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Anatomy Semester 2 > The Mediastinum > Flashcards

The Mediastinum Flashcards

1
Q

what is the mediastinum?

A

the central area of the thorax that lies between the 2 pleural cavities

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2
Q

what are the superior, inferior, anterior, and posterior boundaries of the mediastinum?

A
  • superior = superior thoracic aperture
  • inferior = diaphragm
  • anterior = sternum
  • posterior = thoracic vertebrae
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3
Q

what is the mediastinum divided into?

A
  • superior and inferior mediastinum
  • superior
  • inferior: anterior, middle, posterior compartment
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4
Q

is the superior or inferior mediastinum larger?

A

inferior

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5
Q

what divides the superior and inferior mediastinum?

A

the transverse thoracic plane

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6
Q

where does the transverse thoracic plane pass?

A

passes through the sternal angle anteriorly and the intervertebral disc between T4 + T5 posteriorly

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7
Q

anteriorly to posteriorly, what are the contents of the superior mediastinum?

A
  • thymus
  • brachiocephalic veins + SVC, arch of aorta + branches (brachiocephalic trunk, common carotids + subclavian), vagus and phrenic nerves, cardiac plexus
  • trachea
  • oesophagus
  • vagus and phrenic nerves
  • sympathetic trunk
  • thoracic duct + lymphatic trunks

= essentially anything that need to pass from the neck to the thorax/abdomen and any vascualr structures involved in head/neck/upper limbs

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8
Q

where does the oesophagus pass through the diaphragm and at what level?

A

oesophageal hiatus, T10

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9
Q

identify A, B, C, D, E

A 
A = brachiocephalic vein
B = arch of aorta
C = trachea 
D = oesophagus
E = azygos vein
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10
Q

identify A, B, C, D, E, F, G

A 
A = right brachiocephalic vein
B = left brachiocephalic vein
C = SVC
D = brachiocephalic trunk
E = left common carotid artery
F =  left subclavian vein
G = right phrenic nerve
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11
Q

identify H, I, J

A 
H = left phrenic nerve 
I = left vagus nerve 
J = aortic arch
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12
Q

what unites to form the SVC?

A

right and left brachiocephalic veins

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13
Q

where does the thoracic aorta pass through the diaphragm and at what level?

A

aortic hiatus, T12

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14
Q

what innervates the diaphragm?

A

phrenic nerve

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15
Q

identify A, B, C

A 
A = arch of aorta (cut)
B = trachea
C = right vagus nerve
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16
Q

identify D, E, F, G

A 
D = left vagus nerve
E = left recurrent laryngeal nerve
F = oesophagus
G = azygos vein
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17
Q

what are the superior and inferior boundaries of the inferior mediastinum?

A 
superior = transverse thoracic plane 
inferior = diaphragm
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18
Q

what separates the middle compartment of the inferior mediastinum from other compartments?

A

fibrous pericardium

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19
Q

what are the anterior and posterior boundaries of the anterior mediastinum?

A 
anterior = sternum 
posterior = fibrous pericardium
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20
Q

what are the contents of the anterior mediastinum?

A

sternopericardial ligament, fat, remnants of the thymus, lymph nodes

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21
Q

what are the contents of the middle mediastinum?

A
  • pericardium
  • heart
  • roots of great vessels (SVC, ascending aorta pulmonary trunk, pulmonary veins)
  • lung roots
  • phrenic nerves
  • cardiac plexus
22
Q

identify A, B, C, D, E, F

A 
A = ascending aorta
B = SVC
C = heart
D = left lung root
E = left phrenic nerve 
F = right lung root
23
Q

what are the anterior and posterior boundaries of the posterior mediastinum?

A

anterior = fibrous pericardium and upper surface of diaphragm

posterior = T5-T12

24
Q

what are the contents of the posterior mediastinum?

A
  • oesophagus
  • thoracic aorta
  • azygos system of veins
  • sympathetic chains
  • vagus nerves
  • thoracic duct

IN GENERAL: structures that need to transverse the whole thorax (from inlet to outlet) will need to go through the superior and posterior mediastinum

25
Q

identify A, B, C, D

A 
A = oesophagus 
B = thoracic aorta 
C = left vagus nerve 
D = thoracic duct
26
Q

what does the thoracic duct contain?

