Superior and Posterior Mediastina Flashcards

1
Q

Be able to list/identify the various components of each region of the superior mediastinum.

A

Retrosternal region: thymus, left brachiocephalic v., superior portion of the superior vena cava; Intermediate reion: aortic arch, brachiovcephalic trunk, left common carotid artetry, left subclavian artery; Prevertebral region: trachea, esophagus, thoracic duct, left recurrent laryngeal nerve.

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2
Q

What is the boundary between the superior and inferior mediastina?

A

The sternal angle

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3
Q

Why is the sternal angle important clinically?

A

It represents the level at which the trachea bifurcates as well as the level at which the great vessels leave the heart.

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4
Q

Between what two vertebrae does a line drawn horizontally from the sternal angle
posteriorly pass?

A

T4/T5

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5
Q

What organ is found in the anterior mediastinum - in childhood?

A

The thymus

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6
Q

What replaces this organ it in the adult?

A

Fat and connective tissue

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7
Q

What structures are found only in the right aspect of the posterior mediastinum?

A

Azygous vein

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8
Q

What are found only in the left posterior mediastinum?

A

Hemiazygous and accessory hemiazygous veins, aorta.

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9
Q

Which structures would be found on both sides of the posterior mediastinum?

A

Posterior intercostal aa., intercostal nn., intercostal vv., sympathetic trunk, paravertebral ganglia, rami communicans, splancnic nn., and vagus nn.

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10
Q

Which specific vessels drain the intercostal spaces of the posterior thoracic wall?

A

Intercostal vv.

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11
Q

What system do they form?

A

The azygous system

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12
Q

What is the typical pattern of this system?

A

Broken H

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13
Q

How is the superior vena cava formed?

A

The union of the left and right brachiocephalic vv.

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14
Q

What vessels form the brachiocephalic vv.?

A

The union of the internal jugular vv. with the subclavian vv. on the left and right sides.

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15
Q

In which thoracic division(s) is the thoracic duct located?

A

The posterior (on it’s way from the abdomen) AND superior (as it termninates) mediastina.

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16
Q

Where does the thoracic duct begin?

A

At the cysterna chyli in the upper region of the abdomen.

17
Q

Where does the thoracic duct terminate?

A

At the junction of the left internal jugular and left subclavian vv.

18
Q

How does the internal thoracic aa terminate?

A

Musculophrenic a (lateral to diaphragm)

Superior epigastric a (medial to rictus sheath)

19
Q

Esophageal plexus contributions

A

Left vagus –> anterior vagus

Right vagus –> posterior vagus

20
Q

Phrenic n runs ____ to root of lung

Vagus n runs ____ to root of lung

A

Phrenic anterior

Vagus posterior

21
Q

Right recurrent laryngeal branches where?

Left recurrent laryngeal branches where?

A

Right at subclavian artery

Left at ligamentum arteriosum