Final Gross - The Superior and Posterior Mediastinum

Question 1

This is the median space between 2 pleural sacs

Answer 1

mediastinum

Question 2

What are the boarders of the mediastinum

Answer 2

extends from thoracic inlet to diaphragm

sternum to 12th thoracic vertebrae

Question 3

This is located most anterior in the superior mediastinum

Answer 3

thymus gland

Question 4

What blood vessels are found in the superior midiastinum

Answer 4

SVC
right and left brachiocephalic vein
arch of the aorta
brachiocephalic trunk
left common carotid artery
left subclavian artery

Question 5

What nerves are found in the superior mediastinum

Answer 5

right and left vagus
right and left phrenic
left recurrent laryngeal

Question 6

What structures are found in the superior mediastinum

Answer 6

trachea
esophagus
thoracic duct

Question 7

This structure is prominent and active during childhood and prior to puberty, and is functionally inactive and atrophies in adults; may be a fatty mass

Answer 7

thymus

Question 8

This vein converges at right margin of the manubrium becoming the SVC

Answer 8

brachiocephalic

Question 9

The left brachiocephalic crosses the trachea anterior or posterior?

Answer 9

anterior; and it crosses all major vessels too

Question 10

What vertebrae level is the aortic arch

Answer 10

T4-T5

Question 11

What structures does the aorta arch over

Answer 11

left pulmonary artery

left main bronchus

Question 12

What great arteries does the aorta give rise to

Answer 12

brachiocephalic trunk
left common carotid
left subclavian

Question 13

This enters the thorax between subclavian vein and artery descending posterior to the root of the lung

Answer 13

vagus nerve

Question 14

What type of innervation does vagus supply

Answer 14

parasympathetic innervation to thorax (and abdomen)

Question 15

This enters the thorax between the subclavian artery and vein descending anterior to the root of the lung

Answer 15

phrenic nerve

Question 16

What type of innervation does phrenic supply

Answer 16

somatic innervation to the diaphragm

Question 17

At what vertebral level does the trachea bifurcate at

Answer 17

inferior limit of the superior mediastinum

T4/T5

Question 18

What is the bifurcation point of the trachea called and what is found there

Answer 18

carina

numerous lymph nodes

Question 19

Where do foreign bodies usually aspirate into and why

Answer 19

right main bronchus
it is shorter and wider than the left main bronchus
right is more vertically orientated
carina is usually positioned more left of midline

Question 20

This pierces the diaphragm at T10

Answer 20

esophagus

Question 21

That stomach may herniate through what

Answer 21

the esophageal hiatus = hiatal hernia

Question 22

A type I hiatal hernia is also known as what

Answer 22

sliding hiatal hernia

Question 23

A type II hiatal hernia is also known as what

Answer 23

paraesophageal hernia

Question 24

In this hiatal hernia the stomach slides freely into the thorax, is the most common and is asymptomatic

Answer 24

type 1; sliding

Question 25

In this hiatal hernia it invoves the fundus and often fixed in position risking gastric blood supply

Answer 25

type II; paraesophageal

Question 26

What structures are found in the posterior mediastinum

Answer 26

esophagus esophageal plexus thoracic duct

Question 27

What vessels are found in the posterior mediastinum

Answer 27

azygos system of veins | descending aorta

Question 28

What nerves are found in the posterior mediastinum

Answer 28

thoracic splanchnic nerves | greater, lesser, and least

Question 29

What makes up the esophageal plexus

Answer 29

left and right vagus nerves; forming vagal trunks, due to gut rotation during development

Question 30

Which vagus nerve makes up the anterior vagal trunk

Answer 30

left vagus

Question 31

Which vagus nerve makes up the posterior vagal trunk

Answer 31

right vagus

Question 32

This provides venous drainage for the thorax

Answer 32

azygos system of veins

Question 33

This drains the intercostal veins from the right side of the thorax

Answer 33

azygos vein

Question 34

This drains the left thorax

Answer 34

hemiazygous | accessory hemiazygous

Question 35

What does the hemiazygous and accessory hemiazygous drain into

Answer 35

azygous vein | roughy at T8/T9, but variations are common

Question 36

The azygous veins crosses what to drain into SVC

Answer 36

over right superior bronchus

Question 37

This lies just left of the esophagus and gives rise to posterior intercostal arteries supplying thorax

Answer 37

descending aorta

Question 38

The descending aorta gives off branches to supply what

Answer 38

trachea bronchi esophagus

Question 39

This lies posterior to esophagus and anterior to vertebral bodies between the azygoes and descending aorta

Answer 39

thoracic duct

Question 40

Where does the thoracic duct pass through the diaphragm

Answer 40

with descending aorta

Question 41

Where does the thoracic duct drain lymph from

Answer 41

the body beneath the diaphragm and left upper body

Question 42

Where does the thoracic duct drain lymph into

Answer 42

venous angle between left subclavian and left IJV

Question 43

This is the accumulation of lymph in the pleural cavity

Answer 43

chylothorax

Question 44

What is chylothroax a result from

Answer 44

torn or leaking thoracic duct often from lymphoma or trauma during thoracic surgery

Question 45

Where are the thoracic splanchnic nerve derived from

Answer 45

sympathetic chain ganglia located along lateral aspect of vertebral bodies

Question 46

What do the thoracic splanchinc nerves innervate

Answer 46

the abdomen; | greater lesser and least

Question 47

Where do the thoracic autonomic (symp and psymp) nerve originate from

Answer 47

sympathetic; T1-T5 | parasympathetic; CN X

Question 48

What are the thoracic autonomic plexuses

Answer 48

cardiac pulmonary esophageal