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anatomy last exam > superior and posterior mediastinum > Flashcards

superior and posterior mediastinum Flashcards

1
Q

divisions of the mediastinum

A 
Superior
Inferior
  - anterior
  - middle
  -posterior
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2
Q

where does the mediastinum extend

A

From the thoracic inlet to the diaphram and sternum to 12th vertebra

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3
Q

what is foudn in the superior mediastum

A

Thymus gland (anterior)
SVA and great vv (R and L brachiocephalic V)
Arach of aorta and great aa (Brachiocepahlic trunk, left common caroitd, left subclavian )
Vagus nn
Phrenic nn (anterio)
Left recurrant laryngeal( if above the the aortic arch)
trachea
Esophagus (posterior)
THoracic duct

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4
Q

what does the thymus gland sit posterior to

A

Manubrium

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5
Q

what does the thymus gland lie anterior to

A

Brachiocephalic vv

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6
Q

when is the thymus gland most active

A

childhood

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7
Q

what happens to the thymus gland in adults

A

Inactive and may appear as a fatty mass as it atrophies

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8
Q

what drains into the SVC

A

Right and left brahiocephalic veins

azygous vein

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9
Q

how does the L brachiocephalic v cross the trachea

A

Anteriorly (in addition to being anterior to the 3 great arteries along with nerves)

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10
Q

where does the azygous vein drain superior to

A

The Right bronchus (root of right lugn)

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11
Q

where does the aortic arch begin and end

A

At the same level, sternal angel, t4-5

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12
Q

parts of the aorta

A

ascending
arch
desceding

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13
Q

what part of the aorta is in the superior mediastinum

A

the arch

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14
Q

what part of the aorta is in the interior mesiastium

A

the ascending and descending portions

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15
Q

what part of the middle mediastinum does the ascending aorta come from

A

The middle

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16
Q

what does the aortic arch, arch over

A

L main bronchus and pulmonary Trunk (R pulmonary A)

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17
Q

what arties goes the aortic arch give off

A

Brachiocephalic trunk
L common carotid A
L subclavian

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18
Q

what does the vagus nerve and phrenic nerve pass through the thoracic inlet betwen

A

a vein and artery

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19
Q

Vegus in relation to the root of the lung

A

Posterior to the root (anterior to aortic arch tho)

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20
Q

what does the Vagus do for the thorax and ab

A

Parngasympathetic innervation

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21
Q

relation of phrenic nerve to the root of lung

A

Anterior to the root of lung (very anterior))

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22
Q

roll of phrenic nerves

A

Somatic innervation to diaphram (motor and sensory)

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23
Q

phrenic nerve comes from what

A

C3-C5 (C3 4 and 5 keep me breathing and alive)

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24
Q

what parts of the diaphram does the phrenic nerve serve

A

The superior and inferior portions

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25
Q

how does the R and L phrenic nerve reach the inferior portion of the diaphram

A

R Through the hiatus of the IVC at T8

L: through diaphram at the apex of the heart margin of central tendon with muscle

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26
Q

where is the trachea

A

Immediately anterior to esophagus

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27
Q

where does the trachea bifurcate

A

At inferior limit of superior mediastinum

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28
Q

the gooch of the trachea

A

Carina

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29
Q

where are a lof of lymph nodes found in the trachea

A

at the carina

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30
Q

where does the trachea bifurcate

A

T4/5

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31
Q

the inferior extent of the superior mediastum

A

Carina

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32
Q

where are foreign bodies usually aspirated and why

A

R main bronchi because it is shorter, wider, more verticle

Carina is usually positioned L of median plane

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33
Q

where does the esophagus begin

A

In the kneck below the pharynx. inferior margin of cricoid cartilage

34
Q

what does the esophagus descend behind

A

Posterior to trachea

35
Q

where does the esophagus pierce the diaphram

A

Esophageal hiatus

36
Q

arteries of the esophagus arise from

A

Thoracic aorta, bronchial aa, and ascending L gastric A

37
Q

Venious drainage of teh esophagus

A

Azygous
Hemiazygous
L grastric

38
Q

lymphatics of esophagsu

A

Posterior mediastinum

39
Q

where might the stomach herniate

A

Through the esophogeal hiatus

40
Q

when the stomach herniates through the esophogeal hiatus

A

Hiatal hernia

41
Q

what is a sliding hiatal hernia

A

Type I

42
Q

what happpens in a sliding hiatal hernia

A

Somach slides freely into thorax

Asymptomatic

43
Q

Commonness of sliding hiatal hernia (type I)

