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3. HLTH 213 > Thorax: Viscera (Mediastinum) > Flashcards

Thorax: Viscera (Mediastinum) Flashcards

1
Q

mediastinum: general features

A
  • central portion of thoracic cavity
  • from superior thoracic aperture to diaphragm inferiorly

ant: sternum and costal cartilage
post: bodies of vertebrae

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2
Q

mediastinum: list divisions

A
  • superior mediastinum

- inferior mediastinum

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3
Q

mediastinum: superior mediastinum

A

btw manubrium/sternum and T1-4 vertebrae

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4
Q

mediastinum: inferior mediastinum and list divisions

A
  • manubriosternal j and lower T4 vertebrae to thoracic outlet
  • ant, middle, post mediastinum
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5
Q

mediastinum: ant mediastinum

A
  • inf mediastinum

- btw sternal body and pericardium

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6
Q

mediastinum: middle mediastinum

A
  • inf mediastinum

- broadest part containing cardiovascular viscera

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7
Q

mediastinum: post mediastinum

A
  • inf mediastinum

- btw trachea/ vessels/ pericardium/ diaphragm and thoracic vertebrae from T4 down

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8
Q

superior mediastinum: boundaries

A
  • bound above by thoracic inlet, below sternal plane and laterally by lung pleura
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9
Q

superior mediastinum: contents

A

neck mm:

  • sternohyoid
  • sternothyroid
  • longus colli
  • thoracic viscera (exc lungs)
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10
Q

superior mediastinum: list major structures (10)

A
  • thymus
  • brachiocephalic v
  • sup vena cava
  • arch of aorta w branches
  • trachea
  • oesophagus
  • phrenic n
  • vagus n
  • L recurrent laryngeal n
  • thoracic duct
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11
Q

superior vena cava: forms where

A
  • post to 1st costal cartilage on the R
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12
Q

superior vena cava: enters R atrium where

A
  • 3rd level of costal cartilage
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13
Q

superior vena cava: formed by

A

junction of 2 brachiocephalic veins behind lower border of 1st R costal cartilage as it nears the sternum

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14
Q

arch of aorta: general features

A
  • continues from ascending aorta located to R of upper border of 2nd sternocostal joint
  • continues to arch to L over top of trachea and descends over T4 and continues as descending aorta
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15
Q

arch of aorta: location and branches

A
  • entirely in superior mediastinum
  • R brachiocephalic
  • L common carotid
  • L subclavian
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16
Q

arch of aorta: anatomical (normal) pattern seen in

A

65% of people

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17
Q

arch of aorta: ligamentum arteriosum

A
  • remnant of ductus arteriosus -> allowed blood to bypass lungs during development in utero
  • if doesn’t close after birth, causes congenital heart defect: patent ductus arteriosus which does not produce cyanosis intially
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18
Q

anterior mediastinum: bound by

A
  • laterally: pleura
  • post: pericardium
  • ant: sternum
  • costal cartilages of ribs 5,6,7
19
Q

anterior mediastinum: contains (5)

A
  • loose areolar tissue
  • lymph vessels
  • ant mediastinal lymph nodes
  • mediastinal branches of int thoracic aa
  • thymus (involuted in adults)
20
Q

middle mediastinum: contains (4)

A
  • pericardium
  • heart
  • roots of great vessels
  • nerves
21
Q

posterior mediastinum: contains (6)

A
  • thoracic aorta
  • thoracic duct
  • post mediastinal lymph nodes
  • azygos and hemiazygos veins
  • oesophagus
  • thoracic sympathetic trunks
22
Q

vagus nerve: R

A
  • enters thorax ant to R subclavian aa
  • gives R recurrent laryngeal nn -> hooks around R subclavian aa
  • R vagus nn passes post to R brachiocephalic v, SVC and root of R lung
23
Q

vagus nerve: L

A
  • enters mediastinum btw L common carotid aa and L subclavian aa
  • gives L recurrent laryngeal nn (lateral to ligamentum arteriosum) -> hooks around arch of aorta
  • L vagus nn continues descent and passes post to root of L lung
24
Q

vagus nerve: both nn

A
  • L and R vagus nn form post/ant vagal plexuses around oesophagus and leave thoracic cavity through oesophageal opening of diaphragm (at T10 vertebral level)
  • enters ab cavity and supplies Psy fibres to ab viscera as far as 2/3 of transverse colon
25
Q

vagus nerve: paralysis of recurrent laryngeal nn due to

A
  • aortic arch aneurism (excessive localised swelling of aa wall)
  • thyroid pathology/ surgery
  • surgery in neck, oesophagus, heart and lungs
26
Q

vagus nerve: symptoms and signs of recurrent laryngeal paralysis

A
  • dysphagia (difficulty swallowing)
  • dysphonia (difficulty speaking)
  • aphonia (inability to speak) w inspiratory stridor (bilateral injury to recurrent laryngeal nn)
  • anaesthesia of superior part of larynx
27
Q

phrenic nerve: origin and border

A
  • ventral rami of C3,4,5

- each phrenic nn forms at lateral border of ant scalene m at level of superior border of thyroid cartilage

28
Q

phrenic nerve: L location

A
  • lies on ant scalene mm and crosses ant to first part of subclavian aa
29
Q

phrenic nerve: R location

A
  • lies on ant scalene mm and crosses ant to second part of subclavian aa
30
Q

phrenic nerve: enters superior mediastinum

A
  • btw subclavian aa and origin of brachiocephalic vein

- pass ant to roots of lungs (vs vagus nn which pass post)

31
Q

phrenic nerve: R passes

A
  • along R side of pericardium over R atrium

- then passes through caval opening (T8) to supply inf diaphragm

32
Q

phrenic nerve: L passes

A
  • along L side of pericardium superficial to L atrium and ventricle
  • pierces diaphragm laterally to pericardium
33
Q

thoracic aorta: location

A
  • lies post to root of L lung
34
Q

thoracic aorta: branches

A
  • bronchial
  • pericardial
  • post intercostal
  • superior phrenic
  • oesophageal
  • mediastinal
  • subcostal
35
Q

eg. coarctation of aorta

A

narrowing of small section of aorta

36
Q

azygos vein: features

A
  • azygos sistem of veins drains the back, thoracoabdominal walls and mediastinal viscera
  • forms collateral pathway btw SVC and IVC
37
Q

thoracic duct: features

A

largest lymphatic channel conveys lymph from:

  • lower limbs
  • pelvic cavity
  • abdominal cavity
  • L side thorax
  • L side of head, neck, upper limb
38
Q

thoracic duct: drains into

A
  • empties into venous system

- either subclavian v or brachiocephalic v

39
Q

sympathetic trunks: features

A
  • 2 parallel cords w 11-12 ganglia

- ganglia connected to adjacent spinal nn

40
Q

sympathetic trunks: upper 5 ganglia supply

A

thoracic viscera

41
Q

sympathetic trunks: lower 7 ganglia

A

give sympathetic n supply to abdominal viscera

42
Q

oesophagus: features

A
  • muscular tube in neck from C6 vertebra at junction of pharynx -> ends in abdominal cavity and cardiac opening in stomach at level T11 vertebra
  • R and L vagus nn form post/ant vagal plexuses around oesophagus
43
Q

oesophageal anatomical constrictions:

A

compressed at 4 levels:

  • in neck at junction w pharynx
  • superior mediastinum by aortic arch
  • post mediastinum b L main bronchus
  • at passage through diaphragm
  • have clinical importance
44
Q

eg. dissection of aorta

A
  • injury to aorta causes wall layers to split

- allowing blood to flow btw layers

3. HLTH 213 (22 decks)

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