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Thorax > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

anterior boundary of superior mediastinum

A

manubrium

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2
Q

posterior boundary of superior mediastinum

A

bodies of T1-T4

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3
Q

great vessels found in the superior mediastinum

A
  • arch of the aorta
  • ligamentum arteriosum
  • brachiocephalic veins
  • superior vena cava
  • cardiac plexus
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4
Q

where is the arch of the aorta

A

at level of manubriosternal joint

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5
Q

what three arteries arise from the upper convexity of the arch of the aorta

A

the brachiocephalic trunk, and the left common carotid and left subclavian arteries

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6
Q

what does the adventitial layer of the arch contain

A

baroreceptors innervated by vagal nerve fibres - reflex control of heart rate

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7
Q

what is found under the arch

A

he aortic bodies (also supplied by vagal fibres) - chemoreceptors concerned with respiratory reflexes.

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8
Q

brachiocephalic trunk pathway

A

arises in midline → up across trachea → back of right sternoclavicular joint → divides into right common carotid and right subclavian arteries

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9
Q

branches of braciocephalic trunk

A

No branches apart from the thyroidea ima artery - arises from it or directly from the arch of the aorta

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10
Q

left common carotid artery pathway

A

Left common carotid artery: arises behind brachiocephalic trunk → straight up along side trachea → neck

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11
Q

branches of left common carotid artery

A

none in mediastinum

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12
Q

left subclvian artery pathway

A

arises behind left common carotid → straight up along trachea → moves away from left common carotid behind left sternoclavicular joint

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13
Q

left subclavian artery branches

A

none in the mediastinum

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14
Q

ligamentum arteriosum pathway

A
  • Beginning of left pulmonary artery → concavity of the aortic arch beyond subclavian artery
  • It lies almost horizontally
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15
Q

where are the brachiocephalic veins formed

A

behind the sternoclavicular joints by confluence of the internal jugular and subclavian veins.

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16
Q

four tributaries of the brachiocephalic vein

A
  • vertebral
  • inferior thyroid
  • internal thoracic
  • superior intercostal (only on left side)
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17
Q

where does the right brachiocephalic vein commence

A

behind the right sternoclavicular joint and runs downwards

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18
Q

what lymphatics are received by the right brachiocephalic veins

A

the right jugular, subclavian and bronchomediastinal lymph trunks separately or their confluent channel, the right lymphatic duct.

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19
Q

left brachiocephalic vein pathway

A

passes to the right with a downward inclination → across the superior mediastinum → above the arch of the aorta → behind the thymus and the upper half of the manubrium

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20
Q

what does the commencement of the left brachiocephalic vein receive

A
  • the thoracic duct, which often divides into two or three branches that join the vein separately
  • the vertebral and internal thoracic veins, most of the inferior thyroid veins, the left superior intercostal vein, and a large thymic vein
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21
Q

superior vena cava pathway

A

Lower border of first right costal cartilage → vertically downwards → behind the right border of the sternum → pierces pericardium at the level of the second costal cartilage → upper border of the right atrium at the lower border of the third right costal cartilage

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22
Q

does the inferior vena cava have valves

A

no

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23
Q

what does the cardiac plexux consist of

A

sympathetic, parasympathetic and afferent fibres and small ganglia

24
Q

divisions of cardiac plexus

A
  • The superficial part which lies anterior to the ligamentum arteriosum.
  • The deep part is larger and lies to the right of the ligamentum arteriosum
25
Q

what does the cardiac plexus receive

A
  • ympathetic fibres from the three cervical and the upper four or five thoracic sympathetic ganglia of both sides
  • parasympathetic fibres from both vagi in their cervical course and both recurrent laryngeal nerves.
26
Q

sympathetic fibres function

cardiac plexus

A

accelerate the heart and dilate the coronary arteries

27
Q

parasympathetic fibres function

cardiac plexus

A

slow the heart and constrict the coronary arteries

28
Q

where does the trachea commence

A

in the neck below the cricoid cartilage at the level of C6 vertebra, 5 cm above the jugular notch

29
Q

trachea pathway

A

Entering the thoracic inlet, it passes downwards and backwards behind the manubrium to bifurcate into the two principal or main bronchi level with the upper border of T5 vertebra

