Chapter 9 - Tubes of Thorax Flashcards Preview

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Flashcards in Chapter 9 - Tubes of Thorax Deck (20)
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1

Course of trachea

- Begins at lower end of cricoid cartilage opp C6
- In erect posture, bifurcates opp T6
- Lies in superior mediastinum
- Covered by isthmus of thyroid gland

2

Relations of trachea

ANTERIOR:
1. Manubrium
2. Sternothyroid muscles
3. Left brachiocephalic V
4. Inferior thyroid V
5. Aortic arch
6. Brachiocephalic and left common carotid A
7. Deep cardiac plexus
POSTERIOR:
1. Oesophagus
2. Vertebral column
RIGHT:
1. Right lung
2. Right vagus
3. Azygos V
LEFT:
1. Arch of aorta
2. Left recurrent laryngeal N

3

Structure of trachea

- Fibroelastic wall
- Supported by C shaped cartilaginous rings
- Convex anterolaterally
- Posterior gap closed by fibroelastic membrane
- Contains transverse smooth muscle trachealis
- Lumen has ciliated columnar epithelium with mucus and serous glands

4

Arterial supply of trachea

Inferior thyroid A

5

Venous drainage of trachea

Left brachiocephalic V

6

Lymphatic drainage of trachea

Pretracheal and paratracheal lymph nodes

7

Nerve supply of trachea

Parasymp: vagi, recurrent laryngeal
Symp: middle cervical ganglion

8

Features of oesophagus

- Flattened anteroposteriorly
- Lumen kept collapsed without food
- Pharyngo-oesophageal junction is narrowest part of alimentary canal
- Begins below cricoid cartilage
- Descends in posterior mediastinum
- Pierces diaphragm at level of T10
- Opens into stomach at level of T11

9

Constrictions of oesophagus

1. 6 inch from incisor - cricopharyngeus
2. 9 inch - aortic arch
3. 11 inch - left bronchus
4. 15 inch - diaphragm

10

Relations of oesophagus

ANTERIOR:
1. Trachea
2. Right pulmonary A
3. Left bronchus
4. Pericardium
5. Diaphragm

POSTERIOR:
1. Vertebral column
2. Right posterior intercostal A
3. Thoracic duct
4. Azygos V
5. Thoracic aorta
6. Diaphragm

RIGHT:
1. Right lung
2. Right vagus
3. Azygos V

LEFT:
1. Aortic arch
2. Left subclavian A
3. Thoracic duct
4. Left lung
5. Left recurrent laryngeal N

11

Arterial supply of oesophagus

Cervical: inferior thyroid A
Thoracic: oesophageal branches of aorta
Abdominal: oesophageal branches of left gastric A

12

Venous drainage of oesophagus

Cervical: brachiocephalic V
Thoracic: azygos
Abdominal: left gastric V, hemiazygos

13

Lymphatic drainage of oesophagus

Cervical: deep cervical LN
Thoracic: posterior mediastinal LN
Abdominal: left gastric LN

14

Nerve supply of oesophagus

Parasymp: upper half - recurrent laryngeal
lower half - oesophageal plexus
Symp: upper half - middle cervical ganglion
lower half - upper 4 thoracic ganglia

15

Course of thoracic duct

- Largest lymphatic vessel
- Beaded appearance
- Begins as continuation of cisterna chyli near T12
- Enters aortic opening of diaphragm
- Ascends through posterior mediastinum till T5
- Crosses to left
- Arches laterally at C7
- Opens into angle of junction b/w left subclavian and left internal jugular V

16

Relations of thoracic duct at aortic opening

A: Diaphragm
P: Vertebral column
R: Azygos V
L: Aorta

17

Relations of thoracic duct in posterior mediastinum

ANTERIOR:
1. Diaphragm
2. Oesophagus

POSTERIOR:
1. Vertebral column
2. Right posterior intercostal A
3. Hemiazygos V

RIGHT: Azygos V
LEFT: Descending thoracic aorta

18

Relations of thoracic duct in superior mediastinum

A: aortic arch, left subclavian A
P: vertebral column
R: oesophagus
L: pleura

19

Relations of thoracic duct in neck

ANTERIOR:
1. Left common carotid A
2. Left vagus
3. Left internal jugular V

POSTERIOR:
1. Vertebral A, V
2. Sympathetic trunk
3. Thyrocervical trunk
4. Left phrenic N
5. Scaleneus anterior
6. Left subclvian A

20

Tributaries of thoracic duct

- In thorax, receives from posterior mediastinal, small intercostal nodes
- Vessels from neck form left jugular trunk
- Vessels from axilla form left subclavian trunk
- Left bronchomediastinal trunk drains from left half of thorax
- All these end in thoracic duct