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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
Q

What is a dermatome?

A

An area supplied by a single spinal level or spinal nerve

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26
Q

Where can pain from the heart be felt?

A

Down the arm or across chest

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27
Q

Referred pain from the diaphragm can be felt where?

A

At the shoulder

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28
Q

Where does the phrenic nerve originate?

A

C3, C4 and C5

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29
Q

Describe how dermatomes are arranged

A

Like we still walked on all 4’s

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30
Q

Describe the pathway of splanchnic nerves through the sympathetic trunk

A

Travel from the spinal cord and through the white rami communicantes but don’t synapse. They just leave

31
Q

Where do greater splanchnic nerves originate?

A

T5-T9

32
Q

Where do lesser splanchnic nerves originate?

A

T10 and T11

33
Q

Where do least splanchnic nerves originate?

A

T12

34
Q

What type of information do splanchinic nerves carry?

A

Preganglionic sympathetic fibres to viscera and visceral afferent fibres from abdominal viscera

35
Q

At what level do nerves on the spine all become splanchnic?

A

Below T4/5

36
Q

How does the vagus nerve enter the superior medistinum?

A

Posterior to the sternoclavicular joint

37
Q

What type of autonomic nervous impulses does the vagus nerve carry?

A

Parasympathetic

38
Q

Where does the vagus nerve synapse?

A

At the target plexus

39
Q

Where does the right recurrent laryngeal branch of the vagus nerve hook under?

A

Under the right subclavian artery

40
Q

Between what structures does the right recurrent laryngeal branch of the vagus nerve ascend?

A

The trachea and oesophagus

41
Q

What is the position of the right vagus nerve compared to the hilum of the right lung?

A

Posterior to the right hilum

42
Q

How does the vagus nerve continue down the thorax?

A

Posterior to the trachea, posterior to the brachiocephalic vein and posterior to the hilum (Similar in the left and right)

43
Q

Where does the left recurrent laryngeal branch of the vagus nerve hook?

A

Under the arch of the aorta, immediately lateral to the ligamentum arteriosum

44
Q

Along which vertabrae does the aorta descend?

A

T5-T12

45
Q

Where is the oesophagus compared to the thoracic aorta?

A

To the right of the thoracic aorta

46
Q

Where does the thoracic aorta terminate?

A

At T12, where it passes through the diaphragm

47
Q

Where do the thoracic ducts and azygous veins ascend compared to the thoracic aorta?

A

To the right of the thoracic aorta

48
Q

What are the 4 paired branches of the thoracic aorta?

A

Posterior intercostals, subcostal (under rib 12), bronchial, and superior phrenic

49
Q

Where does the bronchial paired branch of the thoracic aorta branch?

A

Off the 3rd intercostal artery on the right. The left is supplied directly by the aorta

50
Q

What does the superior phrenic branch of the thoracic aorta supply?

A

Superior surface of the diaphragm

51
Q

What are the 3 unpaired branches of the thoracic aorta?

A

pericardial, oesophageal, and mediastinal

52
Q

What does the azygous system drain from?

A

Intercostal veins T5-T11

53
Q

Which intercostal vein forms the azygous vein?

A

T12

54
Q

How many pairs of posterior intercostals are there?

A

12

55
Q

What veins drain T1-T4 on the right?

A

T1 drains straight into the right brachiocephalic vein, superior intercostal vein T2-T4 on the right

56
Q

Where does the azygous vein arch?

A

Over the right hilum and then joins with the superior vena cava

57
Q

What is meant by collateral circulation?

A

When blood can be redirected through a different path if there is a blockage

58
Q

What vein drains T1-T4 on the left?

A

The left superior intercostal vein

59
Q

What intercostal veins does the accessory hemi-azygous vein drain?

A

T5-T8 on the left

60
Q

What intercostal veins does the hemi-azygous vein drain?

A

T9-T11 on the left

61
Q

What veins join with the subcostal veins on either side?

A

The ascending lumbar veins

62
Q

What veins does the superior vena cava split into?

A

The brachiocephalic veins

63
Q

What is a tribetury?

A

A vain that drains into a larger vein

64
Q

Where is the collateral pathway of the azygous system?

A

Between the inferior and superior vena cava

65
Q

Where does the hemi-azygous vein ascend compared to the aorta?

A

Posterior left to the aorta

66
Q

What is the largest lymph channel?

A

The thoracic duct

67
Q

The thoracic duct conveys lymph from which organs?

A

All the body except head, neck and upper limb and thorax on the right

68
Q

Where does the thoracic duct originate?

A

At the Cicterna Chyli in the abdomen (L2)

69
Q

How does the thoracic duct ascend compared to the vertebrae?

A

Anteriorly

70
Q

What does the thoracic duct drain into?

A

The left venous angle

71
Q

Where is the left venous angle?

A

At the junction between the internal jugular and subclavian veins

72
Q

How does the oesophagus pass compared to the aorta?

A

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
Q

What is innervation of the oesophagus?

A

Vagus nerve (CNX) and the sympathetic trunk via the oesophageal plexus

74
Q

What are the 3 constrictions of the oesophagus?

A

The arch of the aorta, left main bronchi and the diaphragm

1. Theme 1 (4 decks)

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