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Anatomy MD3001 > Body cavities 1 and 2 > Flashcards

Body cavities 1 and 2 Flashcards

1
Q

What do serous membranes do?

A
  • Compartmentalize
  • Allow movement, expansion and contraction of organs
  • With a minuscule layer of fluid, create a lubricated potential space which is friction free
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2
Q

What is the thoracic cavity lined by?

A

(parietal) Pleura

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3
Q

What are the abdominal and pelvic cavities lined by?

A

The peritoneum

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4
Q

Visceral

A

Covers the organ

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5
Q

Parietal

A

Next to the wall

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6
Q

Pleural cavities

A

In-between the parietal and visceral layers

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7
Q

What are the compartments of the thoracic cavity?

A
  • Left cavity
  • Right cavity
  • Mediastinum
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8
Q

Describe the covering of the left and right compartments

A
  • Pleura covers the lungs and reflects onto itself around the root of the lung and covers the diaphragm and thoracic wall
  • The left and right compartments are completely independent because the pleura is attached firmly to the root
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9
Q

What is the parietal pleura attached to?

A
  • Thoracic wall
  • Fascia at the throracic inlet, at the 1st rib and T1 (cervical fascia
  • Fibrous pericardium and other mediastinal structures
  • Diaphragm
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10
Q

Describe the mediastinum

A
  • Space between the 2 pleural sacs, the sternum and costal cartilages, thoracic vertebrae and the diaphragm (superiorly, nothing)
  • Highly mobile region, volume and pressure changes
  • Filled with hollow organs
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11
Q

What is the border between the superior and inferior mediastinum?

A

The sternal angle

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12
Q

Where is the Superior mediastinum?

A

• Behind the manubrium, between the inlet and the plane between the sternal angle and T4/5

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13
Q

Where is the Inferior mediastinum?

A
  • Inferior to the transverse plane through the sternal angle and the diaphragm
  • Further divided into the anterior mediastinum, middle mediastinum and posterior mediastinum
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14
Q

Structures on the right of the mediastinum

A
  • Related to the right atrium and veins
  • Superior vena cava
  • Arch of the azygos
  • Inferior vena cava
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15
Q

Structures on the left of the mediastinum

A
  • Related to the left ventricle and the arteries
  • Left common carotid
  • Left subclavian
  • Arch of the aorta
  • Thoracic aorta
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16
Q

Where is the Middle mediastinum and what does it contain

A
  • Centrally located
  • Contains the heart and the pericardium (origins of great vessels: ascending aorta, pulmonary trunk, vena cava) (terminal parts of the SVC and IVC)
  • Contains phrenic nerves and some of the branches of the vagus
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17
Q

What is the pericardium

A

• Fibro-serous sac that encloses the heart and roots of the great vessels

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18
Q

What is the function of the pericardium?

A
  • Compartmentalise
  • Anchors the heart to the surrounding tissues without compromising cardiac movement
  • Prevents the overfilling (over expansion) of the heart
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19
Q

What are the 2 layers of the pericardium?

A
  • Fibrous pericardium (externally)

* Serous pericardium (internally, inside the fibrous)

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20
Q

Describe the fibrous pericardium

A
  • The apex is fused with the adventitia of the great vessels
  • Anteriorly, it is related and attached by the sterno-pericardial ligament to the body of the sternum and 3rd-6th costal cartilages
  • Posteriorly, it is related to and attached to the pericardiovertebral ligaments to the 5th to 8th thoracic vertebrae
  • Inferiorly, it blends with the central tendon of the diaphragm (pericardiophrenic ligament)
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21
Q

What is the purpose of the attachment of the pericardium to the diaphragm?

A

• Halts the descent of the diaphragm during inspiration because of the suspension of the heart

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22
Q

Describe the serous pericardium

A

• Two layers: parietal and visceral
• Parietal:
- Lines the inner aspect of the fibrous pericardium
- reflects onto itself around the roots of the great vessels and continues as the visceral layer= epicardium

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23
Q

Describe the pericardial cavity

A
  • Between the parietal and visceral layers of serous pericardium
  • Contains pericardial fluid
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24
Q

Describe the pericardial fluid

A
  • 10-15ml
  • produced by the serous pericardium
  • reduces friction during contraction of the heart
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25
Q

What is pericardial tamponade?

