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1Principles of Biomedicine - MD1 > 45 - Mediastinum > Flashcards

45 - Mediastinum Flashcards

1
Q

Mediastinum location

A

Between left and right pleural cavities.

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2
Q

Divisions of mediastinum

A

Manubrio-sterno junction/T4/T5 IV disc divides between superior and inferior mediastinum. Middle mediastinum contains heart. Anterior and posterior mediastinum are divided by heart.

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3
Q

Contents of anterior mediastinum

A

Thymus

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4
Q

*Pictorial representation of mediastinum

A
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5
Q

Contents of superior mediastinum (anterior to posterior) 1) 2) 3) 4)

A

1) Thymus 2) Great veins 3) Aortic arch, vagus, phrenic nerves 4) Trachea, oesophagus, thoracic duct, left recurrent laryngeal nerve

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6
Q

Nerves always associated with the aortic arch

A

Vagus, phrenic nerves

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7
Q

In anterior view, where do veins and arteries of the heart lie?

A

Veins lie to the right, with the right heart. Arteries lie to the left, with the left heart

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8
Q
A
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9
Q

Where do the internal jugular veins meet the subclavian veins?

A

Behind sterno-clavicular joints

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10
Q

Shape of right and left brachiocephalic veins

A

Right has a more vertical, shorter course. Left has a longer, more horizontal course

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11
Q

Where do the right and left brachiocephalic veins join?

A

Behind the 1st right costal cartilage

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12
Q

What do the right and left brachiocephalic veins join into?

A

The SVC

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13
Q

Why is JVP taken preferentially on the right side?

A

Right brachiocephalic vein has a shorter, more vertical course, into the right internal jugular. This makes it a more accurate indicator of right atrial pressure.

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14
Q

Veins that join to make brachiocephalic vein

A

Subclavian, internal jugular

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15
Q

Veins that form SVC

A

Brachiocephalic vein, azygous vein

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16
Q

How does the azygous vein join the SVC?

A

Arches forward from the posterior thoracic wall, joins SVC behind second costal cartilage

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17
Q

1, 2, 3 of SVC

A

1) Brachiocephalic veins enter at first costal cartilage 2) Receives azygous vein behind second right costal cartilage 3) Enters heart behind third costal cartilage

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18
Q

Path of the arch of the aorta

A

Upwards, backwards, to the left. Continues

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19
Q

*Left lateral mediastinum

A
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20
Q

Part of lungs that aorta arches over

A

Lung root

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21
Q

What does the ligamentum arteriosum do?

A

Links the aorta and pulmonary trunk arising from the right ventricle

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22
Q

What do branches of the aortic arch supply?

A

Head, neck, upper limbs

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23
Q

Fibrous structure that links aorta and pulmonary trunk arising from right ventricle

A

Ligamentum arteriosum

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24
Q

Branches of aortic arch

A

1st - Brachiocephalic trunk, which becomes right common carotid and right subclavian 2nd - Left common carotid 3rd - Left subclavian (posterior to 1st and 2nd branches)

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25
Q

Blood vessels that form a ‘V’ around trachea

A

Brachiocephalic trunk and left common carotid artery

26
Q

Common alternate arrangement of aortic arch branches

A

Right common carotid becomes last branch (order of branches becomes rIght subclavian, left common carotid, left subclavian, right common carotid). Right common carotid snakes behind oesophagus( retro-oesophageal). Can make swallowing difficult

27
Q

Spinal segments innervating diaphragm

A

C3, C4, C5 keep the diaphragm alive. Innerveate through right and left phrenic nerves.

28
Q
A
29
Q

*Layout of vessels in retroesophageal right common carotid

A
30
Q

Path of right phrenic nerve 1) 2) 3) 4) 5)

A

1) Originates at C3, C4, C5 2) Descends on scalenus anterior 3) Travels between subclavian vein and artery 4) Passes anterior to lung root 5) Pierces diaphragm with IVC, innervates diaphragm.

31
Q

Part of mediastinum where phrenic nerves are found

A

Always most lateral structures in mediastinum

32
Q

*Pictorial representation of phrenic nerve paths

A
33
Q

Which structures is right phrenic nerve lateral to?