30
Q

trachea dimensions

A

10 cm long and 2 cm in diameter

31
Q

blood supply of trachea

A
  • Branches from the inferior thyroid and bronchial arteries form anastomotic networks in the tracheal wall
  • Veins drain to the inferior thyroid vein
32
Q

lymphatic drainage of trachea

A

Lymphatic channels pass to pre- and paratracheal nodes and to inferior deep cervical nodes

33
Q

nerve supply of trachea

A
  • The mucous membrane is supplied by afferent fibres from the vagi and recurrent laryngeal nerves.
  • Sympathetic fibres from upper ganglia of the sympathetic trunks supply the smooth muscle and blood vessels.
34
Q

functions of the parts of the trachea

A
  • The cartilaginous rings keep the airway open
  • Mucus traps particles
  • Cilia beat upwards to clear debris
  • Glandular secretion helps to humidify the passing air
  • During swallowing the trachea is stretched as the larynx moves
    upwards and elasticity restores the normal position.
  • The trachealis muscle controls the diameter of the tube.
35
Q

functions of the parts of the trachea

A
  • The cartilaginous rings keep the airway open
  • Mucus traps particles
  • Cilia beat upwards to clear debris
  • Glandular secretion helps to humidify the passing air
  • During swallowing the trachea is stretched as the larynx moves
    upwards and elasticity restores the normal position.
  • The trachealis muscle controls the diameter of the tube.
36
Q

phrenic nerve pathway

A

Arises from C4 → passes down anterior scalene muscle → across dome of pleura behind subclavian vein → crosses anterior to vagus → through mediastinum in front of lung root

37
Q

what type of structures is the right phrenic vein related to

A

venous

38
Q

what structures lie medially to the right phrenic nerve

A

The right brachiocephalic vein, the superior vena cava, the pericardium over the right atrium, and the inferior vena cava

39
Q

how does the right phrenic nerve reach the underside of the diaphragm

A

y passing through the central tendon alongside the inferior vena cava, piercing the tendon
fibres that fuse with the caval wall.

40
Q

what type of structures is the left phrenic nerve related to medially

A

arterial

41
Q

what lies medially to the left phrenic nerve

A

common carotid and left subclavian arteries

42
Q

how does the left phrenic nerve reach the underside of the diaphragm

A

by piercing the muscular part just to the left of the pericardium.

43
Q

how much of the phrenic nerve fibres are motor and where do they supply

A

2/3 and the diaphrahm

44
Q

where do the sensory fibres of the phrenic nerve supply

A

the diaphragm, the mediastinal pleura, the fibrous pericardium, the parietal layer of serous pericardium, and the central parts of the diaphragmatic pleura and peritoneum

45
Q

vagus nerves associations to the trachea

A
  • The right vagus is in contact with the trachea
  • The left vagus is seperated from the trachea by arteries that spring from the arch of the aorta.
46
Q

vagus nerve pathway

A

Each vagus passes down behind the lung root, dividing into branches which contribute to the pulmonary plexuses and pass onwards to form a plexus around the oesophagus.

47
Q

recurrent laryngeal nerve origins and pathway

A

Left vagus flattens on arch of aorta → gives of recurrent laryngeal nerve → hooks around ligamentum arteriosum → passes on right side of aortic arch → ascends in groove between trachea and oesophagus

48
Q

what do the recurrent laryngeal nerves supply

A

the whole trachea, the adjacent oesophagus and the larynx

49
Q

where is the anterior mediastinum

A

between the pericardium and sternum

50
Q

what does the anterior mediastinum contain

A

the thymus, sternopericardial ligaments, a few lymph
nodes and branches of the internal thoracic vessels.

51
Q

what lies anterior to the thymus

A

the sternohyoid and sternothyroid muscles, the manubrium and upper part of the body of the sternum and their adjacent costal cartilages

52
Q

what lies posteriorly to the thymus

A

he pericardium, the arch of the aorta with its three large branches, the left brachiocephalic vein and the trachea.

53
Q

blood supply to the thymus

A

Small branches enter the thymus from the inferior thyroid and internal thoracic arteries, and their corresponding veins.

54
Q

lymphatic drainage of the thymus

A
  • Efferent channels drain into parasternal, tracheobronchial and brachiocephalic nodes.
  • The thymus does not receive any afferent lymphatics.
55
Q

what does the middle mediastinum contain

A

Contains the pericardium and heart, the adjoining parts of the great vessels, the lung roots, the phrenic nerves, and the deep part of the cardiac plexus.

Thorax (9 decks)

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