A

Most common

44
Q

what is a paraesophageal hernia

A

type II

45
Q

where does a paraesophageal hernia pass through

A

The fundus

46
Q

what problesm occur with a type II hernia

A

Fixed in position risking gastric blood supply

uncomfortable

47
Q

where is the retropharyngeal space

A

Behind the buccopharyngeal fascia and the prevertebral fascia(alar layer)

48
Q

other name for the retropharyngeal space

A

Danger space

49
Q

how far down does the retropharyngeal space go

A

t12

50
Q

what is found in the posterior mediastinum

A 
Esophagus
Esophageal plus
Azygous system of vv
Descending aorta
Thoracic duct
Thoracic splanchnic nn ( pre ganglionic sympa)
51
Q

what forms the plexus around the esophagus

A

Vagus nerve

52
Q

what happens to vagas nerve near disaphragm plexus

A

REforms Vagal runks

53
Q

What is the L vagus N

A

Anterior vagal trunk

54
Q

what is the R vagus N

A

Posterior Vagal trunk

55
Q

what does the L and R vagus N becomes anteror and posterior trunks

A

Due to rotation of gut during development

56
Q

where do both trunks pass through with the esophagus

A

through the diaphragm

57
Q

what provides venous drainage for thorax

A

The azygos system of veins

58
Q

what does the azygous vein drain

A

Intercostal vv from R side of thorax

59
Q

what does the hemiazygous and accessory hemiazygous vv drain

A

L thorax

60
Q

what does the hemiaxygous and accessory hemiazygous drain into

A

Azygous V

61
Q

how does the Azygous v drain into the SVC

A

Arches over the R superior bronchus

62
Q

what more superior, hemiazygous or accessory hemiazygous

A

Accessory is more superior

63
Q

relation of the descending aorta to the esophagus

A

Just left of the esophagus

64
Q

what does the descending aorta give rise to

A

Posterior intercostal aa supplying the throax

Branches to trachea, bronchi, and esophagus

65
Q

location of the thoracic duct

A

Posterior to esophagus and anterior to vertebral bodies
Between azygous v and descending aorta (thorax)
in the mid line

66
Q

where does the thoracic duct pass through the diaphram

A

With the descending aorta

67
Q

what does the thoracic duct drain

A

Entire bod below diaphram

68
Q

where does the thoracic duct enter the venous angel

A

Between L subclavian v and L IJV

69
Q

taccumulationof lymph in the pleural cavity

A

Chylothorax

70
Q

Chylothorax results from

A

Torn or leaking thoracic duct

71
Q

what may cause a tear or leaking thoracic duct

A

Lymphom/trama during thoracic surgery

72
Q

can you see chylothorax on chest films

A

YES

73
Q

where are sympathetic trunks found

A

Lateral to vertebral bodies

74
Q

How do sympa trunks get to ab

A

Pass posterior to diaphram thru cura to enter

75
Q

Types of Branches from sympathetic chain ganglia

A

Postgang sympa to thoracic viscer
Preganglionic sympa to innervate the abodomen
(Greater, lesser, least splanchnic)

76
Q

branches of the greater spanchnic

A

T5-9

77
Q

Branches for the lesser splachnic

A

T10-11

78
Q

Branches of least splanchnic

A

T12

79
Q

Thoracic sympathetics originate from

A

T1-T5

80
Q

Thoracic parasympathetics come from

A

CNX

81
Q

Plexus of the thorax

A

Cardiac
Pulmonary
Esophageal

82
Q

what makes up the thoracic plexues

A

both T1-5

and CNX

anatomy last exam (14 decks)

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