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Gross Anatomy > Thorax: Posterior Mediastinum > Flashcards

Thorax: Posterior Mediastinum Flashcards

1
Q

Posterior Mediastinum

A
  • Between pericardium/diaphragm and vertebral bodies
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2
Q

Posterior Mediastinum Boundaries

A
  • Anterior: pericardium
  • Posterior: T5-12 vertebral bodies
  • Superior: transverse thoracic plane
  • Inferior: diaphragm
  • Lateral: mediastinal pleura
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3
Q

Posterior Mediastinum Contents

A
  • Descending thoracic aorta
  • Lymphatic trunks (thoracic duct)
  • Lymph nodes
  • Azygos, hemiazygos venous system
  • Esophagus
  • Vagus nerve
  • Esophageal nerve plexus
  • Thoracic splanchnic nerves
  • Sympathetic trunk (PROBABLY NOT)
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4
Q

Descending Thoracic Aorta

A
  • Travels from T5 – T12 vertebral bodies, left of the median plane
  • Posterior to root of left lung, pericardium and esophagus.
  • Enters abdomen through aortic hiatus (T12 vertebral level) in the diaphragm
  • Supplies viscera and body wall
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5
Q

Branches of Descending Thoracic Aorta

A
  • Esophageal arteries
  • Bronchial arteries
  • Posterior intercostal arteries
  • Subcostal arteries
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6
Q

Esophageal Arteries

A
  • 2-5 branches
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7
Q

Bronchial Arteries

A
  • Left: paried branches from thoracic aorta

- Right: often arises from the left bronchial or the 3rd right posterior intercostal artery

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8
Q

Posterior Intercostal Arteries

A
  • 9 pairs from the aorta

- First 2 pairs come from somewhere else

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9
Q

Esophagus

A
  • Posterior to heart base (pericardium surrounding left atrium)
  • Enters abdomen through esophageal hiatus, T10 level
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10
Q

4 Natural Constrictions/Impressions of Esophagus

A
  • Junction with pharynx
  • Arch of the aorta
  • Left main bronchus
  • Esophageal hiatus
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11
Q

Azygos Venous System

A
  • Drains thoracoabdominal wall, mediastinal viscera

- A lot of variation

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12
Q

Azygos Vein

A
  • Collateral pathway between SVC and IVC
    formed by right ascending lumber and subcostal vein
  • Drains into SVC
  • Arches over right main bronchus
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13
Q

Tributaries of Azygos Vein

A
  • Bronchial, esophageal mediastinal veins
  • Right intercostal veins 5-11
  • Right superior intercostal veins
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14
Q

Right Superior Intercostal Veins

A
  • Receives right intercostal veins 2-4
  • Hemiazygos
  • Accessory hemiazygos veins
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15
Q

Hemi-Azygos Vein

A
  • Left side
  • Formed by left ascending lumbar and subcostal veins
  • Drains into the azygos vein
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16
Q

Tributaries of Hemi-Azygos Vein

A
  • Esophageal, mediastinal veins

- Receives left intercostal veins 9-11

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17
Q

Accessory Hemi-Azygos Vein

A
  • Left side

- Drains into the azygos vein

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18
Q

Tributaries of the Hemi-Azygos Vein

A
  • Esophageal, mediastinal veins

- Receives left intercostal veins 4 (5)-8

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19
Q

Left Superior Intercostal Vein

A
  • Receives left intercostal veins 2-3(4)
  • Drains into left brachiocephalic
  • Can drain into accessory hemi-azygos vein
20
Q

Left and Right 1st Intercostal Veins

A
  • Drain into the brachiocephalic veins
21
Q

Thoracic Lymphatic Duct

A
  • Receives lymph from most of the body
    except right arm, right head neck, right upper quadrant of torso
  • Originates from the cisterna chyli, level of L1/2
  • Passes through aortic hiatus
  • Posterior to esophagus, between aorta and azygos
  • T5 crosses to the left into superior mediastinum
  • Empties in to left venous angle
22
Q

Thoracic Sympathetic Trunk

A
  • Sympathetic part of autonomic nervous system
  • Lie against head of the ribs
  • Contains ganglia
23
Q

Thoracic Splanchnic Nerves

A
  • Arise from sympathetic trunk ganglia
  • Convey presynaptic neurons
  • Greater splanchnic nerve: T5 – 9
  • Lesser splanchnic nerve: T10 – 11
  • Least splanchnic nerve: T12
  • These supply abdominal organs
24
Q

T5 – 9

A
  • Greater splanchnic nerve
25
Q

T10 – 11

A
  • Lesser splanchnic nerve
26
Q

T12

A
  • Least splanchnic nerve
27
Q

Diaphragm

A
  • Double-domed musculotendinous structure
  • Separates thoracic and abdominal cavities
  • Movement changes pressure in the thoracic and abdominal cavities
  • Fixed at its periphery
  • Right dome reaches 5th rib on expiration
28
Q

Double-Domed Musculotendinous Structure

A
  • Muscular periphery

- Central tendon

29
Q

Movement Changes Pressure in the Thoracic and Abdominal Cavities

A
  • Respiration

- Venous return

30
Q

Right Dome

A
  • Reaches 5th rib on expiration

- Posture dependent (highest when supine)

31
Q

Left Dome

A
  • Left reaches 5th intercostal space

- Posture dependent (highest when supine)

32
Q

Dyspnea

A
  • Sitting up makes breathing easier
33
Q

Parts of the Diaphragm

A
  • Sternal
  • Costal
  • Lumbar
34
Q

Sternal Diaphragm

A
  • Attaches to xiphoid process
35
Q

Costal Diaphragm

A
  • Attaches to inner surface of costal cartilage ribs 7-10

- Attaches to ribs ll & 12

36
Q

Phrenic Nerve

A
  • Motor innervation of diaphragm
37
Q

Phrenic Nerve (Central Portion); Intercostal Portion (Periphery)

A
  • Sensory innervation of diaphragm
38
Q

Major Openings in the Diaphragm

A
  • Caval opening (level of T8)
  • Esophageal hiatus (level of T10)
  • Aortic Hiatus (level of T12)
39
Q

Smaller openings of the Diaphragm

A
  • Transmit greater and lesser splanchnic nerves
  • Sympathetic trunk and least splanchnic nerve pass posterior to medial arcuate ligament
  • Sternocostal foramen
40
Q

Sternacostal Foramen

A
  • Transmit superior epigastric vessels and lymph
41
Q

Caval opening (level of T8)

A
  • Inferior vena cava
  • Right phrenic nerve
  • Lymphatics
42
Q

Esophageal hiatus (level of T10)

A
  • Esophagus
  • Vagus nerves
  • Esophageal branches/tributaries of left gastric artery/vein
43
Q

Aortic Hiatus (level of T12)

A
  • Aorta
  • Azygos vein
  • Hemiazygos vein
  • Thoracic duct
44
Q

Sternal Angle

A
  • Angle of Louis
45
Q

Sternal Angle (Angle of Louis)

A
  • Located at manubriosternal junction
  • Location of the transverse thoracic plane
  • Costal cartilage of rib 2
  • T4/5 disc
  • Beginning and end of aortic arch
  • Bifurcation of trachea, location of carina
  • Bifurcation of pulmonary trunk
  • Left recurrent laryngeal nerve
  • Cardiac plexus
  • Ligamentum arteriosum

Gross Anatomy (50 decks)

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