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Exam 2 > Thorax 5: Superior and Posterior Mediastinum > Flashcards

Thorax 5: Superior and Posterior Mediastinum Flashcards

1
Q

What are the subdivisions of the mediastinum

A

superior and inferior

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2
Q

What is the inferior mediastinum divided further into

A

anterior, middle, and posterior

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3
Q

What nerves are found in the superior mediastinum

A

phrenic, vagus, branches from sympathetic chain

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4
Q

What can the superior mediastinum be further divided into

A

retrosternal
intermediate
prevertebral

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5
Q

What are the contents of the retrosternal mediastinum

A

great vessels and thymus

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6
Q

What are the contents of the intermediate mediastinum

A

aortic arch
great branches
ligamentum arteriosum
nerves (phrenic, vagus, sympathetic cardiac branches)

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7
Q

Where is the brachiocephalic artery found and what will it divide into

A

comes off aorta on the right side: gives rise to subclavian and right common carotid

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8
Q

Where does the vagus nerve course within the mediastinum

A

follow esophagus into the abdomen

branches to form left recurrent under arch of aorta (right recurrent under subclavian)

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9
Q

What is contained in the prevertebral aspect of the superior mediastinum

A 
trachea
esophagus
left recurrent laryngeal
lymph nodes
thoracic duct
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10
Q

What structures are contained in the posterior mediastinum

A 
thoracic aorta
esophagus (autonomic nerves)
thoracic duct
primary bronchi and nodes
azygos system
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11
Q

What structures compose Kuleza’s triangle

A

thoracic aorta, azygos vein, and esophagus

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12
Q

What is contained in Kuleza’s triangle

A

thoracic duct

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13
Q

What type of arches are seen in the mediastinum

A

venous arch on right (azygos system)

arterial arch on left: aorta

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14
Q

What structures are seen in the mediastinum form the right side

A

azygos vein, vagus

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15
Q

What structures are seen in the mediastinum from the left side

A

aorta
vagus/left recurrent
esophagus

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16
Q

What are the 3 places esophagus may become compressed

A

esophageal hiatus at diaphragm
where it crosses aorta
left main bronchus

17
Q

What are the 3 regions of muscle in esophagus

A

proximal 1/3: skeletal
middle 1/3: skeletal+ smooth
distal 1/3: smooth

18
Q

What is the arterial supply to neck esophagus

A

inferior thyroid

19
Q

What is the arterial supply to thoracic esophagus

A

branches from aorta

20
Q

What is the arterial supply to abdominal esophagus

A

celiac artery from left gastric artery

21
Q

What is the venous drainage of the esophagus

A

azygos: upper portion

portal system: lower portion

22
Q

Where might an adenocarcinoma (Barrett’s esophagus) within the abdominal esophagus spread

A

liver through the portal system venous system

23
Q

What is the innervation of the esophagus

A

parasympathetic: vagus
Symp: T1-T4

24
Q

What is Virchow’s node

A

sign of esophageal or gastric cancer

25
Q

Describe the relationship of the thoracic aorta to the esophagus

A

at first is positioned to the left then twists behind the esophagus

26
Q

What are the smaller branches off the thoracic aorta

A 
bronchial
pericardial
posterior intercostal
superior phrenic
esophageal
mediastinal
27
Q

What is coarctation of the aorta

A

narrowing of the aorta within the aortic arch, not completely occluded but impedes flow

28
Q

How will the body compensate for coarctation of the aorta

A

use collateral vessels: internal thoracic, anterior intercostals, posterior intercostals

29
Q

What does the azygos system drain

A

body wall

30
Q

Where does the azygos system return venous to

A

SVC

31
Q

What is the valsalva maneuver

A

exhaling forcibly with the glottis closed: compresses abdominal contents and backs blood up into azygos system

32
Q

What are the pros of the azygos system

A

ensures blood gets back to the heart

33
Q

What are the cons of the azygos system

A

valveless, easily spreads cancer, leads to skull and brain metastasis

34
Q

What is the cisterns chyli

A

large sac that collects lymph from lower body and intestines: termination of thoracic duct

35
Q

Where will the thoracic duct drain

A

left jugulovenous angle

36
Q

What will the sympathetic chain give off on the medial aspect

A

cardiac nerves: in neck

Splanchnic nerves: in thorax

37
Q

How many branches are found in greater, lesser, and least splanchnic nerves

A

greater: 3
lesser: 2
Least 1

38
Q

What patten do splanchnic nerves follow

A

GVAs preganglionic enter sympathethetic chain without synapsing and leave. synapse at ganglia near organ

39
Q

Where are preganglionic GVA cell bodies of splanchnic nerves found

A

bodies in IML

Exam 2 (14 decks)

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