A

Venous structures. SVC, right atrium, IVC

34
Q

Which structures is left phrenic nerve lateral to?

A

Arterial structures. Aortic arch, left ventricle

35
Q

What do the phrenic nerves supply with sensory innervation?

A

Mediastinal and diaphragmatic pleura. Mediastinal and diaphragmatic pericardium.

36
Q

How do phrenic nerves innervate diaphragm?

A

Pierce diaphragm with IVC. Provide innervation from abdominal side

37
Q

Where do phrenic nerve and IVC pierce diaphragm?

A

T8

38
Q

Nerve intimately associated with arch of the aorta

A

Vagus nerve

39
Q
A
40
Q

Where in neck does vagus nerve run?

A

Postero-lateral to common carotid artery

41
Q

Neurovascular bundle in mediastinum

A

Common carotid arteries, internal jugular veins, vagus nerves

42
Q

Where does the vagus nerve pierce the diaphragm?

A

At the oesophageal hiatus at T10

43
Q

Which nerve pierces diaphragm with the IVC?

A

Phrenic

44
Q

Which nerve pierces diaphragm with the oesophagus

A

Vagus

45
Q

Path of right vagus nerve 1) 2) 3) 4) 5)

A

1) Originates as a cranial nerve 2) Runs alongside trachea 3) Goes behind lung root 4) Ramifies, forms oesophageal plexus on anterior oesophagus 5) Passes through diaphragm at oesophageal hiatus at T10.

46
Q

Path of left vagus nerve 1) 2) 3) 4) 5) 6) 7) 8)

A

1) Originates as a cranial nerve 2) Runs alongside trachea 3) Passes lateral to aortic arch 4) Passes posterior to phrenic nerve 5) Crossed by superior intercostal vein 6) Gives off left recurrent laryngeal nerve 7) Goes behind lung root 8) Runs along anterior oesophagus

47
Q

Relationship to aorta that phrenic and vagus nerves have

A

Phrenic are anterior to aorta, vagus are posterior

48
Q

Where does left recurrent laryngeal nerve branch from?

A

From left vagus nerve, behind the left lateral side of the arch of the aorta.

49
Q

Path of left recurrent laryngeal nerve 1) 2) 3)

A

1) Originates from left vagus nerve, behind left lateral side of arch of aorta. 2) Travels under ligament arteriosum 3) Ascends to larynx through tracheo-oesophageal groove

50
Q

Where does the right recurrent laryngeal nerve branch from?

A

From right vagus nerve. Travels under right subclavian artery

51
Q

Where in mediastinum is trachea?

A

Superior mediastinum. Lies anterior to oesophagus

52
Q

Where does oesophagus begin?

A

C6

53
Q

Narrowings of oesophagus 1) 2) 3)

A

1) At beginning (C6) 2) Where is passes arch of aorta (not an intrinsic narrowing. Where aorta impinges on oesophagus) 3) Where it passes through the diaphragm

54
Q

Path of oesophagus relative to spine

A

Travels centrally, tilts off to the left before piercing diaphragm

55
Q

Structure through which lower half of body, upper left quarter of body drains lymph

A

Thoracic duct

56
Q

Path of thoracic duct 1) 2) 3)

A

1) Starts at aortic hiatus at T12 between crura. 2) Runs at back of oesophagus. 3) Arches into the junction between the left internal jugular vein, left subclavian vein.

57
Q

How does upper right quarter of body drain lymph?

A

Through right lymphatic channel. Is much smaller than left (thoracic duct)

58
Q

Path of descending aorta

A

Left of vertebral column

59
Q

Branches of descending aorta 1) 2) 3) 4)

A

1) Intercostal (posterior) 2) Bronchial 3) Pericardial 4) Oesophageal

60
Q

Structures within the posterior mediastinum 1) 2) 3) 4) 5)

A

1) Descending aorta 2) Oesophagus, oesophageal plexus 3) Azygous veins 4) Thoracic duct 5) Sympathetic trunk

1Principles of Biomedicine - MD1 (157 decks)

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