4-B,C,D Vessels of the Thorax (lymph, Azygos and Aorta)

Question 1

Trace the course of the thoracic duct in the thorax (largest lymphatic vessel in the body)

Answer 1

Originates in the upper abdomen at the cisterna chili (lymphatic vessel that receives all lymph from below the diaphragm). Ascends on the right side of the midline in the lower half of the thorax and then shifts to the left side of the midline in the upper half of the thorax. Exits thorax by passing behind the left subclavian artery and ends by joining the left internal jugular or left subclavian vein

Question 2

Indentify the origin and termination of the thoracic duct

Answer 2

cisterna chili and where the left internal jugular joins the left subclavian, respectively

Question 3

What area of the body does the brachiocephalic veins drain?

Answer 3

both arms and the head and neck

Question 4

What area of the body does the superior vena cava drain?

Answer 4

upper half of the body, is connected to the inferior vena cavae by the azygos system

Question 5

Describe the connections and position of the hemiazygos v.

Answer 5

ascends on the left side of the vertebral column, posterior to the aorta as far as T9, at which point it crosses the midline behind the aorta and joins the azygos vein; receives blood from posterior intercostal and esophageal veins

Question 6

Describe the path and connections of the azygos

Answer 6

main channel, connects inferior and superior venae cavae receiving blood from the abdominal and thoracic walls through poster intercostal veins, esophageal and bronchial veins

Question 7

Describe the position and connections of the accessory hemiazygos

Answer 7

begins at the 4th or 5th intercostal vein and descends to cross the midline at T7/T8 to join the azygos; receives a variable number of posterior intercostal veins

Question 8

Identify collateral connections fo the azygos system

Answer 8

provides collateral circulation for the superior or inferior vena cavae

Question 9

What is the immediate branches of the aorta as it exits the left ventricle (right away)

Answer 9

right and left coronary arteries

Question 10

Where do the posterior intercostal veins feed into?

Answer 10

azygos system

Question 11

Name 3 vessels that branch off the descending aorta

Answer 11

posterior intercostal arteries, bronchial arteries and esophageal arteries (visceral branches of descending aorta)

Question 12

This nerve branches laterally from the sympathetic trunk and pass caudally to penetrate the diaphragm ?

Answer 12

thoracic splanchnic nerves

Question 13

Inferior to the esophageal autonomic plexus you can find the anterior and posterior ____ trunks.

Answer 13

vagal

Question 14

The thoracic duct is thin and weak, but usually can be found between ______ ______ and to the right and the _____ to the left.

Answer 14

esophagus and aorta, azygos

Question 15

What are the three arteries that branch off the aortic arch?

Answer 15

brachiocephalic artery/trunk (right) left common carotid artery (heads toward the head) and left subclavian artery (left)

Question 16

Sympathetic and parasympathetic systems are purely ____ in function.

Answer 16

motor (innervates smooth muscle, cardiac muscle and glands

Question 17

Posterior intercostal veins train into ___ ____

Answer 17

azygos system

Question 18

All preganglionic sympathetic nerve cell bodies are located where?

Answer 18

lateral horn at the spinal cord levels T1-L2

Question 19

If presynaptic axons from the spinal cord only exit the spinal cord at levels T1-L2, how does the sympathetic chain run from first cervical to lowest sacral levels?

Answer 19

Presynaptic axons from the spinal cord enter the sympathetic trunk and synapse in a ganglion at that which ever level it must travel to.

Question 20

Sympathetic splanchnic nerves are branches from the sympathetic trunk to ____

Answer 20

viscera : (splanchnic nerves going to heart, lungs and other viscera in the thorax containing mostly postganglionic fibers and synapses in a chain ganglion while splanchnic nerves going to abdominal and pelvic viscera contain mostly preganglionic fibers, synapsing in collateral ganglion or terminal ganglia)

Question 21

The collateral or pre vertebral ganglia contain the post ganglionic cell bodies that send their axons to where?

Answer 21

abdominal (pelvic viscera send pre-ganglionic fibers to terminal ganglia on the organ)

Question 22

What types of fibers does the cardiopulmonary plexus contain?

Answer 22

sympathetic, parasympathetic and sensory fibers

Question 23

Nerves of the sympathetic system that use the gray postganglionic communicating rami primarily innervate targets in ?

