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Regional Anatomy 1 > Superior and Posterior Mediastinum > Flashcards

Superior and Posterior Mediastinum Flashcards

1
Q

superior mediastinum border - anterior

A

manubrium

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2
Q

superior mediastinum border - posterior

A

bodies of T1-T4 vertebrae

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3
Q

superior mediastinum border - inferior

A

transverse thoracic plane

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4
Q

superior mediastinum border - superior

A

thoracic inlet

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5
Q

what is reflected over the structures of the mediastinum on either side of the superior mediastinum

A

parietal pleura

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6
Q

describe the contents of the superior mediastinum from anterior to posterior

A
  • thymus
  • brachiocephalic veins uniting to give SVC
  • arch of aorta
  • trachea
    -oesophagus
  • phrenic and vagus nerves
  • lymphatics
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7
Q

of the contents of the superior mediastinum what is not found in any other part of the adult mediastinum

A

thymus
brachiocephalic veins
arch of aorta
trachea

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8
Q

what lies directly posterior to the brachiocephalic veins draining into SVC

A

arch of aorta and branches

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9
Q

what are the 3 branches of the aorta

A

brachiocephalic trunk
left common carotid
left subclavian

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10
Q

what does the brachiocephalic trunk divide to give

A

right subclavian and right common carotid

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11
Q

describe the path of the right vagus nerve in the superior mediastinum

A

anterior to right subclavian artery

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12
Q

describe the path of the right recurrent laryngeal nerve

A

loops under the right subclavian artery then travels back up to larynx

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13
Q

describe the path of the left vagus nerve in the superior mediastinum

A

travels between left common carotid and left subclavian then passes along left side of arch of aorta

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14
Q

describe the path of the left recurrent laryngeal nerve

A

loops under arch of aorta (posterior to ligamentum arteriosum)

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15
Q

the vagus nerves give branches to what plexuses

A

cardiac plexus
right and left pulmonary plexus

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16
Q

where is the cardiac plexus

A

deep to arch of aorta

anterior surface of bifurcation of trachea // posterior aspect of ascending aorta

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17
Q

where are the pulmonary plexuses

A

on right and left main bronchi

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18
Q

the vagus nerves form what plexus

A

oesophageal plexus

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19
Q

how do the vagal trunks form

A

fibres of oesophageal plexus come together to form anterior and posterior vagal trunks that will continue into abdomen

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20
Q

the anterior vagal trunk is mostly comprised of fibres from the ___ vagus

A

left

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21
Q

the posterior vagal trunk is mostly comprised of fibres from the ___ vagus

A

right

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22
Q

what is the root of the phrenic nerves

A

anterior rami C3,4,5

(keep diaphragm alive)

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23
Q

describe the course of the right phrenic nerve

A

runs alongside right brachiocephalic vein, then SVC and then pericardium over right atrium

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24
Q

the right phrenic nerve passes _____ to root of right lung

A

anterior

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25
Q

where does the right phrenic nerve pierce the diaphragm

A

near caval opening

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26
Q

describe the course of the left phrenic nerve

A

lies between left subclavian artery and vein and continues to left of arch of aorta anterior to vagus
continues onto surface of pericardium over left atrium and ventricle

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27
Q

the left phrenic nerve passes _____ to root of left lung

A

anterior

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28
Q

where does the left phrenic nerve pierce the diaphragm

A

left of pericardium, near apex

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29
Q

where does the trachea begin

A

C6/7
below larynx

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30
Q

what is the point of division of trachea called

A

carina

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31
Q

what is the carina

A

V shaped cartilage that is the bifurcation of trachea

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32
Q

where is the carina

A

transverse thoracic plane (T4/5)

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33
Q

the trachea has C shaped cartilage (anteriorly/posteriorly)

A

anteriorly

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34
Q

what is found on the posterior surface of the trachea

A

trachealis muscle

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35
Q

what would be the issue if the trachea was completely cartilage

A

oesophagus (posterior to trachea) wouldn’t be able to expand to allow bolus of food through

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36
Q

where does the oesophagus begin

A

C6

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37
Q

the oesophagus is a continuation of the

A

pharynx

38
Q

describe the course of the oesophagus in the superior mediastinum

A

travels in superior mediastinum immediately posterior to trachea

39
Q

describe the course of the oesophagus in the inferior mediastinum

A

initially lies to right of aorta then crosses anteriorly prior to piercing the diaphragm

40
Q

at what level does the oesophagus pierce the diaphragm

A

T10

41
Q

what are the 3 constrictions of the oesophagus from

A

arch of aorta
left bronchus
diaphragm

42
Q

boundaries of the posterior mediastinum: superior

A

transverse thoracic plane

43
Q

boundaries of the posterior mediastinum: posterior

A

bodies of T5-T12 vertebrae

44
Q

boundaries of the posterior mediastinum: anterior

A

posterior wall of pericardium and slope of diaphragm

45
Q

what is on either side of the posterior mediastinum and reflected onto structures

