1. The Mediastinum

Question 1

What are the divisions of the mediastinum?

Answer 1

Superior, inferior (anterior, middle and posterior)

Question 2

What are the contents of the superior mediastinum?

Answer 2

Thymus

Veins (brachiocephalic and SVC)

Phrenic (C3,4,5), vagus and recurrant laryngeal nerves

Arteries (aortic arch and great vessels)

Trachea

Oesophagus

Thoracic duct

Lymphatic trunks

Question 3

What spinal level is the trachea and where is the carina?

What spinal level is the oesophagus?

Answer 3

C6 - T4, T4/5

C6 - T10

Question 4

Where is the superior and inferior mediastinum division?

Answer 4

Transthoracic plane/manubriosternal joint (sternal angle) T4/5

Question 5

What are A, B and C?

Answer 5

A: Phrenic nerve

B: Vagus nerve

C: Recurrant laryngeal nerve

Question 6

What is the phrenic nerve sensory and motor to?

Answer 6

Sensory to pericardium

Motor to diaphragm

Question 7

How do the L and R recurrant laryngeal loop back?

Answer 7

L under aortic arch

R under R. subclavian artery

Question 8

What 3 structures does the vagus innervate in the mediastinum?

Answer 8

Oesophagus

Heart

Bronchi

Question 9

What does the anterior mediastinum contain?

Answer 9

Thymus

Question 10

What does the middle mediastinum contain?

Answer 10

Pericardium, heart

Question 11

What does the posterior mediastinum contain?

Answer 11

Primary bronchi

Oesophagus (and oesophageal plexus)

Descending aorta

Thoracic duct

Axygos and hemi azygos veins

Question 12

What are the pericardium layers?

Answer 12

Fibrous

Parietal

Visceral

Question 13

What does the fibrous pericardium do?

Answer 13

Protective, anchors heart - attached to great vessles and diaphragm, prevents over dilation

Question 14

Which pericardium layer is the epicardium associated with?

Answer 14

Visceral

Question 15

What is pericardial effusion/tamponade?

Answer 15

Fluid buildup between parietal and visceral pericardium

Question 16

What are A,B, and C?

Answer 16

A: fibrous pericardium

B: parietal pericardium

C: visceral pericardium

Question 17

What are the 3 heart wall layers and what are they made of?

Answer 17

Out to in:

Epicardium: visceral pericardium

Myocardium: cardiac muscle, bundles

Endocardium: continuous with endothelium

Question 18

What comprises the serous pericardium?

Answer 18

Parietal and visceral pericardium

Question 19

What is A?

Answer 19

Azygos vein

Question 20

What is the basic structure of the thoracic arterial supply?

Answer 20

Internal thoracic artery -> aterior intercostal arteries (run with corresponding vein and nerve as bundle)

Descending aorta -> posterior intercostal arteries (3-12)

AI and PI anastomose in each intercosta space

EXCEPT 1 and 2, which branch from costocervicl trunk of subclavian.

Question 21

What is the order from inferior to superior of the intercostal neurovascular bundle?

Answer 21

VAN

Question 22

What are A, B and C?

Answer 22

A: posterior intercostal artery

B: lateral cutaneous branch

C: anterior intercostal artery

Question 23

What are the main compoents of the thoracic venous drainage system?

Answer 23

Anterior intercostal veins -> internal thoracic vein

Posterior intercostal veins -> azygos vein (R) and hemi azygos veins (L)

Question 24

What are A and B?

Answer 24

A: azygos vein

B: hemiazygos vein

Question 25

What are 6, 9 and 10?

Answer 25

6. Internal thoracic artery
7. Thyrocervical trunk
8. Costocervical trunk