Answer 23

body wall and extremities

Question 24

Vagus nerves arise from the brainstem as cranial nerves and deliver parasympathetic fibers to the viscera where?

Answer 24

all viscera in the thorax and a portion of the viscera in the abdomen

Question 25

The esophageal plexus includes what types of nerve fiber?

Answer 25

parasympathetic from the left and right vagus nerves, branchiomotor and viscerosensory fibers (esophageal muscle includes both skeletal and smooth muscle) …. as well as post ganglionic sympathetic

Question 26

Parasympathetic splanchnic nerves are also known as?

Answer 26

pelvic splanchnic nerves

Question 27

Name the two places that pre-ganglionic sympathetic fibers can synapse.

Answer 27

in the sympathetic trunk or the collateral/prevertebral ganglion

Question 28

There are no sympathetic ganglia in the ___ therefore most sympathetic fibers headed in that direction synapse at the highest cervical chain ganglion called the superior cervical ganglion (fusion of the upper four cervical ganglia).

Answer 28

head

Question 29

Fibers that synapse at the superior cervical ganglion reach their targets by traveling along branches of this artery

Answer 29

carotid artery

Question 30

Postganglionic sympathetic fibers innervating the thorax leave the cervical sympathetic chain called (3nerves)

Answer 30

superior, middle and inferior cardiac nerves which form the cardiopulmonary plexus just below the arch of the aorta; fibers pass from the plexus to the SA node of the heart to the bronchi and arteries of the lungs

Question 31

Preganglionic sympathetic fibers from T5-10, 12 pass through the sympathetic chain and synapse on the collateral ganglia, they continue from the sympathetic chain as what nerves? What part of the body do these nerves innervate?

Answer 31

greater, lesser and least thoracic splanchnic nerves which pass inferiorly through the diaphragm and enter the abdominal cavity synapsing on collateral ganglia at the branch points of the celiac, renal sand superior mesenteric arteries. the postganglionic fibers from the ganglia travel along the branches of the respective artery

Question 32

Prevertebral ganglia such as the inferior mesenteric and hypogastric ganglia receive preganglionic fibers from branches of the sympathetic trunk called ?

Answer 32

lumbar or sacral splanchnic nerves

Question 33

The ___ ___ and ____ do not receive parasympathetic innervation.

Answer 33

body wall and extremities

Question 34

The vagus nerve targets which organs in the thorax

Answer 34

heart and lungs and esophagus

Question 35

The vagus nerve targets which organs in the abdomen?

Answer 35

derivatives of the embryonic foregut and midgut (intestinal tract up to the transverse colon)

Question 36

The sympathetic presynaptic neurons synapse on about 20 post synaptic neurons, this give the sympathetic system the ability to ?

Answer 36

amplify its message, essential feature for a system that must react quickly in an emergency situation

Question 37

The parasympathetic presynaptic neurons synapse with only one or two postsynaptic neurons which allow the system to do what?

Answer 37

have more precise control over the signal it sends

Question 38

Sensory neurons in the dorsal root ganglia that travel with sympathetics carry _____ ____ while sensory neurons that travel with parasympathetics (vagus) carry information for _____

Answer 38

pain sensation (due to excessive distention or contraction of SM); reflexes (sensations such as hunger and nausea)

Question 39

The thoracic duct enters the thorax how?

Answer 39

through the diaphragm by passing through the aortic hiatus, ascending on the the right side of the midline before shifting to the left side of the midline in the upper half of the thorax

Question 40

The azygos vein ascends on the right side of the vertebral column receiving blood from the abdominal and thoracic walls, mainly through the ?

Answer 40

Posterior intercostal veins, also from the esophageal and bronchial veins

Question 41

The azygos vein forms the azygos arch just superior to the ?

Answer 41

Hilus of the lung, where it turns from vertical to more anteriorly in order to drain into the superior vena cava

Question 42

The accessory hemiazygos begins at the 4th or 5th intercostal veins and bends to ____ to join the azygos vein.

Answer 42

T7-8

Question 43

The hemiazygos crosses the body at ___ posterior to the aorta and esophagus to join the azygos vein.

Answer 43

T9

Question 44

The descending aorta has ____ and ___ branches to supply the body wall and he internal organs respectively.

Answer 44

parietal and visceral