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Anatomy > Mediastinum > Flashcards

Mediastinum Flashcards

1
Q

mediastinum is divided by an imaginary plane that runs from the

A

sternal angle to the T4 vertebrae

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2
Q

superior mediastinum

A

bounded anteriorly by the manubrium and posteriorly by the vertebral bodies of T1-T4

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3
Q

inferior mediastinum

A

bounded anteriorly by the body of the sternum and posteriorly by the vertebral bodies of the lower and 8 thoracic vertebrae

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4
Q

the inferior mediastinum is further subdivided into the (3)

A

anterior mediastinum
middle mediastinum
posterior mediastinum

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5
Q

anterior mediastinum

A

space between the pericardium and the sternum

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6
Q

middle mediastinum

A

pericardium and heart

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7
Q

posterior mediastinum

A

between the pericardium and the vertebral column

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8
Q

the superior mediastinum contains

A

neural, vascular and respiratory structures passing from the adjacent regions of the neck and abdomen (via the inferior mediastinum)

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9
Q

in children, the superior mediastinum also contains the

A

thymus

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10
Q

the thymus contributes to the

A

development and maintenance of the immune system

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11
Q

the thymus is large in childhood but

A

involutes after puberty and is replaced by fatty tissue

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12
Q

the thymus is located in the

A

lower part of the neck and anterior part of the superior mediastinum

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13
Q

the thymus lies posterior to the — and in children can extend into the

A

manubrium

in children can extend into the anterior mediastinum to lie anterior to the pericardium

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14
Q

the thymus blood supply is from the

A

internal thoracic arteries

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15
Q

the thymus venous drainage is via the

A

internal thoracic and brachiocephalic veins

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16
Q

the great systemic blood vessels of the heart lie within the

A

superior mediastinum

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17
Q

the great systemic blood vessels main branches arise before passing through the

A

superior thoracic aperture

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18
Q

great vessels (3)

A

arch of the aorta
pulmonary trunk
superior vena cava

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19
Q

these tributaries of the superior vena cava are located within the superior mediastinum (4)

A

–Brachiocephalic veins –draining blood from the upper body.
–Left superior intercostal vein –collects blood from the left 2nd and 3rd intercostal vein. It drains into the left brachiocephalic vein.
–Supreme intercostal vein –drains the vein from first intercostal space directly into the brachiocephalic veins.
–Azygos vein –receiving blood from the right posterior intercostal veins.

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20
Q

SVC returns blood from

A

all structures superior to the diaphragm except for the lungs and the heart

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21
Q

the pulmonary trunk exits from the

A

right ventricle

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22
Q

the pulmonary trunk is initially anterior to the

A

aorta

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23
Q

the pulmonary trunk moves

A

medially and posteriorly

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24
Q

the pulmonary trunk bifurcates into the

A

left and right pulmonary arteries

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25
Q

the aorta begins with ascending aorta at the

A

aortic office of the left ventricle

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26
Q

the branches of the left and right

A

coronary arteries

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27
Q

the major branches of the aortic arch arise within the

A

superior mediastinum

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28
Q

the aortic arch branches into (3)

A

brachiocephalic artery
left common carotid artery
left subclavian artery

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29
Q

brachiocephalic artery

A

supplying the right side of the head and neck and the right upper limb

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30
Q

left common carotid artery

A

to the left side of the head and neck

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31
Q

left subclavian artery

A

to the left upper limb

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32
Q

aberrant right subclavian artery

A

most common arch anomaly
not a true ring
usually asymptomatic
sometimes dysphagia lusonia when dilated subclavian artery compresses esophagus posteriorly

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33
Q

innominate artery compression syndrome

A

in children the brachiocephalic (innominate) artery is located more to the left and may compress the trachea anteriorly

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34
Q

right arch mirror image

A

mirror-image variety of the left arch
asymptomatic
associated congenital heart disease in 98%, mostly tetralogy of allot

35
Q

right arch with aberrant left subclavian

A

left subclavian artery is the last branch

obstructing anomaly

36
Q

double aortic arch

A

complete ring enriches esophagus and trachea

four vessel sign

37
Q

double arch with atretic segment

A

left arch is very small and has atretic posterior segment

still a four vessel sign

38
Q

the superior mediastinum, the vagus nerve has - paths

A

two

39
Q

Right vagus nerve

A

runs parallel to the trachea and passes posteriorly to the superior vena cava and the right primary bronchus

40
Q

Left vagus nerve

A

enters the superior mediastinum between the left common carotid and the left subclavian arteries. It descends anteriorly to the aortic arch (9), before travelling posterior to the left bronchus

41
Q

The right recurrent laryngeal hooks around the right subclavian artery and ascends between the

A

trachea & esophagus to supply the larynx

42
Q

The left recurrent laryngeal nerve arises from the

A

left vagus nerve as it passes the aortic arch. It loops under the arch, to the left of ligamentum arteriosum (11), before continuing its journey to the larynx in the tracheal-esophageal groove.

