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MD3001 > Thorax 7 - Superior & Anterior Mediastinum > Flashcards

Thorax 7 - Superior & Anterior Mediastinum Flashcards

1
Q

Where are the vagus and phrenic nerves positioned in relation to each other?

A

Phrenic nerves lie lateral to the vagus nerves

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2
Q

Which section of the aorta lies in the superior mediastinum?

A

Aortic arch

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3
Q

In relation to where the common carotid artery arises from the aorta, where does the subclavian arise?

A

Posterior

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4
Q

Which directions does the aortic arch travel?

A

Superiorly
Posteriorly
To the left

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5
Q

What landmark marks the superior point of the thymus?

A

Jugular notch

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6
Q

What landmark marks the inferior point of the thymus?

A

4th cc

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7
Q

In which mediastinum is the thymus found?

A

Anterior

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8
Q

Which structures does the thymus lie between?

A

Posterior to manubrium & body of sternum

Anterior to pericardium

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9
Q

What is the function of the thymus?

A

To programme T-lymphocytes

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10
Q

Where do the internal jugular and subclavian veins join and become the brachiocephalic vein?

A

Posterior to the sternoclavicular joint

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11
Q

Which aspect of the arch of the aorta does the LBCV pass closest to?

A

Anterior

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12
Q

Does the LBCV pass anterior to the manubrium?

A

No

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13
Q

Where do the RBCV & LBCV meet to become the SVC

A

Posterior to 1st right cc

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14
Q

Where does the azygos vein join the SVC?

A

Posterior to 2nd right cc

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15
Q

At what level does the SVC enter the right atrium?

A

Posterior to 3rd right cc

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16
Q

Is the pulmonary trunk in the superior mediastinum?

A

No

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17
Q

Is the ligamentum arteriosum in the superior mediastinum?

A

Yes

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18
Q

What are the boundaries of the anterior mediastinum?

A

Sternum, pericardium, lungs & pleura

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19
Q

What are the boundaries of the superior mediastinum?

A

Thoracic inlet, sternal angle (T4/5), posterior to manubrium, anterior to T1-4, oblique from manubrium up to T1, lungs & pleura

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20
Q

Where does the aortic arch lie?

A

At the level of T4/5

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21
Q

At the level of T3, where do the vagus nerves lie in relation to the phrenic nerves?

A

Medially & Posteriorly

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22
Q

At what spinal level does the bifurcation of the trachea into bronchi occur?

A

T5/6

23
Q

Between what two landmarks does the thymus lie?

A

Jugular notch

4th CC

24
Q

From which two arteries does the thymus get its blood supply?

A

Internal thoracic

Inferior thyroid

25
Q

Which vein carries blood away from the thymus?

A

Left brachiocephalic

26
Q

Where are the right and left BCV’s formed and which veins form them?

A

Posterior to the sternoclavicular joints.

Internal jugulars and subclavians

27
Q

Venous drainage:

  1. Azygos
  2. Subclavian
  3. Internal jugular
  4. LBCV
A
  1. posterior chest wall
  2. UL
  3. head & neck
  4. anterior chest wall (via internal thoracic veins)
28
Q

Which vein do the azygos, subclavian, internal jugular and LBC veins drain to?

A

SVC

29
Q

Which veins may be at risk during tracheostomy in children?

A

Thyroid veins, since in children they may protrude above the manubrium

30
Q

A key note to remember…

A

The nerves lie BETWEEN the arteries and veins

31
Q

Which arteries are contained in the superior mediastinum?

A 
Arch of aorta (NOT descending aorta)
BCT
Right subclavian
Right common carotid
Left subclavian
Left common carotid
32
Q

With regard to landmarks, where does the arch of aorta lie?

A

Sternal angle - T4/5 plane

33
Q

At which spinal level does the PT bifurcate?

A

T5

34
Q

Where does the PT lie in relation to the aorta?

A

To the left

35
Q

In which mediastinum does the ligamentum arteriosum lie?

A

Superior

36
Q

What are the C shaped rings in the trachea made of?

A

Hyaline cartilage

37
Q

What is the carina?

A

Tracheal bifurcation

38
Q

Between which spinal levels does the trachea run?

A

C6 - T4/5

39
Q

What structure lies between the trachea (anterior) and the oesophagus (posterior)?

A

Left recurrent laryngeal nerve

40
Q

When does trachealis muscle contract and when does it relax?

A

Contracts at rest

Relaxes upon exertion (greater capacity)

41
Q

At which spinal level does the oesophagus start?

A

C6

42
Q

Between which two structures does the thoracic duct lie?

A

Azygous vein

Thoracic aorta

43
Q

In which mediastinum does the thoracic duct lie?

A

Extends from posterior mediastinum up to the superior mediastinum

44
Q

What assists lymph movement?

A

Aortic pulsations

45
Q

At which vertebral level does the thoracic duct cross behind the oesophagus to ascend on its left side?

A

T4/5

46
Q

Where does the thoracic duct enter the venous system?

A

At the junction between the left internal jugular and the left subclavian veins, i.e. the LBCV

47
Q

What pathology can affect the left recurrent laryngeal nerve and what would the result of this be?

A

Left lung tumours

Causes hoarse voice

48
Q

To which lymph nodes does the lung and lung hilum lymph drain to?

A

Mediastinal

49
Q

Where can mediastinal lymph nodes be found?

A

Clustered around the trachea and oesophagus in the superior mediastinum

50
Q

Where do superior tracheobronchial lymph nodes lie?

A

Above the carina (tracheal bifurcation)

51
Q

Where do inferior tracheobronchial lymph nodes lie?

A

Below the carina

52
Q

Where might palpable lymph nodes be found in lung tumour cases and why?

A

Neck - due to communication with deep cervical lymph nodes

53
Q

Around which structure can anterior lymph nodes be found?

A

Brachiocephalic veins

MD3001 (63 decks)

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