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Anatomy > EXAM3_G23_Superior_Posterior_Mediastinum > Flashcards

EXAM3_G23_Superior_Posterior_Mediastinum Flashcards

1
Q

Order of 6 major structures from Anterior to Posterior of the superior mediastinum

This should be your mental checklist:

TGGTEL

A
  1. Thymus
  2. Great Veins
  3. Great Arteries
  4. Trachea
  5. Esophagus
  6. Lymphatics (mainly posterior)
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2
Q

What arteries supplies blood to the thymus?

A
  1. Internal thoracic artery

2. Anterior intercostal Arteries

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3
Q

Where does blood drain from the thymus?

A
  1. Left brachiocephalic vein
  2. Internal thoracic vein
  3. Inferior thyroid vein
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4
Q

What does lymph from thymus drain to?

A
  1. Parasternal nodes
  2. Brachiocephalic nodes
  3. Tracheobronchial nodes
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5
Q

What drains lymph into the thymus?

A

NOTHING! - no afferent lymphatics for thymus

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6
Q

What drains blood from head neck and upper limbs into the right atrium?

A 
Brachiocephalic Veins (LEFT IS LONGER)
-
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7
Q

What is the point called where the jugular vein and subclavian vein combine to form the LR brachiocephalic vein

A

LR Venous Angles

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8
Q

Blood from all structures superior to diaphragm (except heart and lungs) drain into the ?

A

SUPERIOR VENA CAVA

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9
Q

The Transverse thoracic plane is a landmark for what feature of the heart?

A

Base of arch of the Aorta

ascending and descending shows at this level on radiograph

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10
Q

In an AP radiograph- At the transverse thoracic plane- the aorta ascends anterior to the ________ and ____. It arches over and posterior to the _______. and Descends ___ of midline

A

ascends anterior to right pulmonary artery and tracheal bifurcation.

Arches over and posterior to root of the lung and descends LEFT of midline

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11
Q

What two landmarks that your looking at the Descending aorta on radiograph (at transverse thoracic plane)

A
  1. Left midline deviation

2. Posterior to root of the lung

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12
Q

Blood bypasses the ______ circuit in a fetus via a shunt called the_____ which becomes the ____ _______ after birth. This forms between the ______ and the _____,

A

Pulmonary Circuit via the Ductus Arteriosus

which becomes the ligamentum arteriosum which forms between the LPA and Aortic Arch

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13
Q

The transverse thoracic plane is a landmark for what feature of the trachea?

A

Ends at the transverse thoracic plane by branching into right and left main bronchi

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14
Q

What are two Keys that define you’re looking at the Trachea at the TTP level of a radiograph?

A
  1. widening/bifurcation
  2. slight right deviation
  3. anterior to esophagus
  4. posterior to aortic branches
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15
Q

Vagus and phrenic nerve which is anterior/posterior to ROL?

A

VP- Posterior ROL is Vagus (with Left recurrent laryngeal n)

AP- anterior ROL is PHRENIC

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16
Q

LEFT recurrent laryngeal nerve located? and innervates?

A

Hooks medially under AORTIC ARCH superiorly to innervate laryngeal muscles

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17
Q

RIGHT recurrent laryngeal nerve located?

A

Hooks posteriorly under right SUBCLAVIAN artery superiorly to innervate laryngeal muscles

18
Q

5 Components of the Posterior mediastinum

A
  1. Thoracic Aorta
  2. Thoracic Duct
  3. Azygos system of veins
  4. Esophagus
  5. Nerves
19
Q

What are the Vertebral levels of the posterior mediastinum?

A

Posterior (means inferior mediastinum) Under TTP-

T5 - T12

20
Q

What are the branches of the Thoracic Aorta?

A
  1. Bronchial aa
  2. Esophageal aa (ribs 2-5)
  3. Posterior Intercostal aa (ribs 3-11)- anast w/ Ant Intcstls
  4. Subcostal aa. 1 pair inferior to rib 12
21
Q

Esophageal aa are found at what rib levels of the thoracic aorta?

A

ribs 2-5 (unpaired)

22
Q

Posterior intercostal arteries (9 pairs) course inferior to ribs ? What do they anastomose with?

A

3-11

anastomose with Anterior intercostal aa

23
Q

Subcostal aa (1 pair) run inferior to rib ?

A

12

24
Q

Esophagus runs ____ of the thoracic aorta

A

Right

25
Q

What are the three points of compression of the esophagus?

A
  1. Cervical constriction
  2. Thoracic constriction (Aorta/Trachea)
  3. Diaphragmatic constriction
26
Q

What drains into the azygous veins?

What is a unique feature about these veins?

A

Thoraco-abdominal walls
Mediastinal structures
- NO VALVES
-Communicates with vertebral venous plexuses

27
Q

Azygous veins can communicate with the vertebral venous plexus. This is one pathway for cancer to spread from where to where??

A

From thoracic wall & Viscera to the CNS

28
Q

Azygous vein Transverses along the ____ side of the thoracic vertebrae and provides collateral pathway between the ____ and _____ and joints the SVC at the ______.

A

RIGHT side of vertebrae

SVC & IVC and joins SVC at TTP.

29
Q

Hemiazygous vein courses on ___ side of thoracic vertebrae and usually at ____ turns medially to drain into the _____vein.

A

Left at T9, drains into Azygous vein

30
Q

Acessory hemiazygous vein courses ____ of thoracic ver. usually at ____ vert level turns medially and drains into the ____. vein . sometimes it connects to ______.

A

Left of TV, usually at T8 turns medial drains into Azygous

Sometimes connects to hemiazygous v.

31
Q

Thoracic duct courses superiorly on the ____ side of the thoracic vertebrae and switches to the ___ side at ___ to ___ vert levels

A

Right side, switches to left side at t4-t6 vertebral levels

32
Q

The thoracic duct returns lymph to venous circulation where?

A

at Left venous angle

33
Q

Posterior Mediastinal Lymph nodes filter lymph from 4 places?

A
  1. esophagus
  2. posterior pericardium
  3. diaphragm
  4. posterior intercostal space
34
Q

Esophagus, posterior pericardium, diaphragm, and posterior intercostal space drain their lymph into?

A

Posterior mediastinal lymph nodes

35
Q

Sympathetic trunks

A

Bilateral chain of paravertebral ganglia

36
Q

Sympathetic trunks supply sympathetic innervation to viscera of body wall & cavities (sweat glands, arector pili).
the thoracic portion gives rise to ____. nerves

A

abdominopelvic splanchnic nn.

White/Gray RC- >ParaVert ganglion- >abdominopelvic splanchnic nn

37
Q

Abdominopelvic splanchnic nerves- where do they arise? what do they innervate?

A

Three bilateral pairs of abdominopelvic splanchnic nerves originate in the thorax and supply sympathetic innervation to viscera inferior of the diaphragm.

38
Q

Vert level for Greater splanchnic Nerves

A

T5-T9

39
Q

Vert level for Lesser splanchnic Nerves

A

T10-T11

40
Q

Vert level for Least splanchnic nerves

A

T12

41
Q

4 contents of anterior mediastinum

A
  1. Adipose/thymus
  2. Internal thoracic aa/vv
  3. Anterior intercostal aa/vv
  4. Parasternal nodes

Anatomy (24 decks)

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