43
Q

the vagus nerve travels through the neck with the

A

internal jugular veins and the common carotid arteries

44
Q

the right and left vagus nerves give off parasympathetic branches that contribute to the

A

cardiac and pulmonary plexuses

45
Q

After the nerves pass behind the main bronchi, they converge on the esophagus and form the

A

esophageal plexus

46
Q

Just superior to the diaphragm, the plexus gives rise to two

A

vagal trunks (the anterior and posterior vagal trunks)

47
Q

The vagi give off the recurrent laryngeal branches that ascend to the larynx to innervate

A

all but one muscle of the larynx

48
Q

The right recurrent laryngeal nerve does not enter the mediastinum–it hooks around the — — — before ascending to the right side of the larynx.

A

right subclavian artery

49
Q

The right recurrent laryngeal nerve is also spatially related to the

A

apex of the right lung

50
Q

The left recurrent laryngeal nerve hooks around the aortic arch and ascends in the groove between the

A

trachea and the esophagus

51
Q

The left recurrent laryngeal nerve is also spatially related to the

A

lymph nodes of the aortic arch

52
Q

The recurrent laryngeal nerves may be injured as a result of (4)

A

trauma, during surgery, as a result of tumor spread, or due to other means

53
Q

Injury to the recurrent laryngeal nerves can result in (4)

A

unproductive cough, a weakened voice (hoarseness) or loss of voice (aphonia) and cause problems in the respiratory tract

54
Q

ligamentum arteriosum

A

A fibrous remnant of the ductus arteriosus extending between the aortic arch and the pulmonary trunk

55
Q

Ductus arteriosus

A

a fetal blood vessel that connects the left pulmonary artery to the descending aorta

56
Q

In utero, the ductus arteriosus serves as a

A

bypass for the lungs

57
Q

the phrenic nerve provides

A

motor to the diaphragm, sensory to the mediastinal and diaphragmatic pleura

58
Q

phrenic nerve pathway

A

From the anterior surface of the anterior scalene muscle, the phrenic nerves (roots C3, C4 and C5) enter the superior mediastinum lateral to the great vessels. They then descend anteriorly into the middle mediastinum, passing anteriorly to the hilum of the lungs.

59
Q

Cardiac nerves originate from the

A

superior, middle and inferior cardiac ganglia

60
Q

cardiac nerves form the

A

form the superficial and deep cardiac plexuses in the superior mediastinum

61
Q

The superior plexus sits between the

A

aortic arch and right pulmonary vein

62
Q

The deep plexus lies on the surface of the trachea at the point of

A

bifurcation

63
Q

Sympathetic trunk runs bilaterally to the vertebral bodies along

A

the entire length of the vertebral column

64
Q

trachea descends anterior to the

A

esophagus

65
Q

posterior surface of the trachea is flat where applied to the

A

esophagus

66
Q

trachea ends at the level of the

A

sternal angle

67
Q

the trachea divides into the

A

left and right primary bronchi

68
Q

thoracic aorta is also known as the

A

descending aorta

69
Q

thoracic aorta begins at the

A

inferior border of T4

70
Q

thoracic aorta descending on the left side of the

A

T5-T12 vertebrae

71
Q

thoracic aorta becomes the abdominal aorta when it passes through the

A

aortic hiatus (thoracic duct and azygous vein)

72
Q

thoracic aorta supplies the

A

ntercostal spaces and thoracic viscera (bronchial aa., esophageal aa., mediastinal aa., superior phrenic aa., and occasionally some“percardioacophrenic aa.”)

73
Q

esophagus is posterior to the

A

arch of aorta, pericardium/left atrium

74
Q

the esophagus passes through the

A

esophageal hiatus

75
Q

esophagus has – and – vagal trunks

A

anterior and posterior

76
Q

what is the largest lymphatic channel in the body?

A

the thoracic duct

77
Q

where does the thoracic duct originate from?

A

cisterna chili in the abdomen and scents through the posterior and superior mediastina to drain into the union of the left internal jugular and subclavian

78
Q

The thoracic duct drains lymph from the whole body except for the (4)

A

right side of the head and neck, the right upper limb, and the right side of the thorax and upper surface of the liver

79
Q

These drain into the right jugular, subclavian, and bronchomediastinal trunks which enter the veins on the right side of the neck as the

A

right lymphatic duct

80
Q

The superficial tissues of the chest wall (e.g., breasts) drain into the (2)

A

axillary and internal thoracic nodes

81
Q

The deeper tissues drain into the (4)

A

internal thoracic, intercostal, and diaphragmatic nodes, and subsequently into the thoracic duct

82
Q

The heart drains via lymphatic vessels that follow the coronary arteries and ultimately drain to the

A

inferior tracheobronchial nodes

83
Q

Deep lymphatics of the lungs follow

A

air passages

Anatomy (29 decks)

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