Thorax 8: Anterior and Superior Mediastinum

Question 1

What is the level of the sternal angle?

Answer 1

T4/5

Question 2

What is not found in the superior and anterior mediastina?

Answer 2

coronary arteries, pulmonary trunk, ascending and descending aorta

Question 3

describe the course of the right phrenic nerve

Answer 3

runs lateral to Right SCV

anterior to run with Right BCV and SVC

Question 4

what is found anterior to the arch of the azygous

Answer 4

right lung hilium

Question 5

where does the arch of the azygous empty

Answer 5

SVC

Question 6

describe the course of the right vagus nerve

Answer 6

runs anterior to the right SCV and then with the trachea between the venous and arterial planes

Question 7

what neurovascular structures lie on the aortic arch

Answer 7

left phrenic nerve, left superior intercostal vein and left vagus nerve

Question 8

what nerves lies posterior to brachiocephalic trunk

Answer 8

left vagus and phrenic nerves

Question 9

what is the landmark for the formation of the brachiocephalic veins

Answer 9

sternoclavicular joint

Question 10

what happens to the left BCV at the manubrium?

Answer 10

passes diagonally anterior to the aortic arch

Question 11

at what landmark does the left BCV merges to form the SVC

Answer 11

1st right costal cartilage

Question 12

where does the azygous empty into the SVC

Answer 12

2nd right costal cartilage

Question 13

where does the SVC enter the right atrium

Answer 13

3rd right costal cartilage

Question 14

what to the azygous veins drain

Answer 14

posterior chest wall

Question 15

what so the subclavian veins drain

Answer 15

upper limb

Question 16

what does the left brachiocephalic veins drain?

Answer 16

receives the anterior wall via internal thoracic veins and drains the thyroid veins

Question 17

what vein is at risk during a tracheostomy

Answer 17

thyroid and left brachiocephalic veins

Question 18

what nerves lie between the venous and aterial planes

Answer 18

phrenic and vagus nerves

Question 19

what defines the arch of the aorta

Answer 19

T4/5

Question 20

at what level does the brachiocephalic trunk bifurcate

Answer 20

right sternoclavicular joint at T2/3

Question 21

what vessel is found posterior and to the left of the trachea?

Answer 21

Left subclavian

Question 22

which vessels clasp the trachea?

Answer 22

brachiocephalic trunk and the left common carotid

Question 23

at what level does the pulmonary trunk divide?

Answer 23

T5

Question 24

describe the course of the right PA

Answer 24

posterior to ascending aorta and SVC

enters right lung anterior to bronchus

Question 25

describe the course of the left PA

Answer 25

inferior to aortic arch, anterior to thoracic aorta

enters left lung superior to bronchus

Question 26

what alters the tracheal diameter?

Answer 26

trachealis

Question 27

where does the trachea start and end

Answer 27

C6 to T4/5

Question 28

what is another name for the bifurcation of the trachea?

Answer 28

carina

Question 29

what lies in between the trachea and oesophagus

Answer 29

left recurrent nerve

Question 30

at what level does the oesophagus arise and what is its relationship to the aorta?

Answer 30

arises at C6 and passes tot he right of the aortic arch

Question 31

what is the blood supply of the thymus

Answer 31

internal thoracic and inferior thyroid arteries

Question 32

to which vein does the thymus drain?

Answer 32

left brachiocephalic

Question 33

what is the extent of the thymus

Answer 33

from jugular notch to 4th costal cartilage

Question 34

what might cause a thyoma?

Answer 34

myasthenia gravis

Question 35

what is the thoracic duct a continuation of?

Answer 35

the cisterna chyli

Question 36

between which vessels does the thoracic duct lie?

Answer 36

aorta and azygous veins

Question 37

where does the thoracic duct enter circulation?

Answer 37

junction of left internal jugular vein and subclavian vein

Question 38

where are the mediastinal nodes found?

Answer 38

clustered around the trachea and oesophagus to drain lung and lung hilium

Question 39

how are medistinal nodes classified

Answer 39

superior/inferior tracheobronchial nodes depending on location around tracheal bifurcation

Question 40

what nodes are clustered around the brachiocephalic veins

Answer 40

anterior mediastinal nodes that drain to the ducts and communicate with deep cervical nodes

Question 41

what might cause a hoarse voice

Answer 41

left lung tumours and thyroid surgery affecting the left recurrent nerve