Diseases of Mediastinum & Pleura Flashcards Preview

CVPR: Pulmonary > Diseases of Mediastinum & Pleura > Flashcards

Flashcards in Diseases of Mediastinum & Pleura Deck (10)
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1

Contents of the anterior-superior mediastinum

  • great vessels and aortic root
  • the thymus gland
  • inferior aspects of the trachea and esophagus

2

Contents of posterior mediastinum


 



  • interfaces with the paravertebral sulci and anterior vertebral column 


  • spinal nerve roots ==> form intercostal nerves 


  • sympathetic chain 


  • thoracic duct  


  • descending aorta
     

 

 

3

Contents of middle mediastinum

  • middle mediastinum = space bounded by the pericardium anteriorly, the vertebral bodies posteriorly, diaphragm inferiorly and pleura laterally
  • contains within its confines the only true mediastinal compartment, the pericardial sac.

4

Tumors of the anterior mediastinum

  • "terrible T's"
  • Thymoma
  • Tetratoma/GCT
  • {terrible} lymphoma
  • thyroid tissue

5

Major clinical syndromes of the anterior/anterior-superior mediastinum

  • thymic masses = majority of masses
    • malignant = thymoma w/myasthenia gravis + locally invasive
    • benign = thymic cyts
  • thyroid
    • substernal thyroid goiter
  • lymph tissue
    • benign = germ-cell tumors/tetratoma
    • malignant germ-cell tumors
    • lymphoma 

6

Major clinical syndromes of the middle mediastinum

  • pericardial sac = pericardial cysts ==> compression
  • proximal airways = bronchogenic cysts
  • esophagus = enteric cysts
  • lymphatics = lymphadenopathy is most common mass of middle mediastinum
    • caused by lymphoma, sarcoid, lung cancer

7

Major clinical syndromes of the posterior mediastinum


  • Spinal nerve roots/Intercostal nerves

    • Neurinomas (benign tumors of the peripheral nerves) = most common masses found in the posterior mediastinum ( > 60%) 



    • Benign = schwannomas/ neurofibromas, 




      ganglioneuromas  







    • Neuroblastomas and ganglioneuroblastomas are malignant and arise from the sympathetic ganglia







      • most commonly present during childhood 
         

 

 

8

Diagnostic procedures used to evaluate abnormalities of pleural space

  • CXR ==> pneumothorax, pleural effusion
  • Ultrasound

9

Transudative vs. Exudative pleural effusions


  • Exudate
    • protein, LDH, cells ++
  • Transudate
    • primarly fluid

 

 

10

Common abnormalities w/in pleural space

  • pneumothorax
    • spontaneous
    • traumatic
    • tension pneumothorax
  • pleural effusions
    • transudative <== CHF, cirrhosis w/ascites
    • exudative <== infection, cancer, PE, autoimmune disease
  • pleural thickening
  • pleural plaques
  • pleural tumors