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Phase 1b - Anatomy > Thorax Part 4 > Flashcards

Thorax Part 4 Flashcards

1
Q

What are the 4 parts of the mediastinum?

A
  • Superior mediastinum
  • Anterior mediastinum
  • Middle mediastinum
  • Posterior mediastinum
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2
Q

What are the boundaries of the mediastinum?

A
  • Superiorly: Superior thoracic aperture
  • Inferiorly: Diaphragm
  • Anteriorly: Sternum
  • Posteriorly: 12 thoracic vertebrae
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3
Q

Where are the boundaries of the superior mediastinum?

A
  • Superiorly: Superior thoracic aperture
  • Inferiorly: Sternal angle
  • Anteriorly: Manubrium
  • Posteriorly: Thoracic vertebrae (T1 - T4)
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4
Q

Where are the boundaries of the anterior mediastinum?

A
  • Superiorly: Sternal angle
  • Inferiorly: Diaphragm
  • Anteriorly: Sternum
  • Posteriorly: Pericardium
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5
Q

Where are the boundaries of the middle mediastinum?

A
  • Superiorly: Sternal angle
  • Inferiorly: Diaphragm
  • Anteriorly: Pericardium
  • Posteriorly: Pericardium
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6
Q

Where are the boundaries of the posterior mediastinum?

A
  • Superiorly: Sternal angle
  • Inferiorly: Diaphragm
  • Anteriorly: Pericardium
  • Posteriorly: Thoracic vertebrae (T5 - T12)
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7
Q

What important structures are found in the superior mediastinum before adulthood but not after?

A

Thymus gland

  • Prominent before & during puberty
  • Turns into a fatty connective tissue that is a residual structure in adults
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8
Q

What important arteries are found in the superior mediastinum? (8)

A
  • Ascending aorta
  • Aortic arch
  • Brachiocephalic artery
  • Right subclavian artery
  • Right common carotid artery
  • Left common carotid artery
  • Left subclavian artery
  • First part of the thoracic aorta
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9
Q

What important veins are found in the superior mediastinum? (11)

A
  • Pulmonary trunk
  • Right pulmonary artery
  • Left pulmonary artery
  • Superior vena cava
  • Azygous vein
  • Right brachiocephalic vein
  • Right subclavian vein
  • Right internal jugular vein
  • Left brachiocephalic vein
  • Left subclavian vein
  • Left internal jugular vein
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10
Q

What important lymphatic ducts are found in the superior mediastinum?

A
  • Right lymphatic duct
  • Thoracic duct
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11
Q

What important pulmonary structures are found in the superior mediastinum?

A

Trachea

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12
Q

What important digestive structures are found in the superior mediastinum?

A

Oesophagus

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13
Q

What important neurological structures are found in the superior mediastinum?

A
  • Upper portions of the sympathetic trunk
    • Vagus nerves travelling down from the neck:
      • Right vagus nerve crossing over right subclavian artery where the right recurrent laryngeal nerve branches off and travels back up to the larynx
      • Left vagus nerve crossing over arch of aorta where the left recurrent laryngeal nerve branches off and travels back up to the larynx
      • Superficial cardiac plexus lying on the arch of the aorta which is formed by branches from the left and right vagus nerves (parasympathetic), and branches from T1-T4 portions of the sympathetic trunk (see image below)
    • Phrenic nerves travelling down from the neck
      • Right and left internal thoracic arteries branching from the right and left subclavian arteries respectively.
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14
Q

What are the functions of the superficial cardiac plexuses?

A
  • Parasympathetic innervation
    • Decreases heart rate
    • Reduces force of contraction
    • Constricts the coronary arteries
  • Sympathetic innervation
    • Increases heart rate
    • Increases the force of contraction
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15
Q

What important structures are found in the anterior mediastinum?

A
  • Thymus gland
    • Prominent before & during puberty
    • Turns into a fatty connective tissue that is a residual structure in adults
  • Arteries:
    • Internal thoracic artery
  • Lymph nodes:
    • Parasternal nodes
      • Drain a small portion of lymph from the breast
    • Prepericardial lymph vessels
      • Drain a small portion of lymph from the breast
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16
Q

What important structures are found in the middle mediastinum?

A
  • Cardiac structures:
    • Pericardium containing the heart
    • Ascending aorta
    • Pulmonary trunk
    • SVC/IVC
    • Pulmonary veins
    • Pericardiacophrenic artery and vein
  • Pulmonary structures:
    • Bifurcation of the trachea
      • Right and left main bronchi
  • Neurological structures:
    • Left and right phrenic nerves
    • Deep cardiac plexus formed by cardiac branches of left and right vagus nerves (parasympathetic) and cardiac branches from the sympathetic trunk (T1-T4)
  • Lymphatic structures:
    • Tracheobronchial lymph nodes lying on main bronchus and inferior trachea
17
Q

What are the functions of the superficial cardiac plexuses?

A
  • Parasympathetic innervation
    • Decreases heart rate
    • Reduces force of contraction
    • Constricts the coronary arteries
  • Sympathetic innervation
    • Increases heart rate
    • Increases the force of contraction
18
Q

What is the pathological significance of the tracheobronchial lymph nodes?

A
  • These nodes may become enlarged in the case of pathology of the lungs
  • Biopsies of these nodes can be taken to determine different disease states
    • They can be accessed by making a slit above the jugular notch to enter the superior mediastinum, travel down the trachea until the point of bifurcation where the nodes are located
      • This allows access to these nodes without damaging the pleurae or lung tissue itself
19
Q

What important structures are found in the posterior mediastinum (More anteriorly)?

A
  • Cardiac structures
    • Descending aorta
      • Intercostal arteries
      • Mediastinal branches of the descending aorta
      • Pericardial branches of the descending aorta
      • Oesophageal branches of the descending aorta
    • Superior phrenic arteries
  • Digestive structures
    • Oesophagus
  • Neurological structures
    • Vagus nerves (Left & Right) (Parasympathetic)
      • Oesophageal plexus
      • Anterior vagal trunk
      • Posterior vagal trunk
20
Q

What important structures are found in the posterior mediastinum (More posteriorly)?

A
  • Cardiac structures
    • Azygous vein
      • Formed by the marching of the right subcostal vein & the right ascending lumbar vein
      • Posterior intercostal veins
      • Hemiazygos vein
      • Accessor hemiazygos vein
    • Superior intercostal veins (Left & Right)
  • Lymphatic structures
    • Thoracic duct (Begins as cisterna chyli)
  • Neurological structures:
    • Greater Thoracic Splanchnic Nerve (Left & Right) (Sympathetic)
      • Originate from T5 - T9

Phase 1b - Anatomy (8 decks)

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