Thorax - mediastinum Flashcards
Mediastinum parts
Superior (above sternal angle)
Inferior: anterior, middle, posterior
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Different parts of pericardium
Fibrous
Serous : Parietal, Visceral (aka epicardium)
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Neurovascular bundle through fibrous pericardium
Phrenic nerve
Pericardiacophrenic vessel
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Oblique pericardial sinus
Serous pericardium reflection
Reflection onto pulmonary veins
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Transverse oblique sinus
Serous pericardium reflection
Seperates arteries from veins
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Pericardium arterial blood supply
Internal thoracic
Pericardiophrenic
Musculophrenic
Inferior phrenic
Thoracic aorta
Pericardial venous supply
Azygous vein
Internal thoracic
Superior phrenic
Nerve supply of pericardium
Vagus
Sympathetic
Phrenic
Coronary arteries and veins pairing
Great cardiac vein and LAD
Middle cardiac vein and posterior interventricular branch of RCA
Small cardiac vein and RCA
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Coronary sulcus
Divides atria from ventricles
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Interventricular sulcus
Anterior and posterior
Separates ventricles from each other
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Right atrium anatomy
Note:
Musculi pectinati (sepperated from smooth wall by crista terminalis)
Opening of coronary sinus
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Anatomy of right ventricle
Note:
- Cordae tendineae attaches tricuspid cusps to papillary muscles
- Conus arteriosus (infundibulum) is outflow tract
- Inflow tract covered by trabeculae carnae
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Anatomy of left atrium
Note:
- anterior half is continuous with left auricle, contains musculi pectinati,
- no structures sepparte the smooth from muscular part of the atrium
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Left ventricle anatomy
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Where are coronary arteries originated from
Aortic root
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Coronary artery branches
Note:
anterior Interventricular = LAD
Marginal branch = obtuse
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Lymphatic drainage of heart
brachiocephalic nodes
tracheobronchial nodes
Cardiac conduction
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Cardiac innervation
Deep and superficial cardiac plexus formed from PSN and SN
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Structures within superior mediastinum
Thymus
Vessels: Brachiocephalic vessels, Left superior intercostal vein, SVC, Arch of aorta
Trachea
Oesophagus
Phrenic/vagus nerve (recurrent laryngeal )
Thoracic duct
Structures within the posterior mediastinum
DATES
Descending aorta
Azygous vein and hemiazygos vein
Thoracic duct
Esophagus
Sympathetic trunk/ganglia.
Branches of thoracic aorta
6 branches
Pericardial
Bronchial
Eesophageal
Mediastinal
Superior phrenic
Subcostal
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Azygous venous system
Thoracic duct origin
Begins with abdominal lymph nodes joining forming cisterna chyli
Thoracic duct vertebral level
L2 to root of neck
Where does the thoracic duct drain into
Left subclavian trunk
Points of narrowing in oesophagus
ABCD
A- aortic arch
B- left main bronchus
C- Cricoid cartilage
D- Diaphragmatic hiatus
Upper 3rd oesophagus artery/vein/lymph supply
Inferior thyroid artery and vein
Deep cervical
Middle 3rd oesophagus artery/vein/lymph supply
Aortic branches
Azygous vein
Pre/para aortic nodes
Lower 3rd oesophagus artery/vein/lymph supply
Left gastric artery and vein
Coeliac nodes
Innervation of upper oesophagus
Recurrent laryngeal nerve
Innervation of lower oesophagus
Oesophageal plexus (vagus)
Thebesian drain into where
Small veins drain directly into atrium
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Course of phrenic nerve entering mediastinum
Anterior to subclavian artery, posterior to subclavian vein and lateral border of anterior scalene
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Xiphosternum dermatome
T7
Collateral systems to SVC obstruction
Azygous system
Internal thoracic path
Long thoracic connected to femoral vein
Long thoracic connected to vertebral veins
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