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1. Theme 1 > T1 L4: Posterior Mediastinum > Flashcards

T1 L4: Posterior Mediastinum Flashcards

1
Q

What is the anterior border of the posterior mediastinum?

A

Posterior pericardium

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2
Q

What is the posterior border of the posterior mediastinum?

A

Vertebrae T5-T12

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3
Q

What is the lateral border of the posterior mediastinum?

A

Mediastinal pleura

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4
Q

What is the superior border of the posterior mediastinum?

A

The transverse thoracic plane (T4/5)

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5
Q

What is the inferior border of the posterior mediastinum?

A

The diaphragm

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6
Q

Name some structures within the posterior mediastinum

A

Oesophagus, Thoracic aorta, azygous system of veins, Thoracic duct, Vagus nerve, sympathetic trunk, Splanchnic nerves

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7
Q

Which vertebrae contribute to the nervous chain?

A

T1-L2

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8
Q

Which vertebrae contribute to the thoracolumbar outflow of nerves?

A

T1-L2

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9
Q

Which vertebrae contribute to the craniosacral outflow of nerves?

A

Some cranial nerves (like the vagus nerve) and S2,S3 and S4

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10
Q

What type of autonomic nerve has a long pre-ganglionic bit?

A

Parasympathetic. Sympathetic synapse once they reach the plexus or organ

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11
Q

What is the sympathetic trunk?

A

A vertical chain of sympathetic nerves along both sides of the length of the vertebral column

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12
Q

How many sympathetic ganglion are there per a thoracic spinal level?

A

1

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13
Q

All thoracic viscera receive sympathetic supply from which vertebral levels?

A

T1-T4/5

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14
Q

Through which rami do preganglionic sympathetic fibres leave the sympathetic trunk?

A

Through the white rami communicantes

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15
Q

What is the white rami communicantes?

A

It anteriorly connects the spinal nerve to the sympathetic trunk and contains pre-ganglionic fibres of the sympathetic system

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16
Q

What is the grey rami communicantes?

A

Exist at every level of the spinal cord and contain postganglionic nerve fibres of the sympathetic nervous system

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17
Q

How do postganglionic sympathetic fibres leave the sympathetic chain?

A

Through the grey rami communicantes

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18
Q

What does efferent mean?

A

Away

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19
Q

What are somatic nerves?

A

Ones that don’t synapse. They’re part of the reflex arc

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20
Q

What is the difference between grey and white matter?

A

Grey matter contains the cell bodies, dendrites and the axon terminals. The white matter is made up of axons, which connect different parts of grey matter to each other

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21
Q

Describe the path of an afferent sensory nerve

A

They enter through the ventral rami and then travel through the dorsal root ganglia and don’t synapse

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22
Q

What does dorsal mean?

A

Back

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23
Q

What does ventral mean?

A

Front

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24
Q

Describe the pathway of a T1-T4/5 sympathetic nerve

A

They travel from the lateral grey horn, through the white rami communicantes and synapse in the sympathetic chain. They leave through the grey rami communicantes towards the ventral rami