A

lymph

27
Q

where does the thoracic duct begin? level?

A

cisterns chyli, level L1 + L2

28
Q

what does the thoracic duct empty into and where?

A

venous system at the left venous angle

29
Q

identify A and B

A 
A = azygos vein
B = right sympathetic chain
30
Q

where does the azygos vein pass through the diaphragm and at what level?

A

aortic opening, T12

31
Q

what drains into the azygos vein?

A
  • lower 8 RHS posterior intercostal veins
  • superior intercostal vein
  • hemiazygos and accessory hemiazygos veins
32
Q

what does the azygos vein drain into?

A

SVC

33
Q

what are drained by the azygos system of veins?

A
  • posterior thoracic wall
  • bronchi
  • pericardium
  • oesophagus
34
Q

identify structures A-F of this transverse section at level of C5

A 
a - ascending aorta 
b - descending aorta 
c - bifurcation of pulmonary trunk 
d - azygos vein 
e - oesophagus 
f - SVC
35
Q

identify A, B, C, D, E — transverse section at level of C6

A 
A = fibrous pericardium
B = heart
C = sternopericardial ligament
D = oesophagus
E = descending aorta
36
Q

what are the 3 branches of the aortic arch and what do they supply?

A
  1. brachiocephalic trunk — largest branch, supplies the right side of the head and neck and right upper limb
  2. left common carotid artery — supplies the left side of the head and neck
  3. left subclavian artery — supplies the left upper limb
37
Q

what is the thoracic duct located between?

A

the oesophagus anteriorly and the thoracic vertebrae posteriorly

38
Q

what side of the thorax is the thoracic duct typically on?

A

the left

39
Q

what is the oesophageal nerve plexus formed from and what does it surround?

A
  • surround the inferior aspect o the oesophagus

- formed by the vagus nerve and visceral branches of the sympathetic trunk

40
Q

widened mediastinum is a mediastinum with a width great er than what on a PA CXR?

A

> 8cm

41
Q

describe pulmonary circulation + what vessels are involved

A

= carries oxygen depleted blood away from the heart, to the lungs, and returns oxygenated blood back to the heart
- involves pulmonary arteries and veins, lobar and segmental arteries and veins

42
Q

what factors promote gas exchange?

A
  • large SA in the lungs
  • thin respiratory membrane for a short diffusion distance
  • large diffusion gradient
  • moist exchange surface — alveoli release a surfactant which reduces surface tension - increases compliance and decreases risk of alveolar collapse
  • close proximity of blood vessels to alveoli
43
Q

what factors inhibit gas exchange?

A
  • surface tension caused by water molecules on the alveoli — alveolar collapse/difficult to expand alveoli during inhalation
  • smoking - COPD - airflow obstruction, destruction of alveoli
44
Q

describe systemic circulation

A

= the part of the CV system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart
- blood leaves via LV and enters back into RA

45
Q

what artery is used to draw blood from?

A

radial artery

46
Q

what artery is used to take BP?

A

brachial artery

47
Q

bronchial vs. vesicular breathing

A

BRONCHIAL:

  • loudest over sternum
  • from larger airways
  • higher frequency
  • loud on expiration
  • expiration > inspiration

VESICULAR:

  • most areas over chest
  • from smaller airways
  • lower frequency
  • soft on expiration
  • inspiration > expiration
48
Q

differences between phrenic and vagus nerves

A
  • phrenic: straight from neck to diaphragm with no branches
  • vagus: has branches
  • vagus innervates lots of things
  • phrenic innervates diaphragm
49
Q

what side of the vertebral column does the azygos vein travel on?

A

right

50
Q

describe the accessory hemiazygos and hemiazygos veins

A
  • on LHS
  • accessory hemiazygos vein at top
  • hemiazygos vein at bottom
  • both cross to RHS to join the azygos vein

Anatomy Semester 2 (10 decks)

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