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103-theme 1 > superior mediastinum > Flashcards

superior mediastinum Flashcards

1
Q

what is the location of the mediastinum? 2

A
  • central compartment of the thorax

- located between the left and right pleural cavities

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2
Q

what is the mediastinum divided into? 2

A
  • superior (normally pass into the posterior)

- inferior (at T4/5)

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3
Q

what is the inferior mediastinum divided into? 3

A
  • anterior
  • middle
  • posterior
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4
Q

what is the level t4/5 also known as? 2

A
  • the sternal angle

- transverse thoracic plane

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5
Q

what are the boundaries of the superior mediastinum? 5

A
  • superior= thoracic aperture (manubrium, 1st rib, costal cartilage, T1, vertebra)
  • inferior= transverse thoracic plate
  • anterior=manubrium
  • posterior= T1-T4/5 vertebral bodies
  • lateral= mediastinal pleura
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6
Q

what are the contents of the superior mediastinum? 8

A
  • arteries (arch of aorta and branches)
  • veins (brachiocephalic and superior vena cava)
  • phrenic and vagus nerves
  • oesophagus
  • trachea
  • thoracic duct
  • thymus gland
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7
Q

what is the thymus gland? 6

A
  • located immediately deep to the sternum and superior and anterior mediastinum
  • lymphoid organ
  • T cells mature in the thymus gland
  • lymph drains from parasternal, brachiocephalic and tracheobronchial nodes
  • after puberty it atrophies and is replaced by fat
  • supplied by the internal thoracic arteries
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8
Q

what are the arteries in the superior mediastinum? 4

A
  • arch of aorta
  • brachiocephalic trunk
  • left common carotid artery
  • left subclavian artery
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9
Q

what does the brachiocephalic trunk branch into? 2

A
  • right common carotid artery

- right subclavian artery

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10
Q

what are the branches of the ascending aorta? 2

A
  • left coronary artery

- right coronary artery

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11
Q

what are the branches of the descending aorta? 3

A
  • posterior intercostal
  • bronchial arteries
  • lumbar arteries
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12
Q

what are the veins in the superior mediastinum? 5

A
  • superior vena cava is formed by the union of the
  • right brachiocephalic vein
  • left brachiocephalic vein- each are formed from
  • internal jugular vein
  • subclavian vein
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13
Q

what is the ligamentum arteriosum? 4

A
  • important landmark for surgeons
  • embryological remnant of ductus arteriosum: open duct containing pulmonary trunk and arch of aorta
  • important for foetal circulation allowing the blood to bypass the lungs
  • ligamentous structure in adults as it closes at birth
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14
Q

what is the oesophagus? 2

A
  • muscular tube

- runs from the pharynx to the stomach

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15
Q

what is the thoracic duct? 4

A
  • transports lymph to venous system
  • received multiple branches throughout thorax
  • numerous lymph nodes associated with descending aorta
  • thoracic duct and oesophagus pass through superior and posterior mediastinum
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16
Q

what is the phrenic nerve? 5

A
  • originates from anterior rami of spinal nerves C3,4,5
  • enters the superior mediastinum between the brachiocephalic veins and the subclavian arteries
  • passa anterior to main bronchi along pericardium
  • motor supply to diaphragm
  • sensory supply to central region of diaphragm and parietal pleura
17
Q

what is the vagus nerve? 5

A
  • cranial nerve (CNX) so originates from the brainstem
  • each enters the superior mediastinum medial to the phrenic nerve
  • each gives rise to recurrent laryngeal branches to supply to the larynx
  • continues into the posterior mediastinum posterior to the main bronchi
  • provide parasympathetic supply via pulmonary, cardia and esophageal plexus
18
Q

describe the anterior mediastinum? 5

A
  • narrow cavity
  • thymus
  • pericardial-sternal ligaments
  • lymph nodes and vessels
  • internal thoracic cavity
19
Q

what are the boundaries of the anterior mediastinum? 4

A
  • anterior= sternum
  • posterior=pericardial sac
  • inferior=diaphragm
  • superior= level T4/5
20
Q

explain the beginning of heart development? 5

A
  • angiogenic clusters form in the mesoderm and these canalise to forme early blood vessels
  • two large blood vessels known as the heart tubes form in the cardiogenic area
  • these grow nad fuse at day 21
  • outflow will be arterial end
  • inflow will be venous end
21
Q

describe the heart tube before folding? 5

A

-newly formed heart tube divided into regions
-sinus venosus
-primordial atrium
primordial ventricle
-truncus arteriosus
-by day 23 it is too long for the pericardial cavity so has to fold

22
Q

describe the heart tube after folding? 3

A
  • ventricles and outflow are anterior
  • atria and inflow are posterior
  • septa then grow to divide the heart into 4 chambers
23
Q

describe the foetal heart and its strange circulation? 4

A
  • needs blood to bypass lungs
  • foramen ovale
  • ductus arteriosus
  • small amount of blood needed for lung development
24
Q

what is the foramen ovale?

A
  • opening between the left and right atria in the foetus allowing oxygenated blood to bypass the lungs
  • driven by higher pressure in the right atrium
25
Q

what is the fossa ovalis?

A

the embryological remnant of the foramen ovale which closes after birth in the adult atrial septum

103-theme 1 (5 decks)

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