerves are found at T5-9, 10-11

These levels are crucial for innervating specific abdominal organs.

47
Q

What are the spinal levels for lesser splanchnic nerves?

A

T10-11

Lesser splanchnic nerves innervate different abdominal structures.

48
Q

Which spinal levels do sympathetic nerves that innervate thoracic organs stem from?

A

T1-2

These levels are involved in the autonomic regulation of thoracic organs.

49
Q

What are the direct branches of the sympathetic system?

A

Esophageal plexus, cardiac plexus, and pulmonary plexus

These plexuses are important for the autonomic regulation of thoracic functions.

50
Q

Describe tension pneumothorax and its effect on the mediastinum.

A

Loss of integrity of the pleural cavity leads to difficulty in breathing out, causing the mediastinum to shift to the uninjured side

This condition can be life-threatening and requires immediate medical intervention.

Block 3 (29 decks)

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