Sup/Post Mediastinum Flashcards

1
Q

Where is the Superior Mediastinum?

A

Superior to a “line” from the eternal angle (anteriorly) to the T4/T5 intervertebral disc (posteriorly)

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2
Q

Contents of the Superior Mediastinum

A

Thymus,
Branchiocephalic veins, Superior Vena Cava, Arch of Aorta (and branches),
Phrenic, vagus, left recurrent laryngeal nerves, and cardiac plexus
Trachea, Esophagus, and Thoracic Duct

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3
Q

What is the Thymus?

A

A 2 lobed lymphoid organ help together by dense irregular connective tissue

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4
Q

Where is the thymus?

A

Between the sternum and base of heart

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5
Q

Size of the thymus?

A

~40 grams max around 10-12 yrs, then a trophies as you age, ~6grams around 65 yrs

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6
Q

Function of the Thymus?

A

It is the maturation sure of the T-lymphocytes

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7
Q

The superior vena cava branches off into the:

A

Right Brachiocephalic vein and left brachiocephalic vein

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8
Q

Each brachiocephalic vein branches off into:

A

A subclavian vein and an internal jugular vein

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9
Q

The superior vena cava descends into the:

A

Upper part of the right atrium

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10
Q

The superior vena cava is located in the:

A

Upper part is in the superior mediastinum and the lower part I in the middle mediastinum

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11
Q

What is the function of the Superior Vena Cava?

A

To return deoxy blood to the heart from all structures superior to the diaphragm

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12
Q

The superior vena cava returns blood from all the structures above the diaphragm except:

A

The heart and the lungs

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13
Q

The Superior Vena Cava receives one tributary , which is:

A

The Azygos vein (posteriorly) from the thoracic wall

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14
Q

What are the parts of the aorta?

A

Ascending aorta, arch of the aorta, descending aorta

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15
Q

The descending aorta divides into the:

A

Thoracic aorta and abdominal aorta (divided at the diaphragm)

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16
Q

The ascending aorta begins at the:

A

Aortic orifice of the left ventricle

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17
Q

Where does the ascending aorta terminate?

A

About 2” above the left ventricle (where it meets the arch)

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18
Q

Where does the ascending aorta lie?

A

Within the pericardial sac (middle mediastinum)

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19
Q

What are the branches of the ascending aorta?

A

Right coronary artery and left coronary artery

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20
Q

Where does the arch of aorta terminate?

A

To the left of the t4 vertebral body (where it meets the descending thoracic aorta) in the posterior mediastinum

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21
Q

What is the ligamentum arteriosum?

A

A fibrous band that connects the arch of the aorta to the left pulmonary artery

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22
Q

What is the ligamentum arteriosum a remnant of?

A

The fetal Ductus Arteriosis

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23
Q

What are the three branches of the aortic arch?

A

Brachiocephalic trunk, left common carotid artery, and left subclavian artery

24
Q

The brachiocephalic trunk divides into the:

A

Right common carotid and the right subclavian arteries

25
Q

The Left common carotid artery ascends into the:

A

Left side of the neck

26
Q

The Left subclavian artery travels to the:

A

Over the left first rib, toward the left upper limb

27
Q

Nerves of the superior mediastinum:

A

Cardiac plexus, phrenic nerves, vagus nerves, and left recurrent laryngeal nerve

28
Q

Phrenic nerve innervation

A

Motor: diaphragm
Sensory: fibrous pericardium & parietal layer of serous pericardium
-mediastinal pleura & central part of diaphragmatic pleura
- parietal peritoneum on undersurface of diaphragm

29
Q

Vagus nerve originates from the:

A

Ventral surface of the brain stem

30
Q

The vagus nerve innervation:

A

Root of neck: palate, pharynx, and larynx
Thorax: esophagus, trachea, heart, bronchi, and lungs
Abdomen: terminal esophagus, stomach, and intestinal tract as far as left colic flexure

31
Q

Nerves that take place in esophageal plexus?

A

Left vagus nerve and right vagus nerve

32
Q

Where are the anterior and posterior vagal trunks formed?

A

Close to the diaphragm, left is anterior and right is posterior

33
Q

Function of both Left and Right Recurrent Pharyngeal Nerves

A

Innervates trachea, esophagus, and all intrinsic muscles of layrnx except cricothyroid muscle

34
Q

Origination of Left and Right Recurrent Laryngeal Nerve

A

Left - from left vagus nerve as it crosses left side of aortic arch

Right- from right vagus nerve in root of neck

35
Q

Injury to a recurrent laryngeal nerve can cause:

A

Hoarseness or dysphyonia

36
Q

Paralysis of both recurrent laryngeal nerves can cause:

A

Aphonia and inspiratory stridor

37
Q

Where is the Trachea located?

A

Anterior to the esophagus

38
Q

Trachea divides into the..

A

Right main/primary bronchus and left main/primary bronchus

39
Q

The c-shaped incomplete rings around the trachea are made of..

A

Hyaline cartilage

40
Q

Holding the open ends of the incomplete rings is the…

A

Trachealis muscle

41
Q

What is the carina?

A

an internal ridge where the trachea divides, formed by the posteroinferior projection of the last tracheal cartilage

42
Q

Function/location of Esophagus?

A

Connects the pharynx to the stomach, descends though superior mediastinum and posterior mediastinum

43
Q

What is the esophageal hiatus?

A

Where the esophagus pierces the diaphragm before it becomes continuous with the stomach

44
Q

What is the thoracic duct?

A

A major lymphatic vessel that extends from the abdomen to the neck

45
Q

Where is the Posterior Mediastinum?

A

Area posterior to the pericardial sac, anterior to T5-T12 vertebrae, inferior to the ‘line’ marking the superior mediastinum, and superior to the diaphragm

46
Q

What is in the Posterior Mediastinum?

A

Esophagus, esophageal plexus, thoracic aorta, Azygos venous system, thoracic duct, thoracic sympathetic trunk

47
Q

What is the aortic hiatus?

A

Where the thoracic part of the descending aorta pierces the diaphragm

48
Q

Where does the blood in the Azygos vein drain into?

A

The superior vena cava

49
Q

Azygos venous system consists of:

A

Azygos vein, hemiazygos vein, and accessory hemiazygos vein

50
Q

Function of the Azygos Venous System

A

to drain blood from body walls of thorax and abdomen

Receives venous blood from some thoracic structures

51
Q

What is the cisterna chyli?

A

An enlarged region of the lymphatic vessel, which is the beginning of the thoracic duct

52
Q

Where does the thoracic duct end?

A

At the Union of left subclavian vein and left internal vein

53
Q

Function of the Thoracic duct?

A

To collect lymph from the lower limbs, pelvis, abdomen, left side of thorax, left side of head and neck, and left upper limb

54
Q

Where is the Thoracic sympathetic trunk?

A

Inferior to the cervical sympathetic trunk and superior to the lumbar sympathetic trunk

55
Q

What do the splanchnic nerves of the thoracic sympathetic trunk do?

A

Carry preganglionic sympathetic fibers to prevertebral ganglia in the abdomen for innervation of the abdominal viscera