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25
What is a dermatome?
An area supplied by a single spinal level or spinal nerve
26
Where can pain from the heart be felt?
Down the arm or across chest
27
Referred pain from the diaphragm can be felt where?
At the shoulder
28
Where does the phrenic nerve originate?
C3, C4 and C5
29
Describe how dermatomes are arranged
Like we still walked on all 4's
30
Describe the pathway of splanchnic nerves through the sympathetic trunk
Travel from the spinal cord and through the white rami communicantes but don't synapse. They just leave
31
Where do greater splanchnic nerves originate?
T5-T9
32
Where do lesser splanchnic nerves originate?
T10 and T11
33
Where do least splanchnic nerves originate?
T12
34
What type of information do splanchinic nerves carry?
Preganglionic sympathetic fibres to viscera and visceral afferent fibres from abdominal viscera
35
At what level do nerves on the spine all become splanchnic?
Below T4/5
36
How does the vagus nerve enter the superior medistinum?
Posterior to the sternoclavicular joint
37
What type of autonomic nervous impulses does the vagus nerve carry?
Parasympathetic
38
Where does the vagus nerve synapse?
At the target plexus
39
Where does the right recurrent laryngeal branch of the vagus nerve hook under?
Under the right subclavian artery
40
Between what structures does the right recurrent laryngeal branch of the vagus nerve ascend?
The trachea and oesophagus
41
What is the position of the right vagus nerve compared to the hilum of the right lung?
Posterior to the right hilum
42
How does the vagus nerve continue down the thorax?
Posterior to the trachea, posterior to the brachiocephalic vein and posterior to the hilum (Similar in the left and right)
43
Where does the left recurrent laryngeal branch of the vagus nerve hook?
Under the arch of the aorta, immediately lateral to the ligamentum arteriosum
44
Along which vertabrae does the aorta descend?
T5-T12
45
Where is the oesophagus compared to the thoracic aorta?
To the right of the thoracic aorta
46
Where does the thoracic aorta terminate?
At T12, where it passes through the diaphragm
47
Where do the thoracic ducts and azygous veins ascend compared to the thoracic aorta?
To the right of the thoracic aorta
48
What are the 4 paired branches of the thoracic aorta?
Posterior intercostals, subcostal (under rib 12), bronchial, and superior phrenic
49
Where does the bronchial paired branch of the thoracic aorta branch?
Off the 3rd intercostal artery on the right. The left is supplied directly by the aorta
50
What does the superior phrenic branch of the thoracic aorta supply?
Superior surface of the diaphragm
51
What are the 3 unpaired branches of the thoracic aorta?
pericardial, oesophageal, and mediastinal
52
What does the azygous system drain from?
Intercostal veins T5-T11
53
Which intercostal vein forms the azygous vein?
T12
54
How many pairs of posterior intercostals are there?
12
55
What veins drain T1-T4 on the right?
T1 drains straight into the right brachiocephalic vein, superior intercostal vein T2-T4 on the right
56
Where does the azygous vein arch?
Over the right hilum and then joins with the superior vena cava
57
What is meant by collateral circulation?
When blood can be redirected through a different path if there is a blockage
58
What vein drains T1-T4 on the left?
The left superior intercostal vein
59
What intercostal veins does the accessory hemi-azygous vein drain?
T5-T8 on the left
60
What intercostal veins does the hemi-azygous vein drain?
T9-T11 on the left
61
What veins join with the subcostal veins on either side?
The ascending lumbar veins
62
What veins does the superior vena cava split into?
The brachiocephalic veins
63
What is a tribetury?
A vain that drains into a larger vein
64
Where is the collateral pathway of the azygous system?
Between the inferior and superior vena cava
65
Where does the hemi-azygous vein ascend compared to the aorta?
Posterior left to the aorta
66
What is the largest lymph channel?
The thoracic duct
67
The thoracic duct conveys lymph from which organs?
All the body except head, neck and upper limb and thorax on the right
68
Where does the thoracic duct originate?
At the Cicterna Chyli in the abdomen (L2)
69
How does the thoracic duct ascend compared to the vertebrae?
Anteriorly
70
What does the thoracic duct drain into?
The left venous angle
71
Where is the left venous angle?
At the junction between the internal jugular and subclavian veins
72
How does the oesophagus pass compared to the aorta?
Posterior and to the right of the aorta but then moves to the left and becomes anterior to the abdominal aorta before entering the stomach. This switch happens at T4/5
73
What is innervation of the oesophagus?
Vagus nerve (CNX) and the sympathetic trunk via the oesophageal plexus
74
What are the 3 constrictions of the oesophagus?
The arch of the aorta, left main bronchi and the diaphragm

1. Theme 1 (4 decks)

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