A
  • When fluid in the pericardium builds up, resulting in compression of the heart
  • Beck’s triad: distant heart sounds, distended neck veins, decreased pulse pressure
  • Hypotension
  • Tachycardia
  • Tachypnoea
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26
Q

What are the two sinuses in the serous pericardium?

A
  • Transverse pericardial sinus (sinus of Theile)

* Oblique sinus

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27
Q

How do the two sinuses in the serous pericardium form?

A

During embryological development, the heart tube folds and invaginate into the serous pericardium

28
Q

Describe the transverse pericardial sinus

A
  • Sinus of Theile
  • Separates the arterial and venous ends of the heart tube
  • Posterior to the ascending aorta and pulmonary trunk, anterior to the superior vena cava
  • Superior to the left atrium and the pulmonary veins
29
Q

Describe the oblique pericardial sinus

A
  • Haller’s culture de sac
  • Surrounded by the reflection of the serous pericardium around the right and left pulmonary veins and inferior vena cava
30
Q

What is the nerve supply of the pericardium?

A
  • Sensory fibres from the phrenic nerve

* Vasomotor fibres from the vagus nerve (parasympathetic) and the cardiopulmonary splanchnic nerves (sympathetic)

31
Q

Describe the roots of the phrenic nerve

A
  • Branch of the cervical plexus

* Arises from the ventral rami of C3,4 and 5 (majority from C4)

32
Q

Describe the route of the phrenic nerve

A
  • Travels over the scalenus anterior muscle
  • Enters the mediastinum between the arterial and venous planes (subclavian artery and vein)
  • Passes anterior to the root of the lung
  • Lies between the fibrous pericardium and the parietal pleura
  • Right phrenic nerve enters via the canal opening of the diaphragm
33
Q

What does the phrenic nerve supply?

A
  • Sole motor supply to the diaphragm

* Sensory fibres to the mediastinal parietal pleura and peritoneum and pleura related to the diaphragm

34
Q

What is the site of referred pain of the phrenic nerve?

A
  • Supraclavicular nerves C3,4,5
  • Lateral supraclavicular
  • Structures with a sensory supply via the phrenic nerve may refer pain to the back of neck, supraclavicular region, shoulder tip
35
Q

What are the boundaries of the anterior mediastinum?

A
  • Sternal body and xiphisternum
  • Pericardium
  • Lungs with pleura
36
Q

What is the contents of the anterior mediastinum?

A
  • Thymus
  • Internal mammary vessels
  • Lymph nodes
  • Connective tissue
  • Fat cell tissue
  • Lower pole end of thyroid
  • Ectopic parathyroid
37
Q

What is the thymus?

A

• Bi lobed organ of lymphoid tissue

38
Q

Where is the thymus

A

Between the manubrium, sternum and pericardium

• It extends from the lower neck (jugular notch) to 4th costal cartilage (sometimes below the aortic arch

39
Q

Describe the use of the thymus in relation to age

A
  • Active in childhood until puberty

* Increasing fibro fatty infiltration with age

40
Q

What are the 3 planes of the superior mediastinum?

A
  • Venous plane
  • Arterial plane
  • Trachea and oesophagus
41
Q

Venous plane of the superior mediastinum

A
  • Brachiocephalic veins are formed by the internal jugular and subclavian veins
  • Left brachiocephalic vein passes anteriorly to the arch of the aorta; posterior to the manubrium
  • Superior vena cava is formed by the right and left brachiocephalic veins
  • Arch of azygos vein joins the superior vena cava
  • Superior vena cava enters the right atrium
42
Q

Arterial plane of the superior mediastinum

A
  • Ascending aorta with its branches (coronary arteries) are in the middle mediastinum
  • Ascending aorta contines as the aortic arch above the sternal angle - T4/5 plane
  • Aortic arch curves up, backwards and slightly left behind the lower half of the manubrium
  • continues as the thoracic (descending) aorta in the posterior mediastinum
43
Q

What are the branches of the aortic arch?