A

parietal pleura

46
Q

when does the arch of aorta become thoracic aorta

A

continuation of arch of aorta at level of transverse thoracic plane (T4/5)

47
Q

when does thoracic aorta become abdominal aorta

A

after passing through aortic hiatus of diaphragm

48
Q

thoracic aorta gives branches to

A

oesophagus
pericardium
bronchi
thoracic wall
diaphragm

49
Q

what drains the thoracic wall

A

azygous vein

50
Q

where is the azygous vein

A

posterior mediastinum

51
Q

on the right side of the thoracic wall, posterior intercostal veins 2-11 and subcostal drain where

A

directly into azygous vein

52
Q

on the right side of the thoracic wall, the 1st posterior intercostal vein drains where

A

directly to right brachiocephalic vein

53
Q

on the left side of the thoracic wall, the 1-4 posterior intercostal veins drain where

A

left brachiocephalic vein

54
Q

on the left side of the thoracic wall, the 5-8 posterior intercostal veins drain where

A

accessory hemiazygous

55
Q

on the left side of the thoracic wall, the 9-11 posterior intercostal veins and subcostal drain where

A

hemiazygous

56
Q

the hemiazygous and accessory hemiazygous go where

A

to azygous vein

57
Q

azygous vein drains where

A

SVC

58
Q

left posterior intercostal veins drain in groups of _ to left brachiocephalic vein, accessory hemiazygous and hemiazygous

A

4
(1-4)
(5-8)
(9-11 + subcostal)

59
Q

what is the major lymphatic vessel in the thoracic region

A

thoracic duct

60
Q

the thoracic duct drains what

A

all of the lymph from the lower limbs, pelvis and abdomen and from left side of thoracic cavity

61
Q

where does the thoracic duct join the venous system

A

at the left venous angle

62
Q

where is the left venous angle

A

junction of left internal jugular vein and left subclavian

63
Q

where is the thoracic duct located

A

between thoracic aorta and azygous vein on surface of bodies of thoracic vertebrae

64
Q

what is the sympathetic chain

A

chain of sympathetic ganglia extending the length of the vertebral column on either side

65
Q

where does sympathetic outflow come from

A

T1-L2/3

66
Q

what can be seen in the thoracic region of the sympathetic chain

A

both white and grey rami communicantes travelling between the spinal nerves and the sympathetic chain

67
Q

what are white rami communicantes

A

myelinated nerves travelling from spinal cord into the sympathetic chain

68
Q

what are grey rami communicantes

A

post-ganglionic non-myelinated fibres passing from chain into spinal nerve to be distributed to body wall

69
Q

how many splanchnic nerves are there and what are their names

A

3 either side
- greater, lesser and least

70
Q

what do the splanchnic nerves supply

A

sympathetic innervation to the abdominal viscera

71
Q

the splanchnic nerves will pass through the _____ to be distributed in the abdominal cavity

A

diaphragm

72
Q

what do the splanchnic nerves carry

A

pre-synaptic sympathetic fibres for abdominal viscera

73
Q

describe the course of the splanchnic nerves as they pass through the diaphragm

A

synapse in ganglia assoc. with the aorta

74
Q

where does the greater splanchnic nerve receive fibres from

A

T5-T9 ganglia

75
Q

greater splanchnic nerve assoc. with what ganglia

A

coeliac and superior mesenteric

76
Q

where does the lesser splanchnic nerve receive fibres from

A

T10 and T11

77
Q

the lesser splanchnic nerve assoc. with what ganglia

A

superior mesenteric and aorticorenal

78
Q

where does the least splanchnic nerve receive fibres from

A

T12 ganglion

79
Q

what ganglia does the least splanchnic nerve assoc with

A

aorticorenal

80
Q

what is the broad tendinous region in the centre of the diaphragm called

A

central tendon of the diaphragm

81
Q

what opening in the diaphragm allows the passage of the IVC

A

caval opening

82
Q

what does the oesophageal hiatus allow the passage of

A

oesophagus and assoc. vagus nerves

83
Q

where is the oesophageal hiatus located

A

within muscle of left crus

84
Q

what does the aortic hiatus allow the passage of

A

aorta
thoracic duct
azygous vein

85
Q

where is the aortic hiatus

A

space posterior to the median arcuate ligament

86
Q

at what level does the IVC pierce the diaphragm

A

T8

87
Q

at what level does the oesophagus and vagal trunks pierce the diaphragm

A

T10

88
Q

at what level does the aorta pierce the diaphragm

A

T12

89
Q

how and at what level do the greater and lesser splanchnic nerves pierce the diaphragm

A

T12
small openings in the crura

90
Q

how and at what level does the least splanchnic nerve and the sympathetic trunk pierce the diaphragm

A

T12
posterior to medial arcuate ligament

91
Q

why does the right dome often bulge more superiorly

A

overlies the liver

Regional Anatomy 1 (30 decks)

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