A

• Brachiocephalic trunk which divides into the right subclavian and right common carotid arteries
• Left common carotid artery
• Left subclavian artery
- posterior and the the left of the trachea

44
Q

Describe the position of the pulmonary trunk

A

• Within the pericardium, to the left of the ascending aorta
• At the level of T4/5 disc, inferior to the aortic arch, it divides into:
- Right pulmonary artery, posterior to the ascending aorta and superior Vena cava
- Left pulmonary artery, inferior to the arch of the aorta and anterior to the thoracic aorta

45
Q

What is posterior to the sternoclavicular joint?

A
  • Formation of the brachiocephalic veins by the internal jugular vein and the subclavian veins
  • Division of the brachiocephalic trunk divides to its branches on the right side
46
Q

What is posterior to the 1st right costal cartilage?

A

Formation fo the superior vena cava by right and left brachiocephalic veins

47
Q

What is posterior to the 2nd right costal cartilage?

A

Arch of the azygos vein joins the superior vena cava

48
Q

What is posterior to the 3rd right costal cartilage?

A

Superior vena cava enters the right atrium

49
Q

What is in the posterior mediastinum?

A
  • Vertebral bodies
  • Proximal costal segments
  • Proximal segments of intercostal nerves
  • Sympathetic chain with its ganglia
50
Q

Position of the thoracic aorta

A
  • Continuation of the aortic arch
  • Between the level of the sternal angle and aortic hiatus (T12)
  • Lies on the left of the thoracic vertebral bodies but moves to the midline in the lower thorax
51
Q

Visceral branches of the thoracic aorta

A
  • Oesophageal arteries to the middle third of the oesophagus
  • Bronchial arteries, usually 2 on the left and 1 on the right
  • Pericardial branches
  • Mediastinal branches
  • Superior phrenic artery
52
Q

Position of the trachea

A
  • Starts at C6 vertebra, ends at the tracheal bifurcation (carina)
  • May rise and descend to the level of T4 and T6 with deep inspiration and expiration, respectively
53
Q

Position of the oesophagus

A
  • Starts in the midline as the continuation of the pharynx at C6, inferior border of the cricoid cartilage
  • Descends between the trachea and the vertebral column
  • Enters the thorax behind the trachea, with he arch arch of aorta to its left in the superior mediastinum
  • In the lower posterior mediastinum it swings forwards and to the left
  • Pierces the diaphragm at T10
54
Q

Upper 1/3 histology of the oesophagus

A

Striated muscle as swallowing is voluntary and rapid

55
Q

Middle 1/3 histology of the oesophagus

A

Mixed striated and smooth muscle

56
Q

Lower 1/3 histology of the oesophagus

A

Smooth muscle

57
Q

Cells of the oesophagus

A

Stratifies squamous epithelium

58
Q

What are the constrictions of the oesophagus?

A
  • Upper oesophageal sphincter
  • Arch of aorta
  • Left main bronchus
  • Diaphragm
59
Q

What are the risks associated with the constrictions of the oesophagus?

A
  • They are more likely to cause blockage
  • Hinders the passage of instruments
  • Slow down the passage of caustic substances which will therefore cause more damage
60
Q

Where do the veins related to the oesophagus drain to?

A

Veins of upper and middle thirds:
• Azygos
• Hemiazygos
• Accessory hemiazygos

Lower third:
• Left gastric portal vein

61
Q

What is the Porto systemic anastomosis?

A
  • Portocaval anastomosis

* Anatomoses of veins of the middle and lower thirds

62
Q

Give an example of a cause of oesophageal varices

A

Cirrhotic liver disease causes portal hypertension, forming the oesophageal varices

63
Q

Where does lymph from around the lung drain to?

A

Superior and inferior tracheobrachial nodes

64
Q

Which lymph nodes are located around the brachiocephalic veins?

A

Anterior mediastinal

65
Q

Which lymph nodes are located behind the Heart and adjacent to the oesophagus?

A

Posterior mediasitnal

66
Q

Where does the thoracic duct start?

A

• Cisterna chyli

67
Q

Describe the position of the thoracic duct

A
  • Lies between the aorta and the azygos vein in the posterior mediastinum (pulsation of the aorta promotes lymph flow)
  • At T4/5 level it crosses behind the oesophagus to ascend on the left side
  • Arches over the apex of the left lung and pleura
  • Opens into the left brachiocephalic vein at the junction of the left internal jugular and left subclavian vein (Pirogoffs angle)

Anatomy MD3001 (13 decks)

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