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CR > mediastinum > Flashcards

mediastinum Flashcards

1
Q

what are the 3 parts of the thoracic cavity from l to r

A

plueral, mediastinum, pleural

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2
Q

what are the upper and lower boundaries of the mediastinum

A

sternum, diaphragm

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3
Q

why does the pericardial sac elongate

A

attached to diaphragm, stretches on inspiration

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4
Q

what is the transthoracic plane

A

angle of Louis thru T4/5

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5
Q

when supine, what does the transthoracic plane pass through

A

aortic arch, carina

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6
Q

which nerves innervate the diaphragm

A

C3,4,5 phrenic nerve

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7
Q

whst else does the phrenic nerve innervate and what sort of nerves are they

A

diaphragm - motor
pericardium - sensory
mediastinal pleura - sensroy

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8
Q

what is in the superior mediastinum

A

aortic arch
phrenic nerves
vagus nerve
recurrent laryngeal nerves
oesophagus
trachea
thoracic duct

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9
Q

what is in the posterior mediastinum

A

goose x 3
duck
(vagus, azygous, oesophagus, thoracic duct)

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10
Q

where do the thyrocervical arteries branch from

A

subclavian

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11
Q

what is supplied by the thyrocervical arteries (5)

A

Inferior part of the thyroid gland, parathyroid glands, larynx, pharynx, platysma, brachial plexus, deep cervical and shoulder muscles, skin of the neck and shoulders

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12
Q

where does the recurrent laryngeal nerve branch from

A

vagus

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13
Q

where do R and L recurrent laryngeal nerves go

A

L under aortic arch
R under subclavian

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14
Q

why is paralysis of phrenic nerve after surgery usually transient

A

peripheral nerves can regenerates

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15
Q

what are the vertebral levels of the trachea

A

C6-T4

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16
Q

where is the bifurcation of the trachea

A

T4/5

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17
Q

what does the aorta branch over

A

primary branch of L bronchus and L hilum

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18
Q

what are the vertebral levels of the oesophagus

A

C6 (same as trachea)-T10

(count letters of oesophagus)

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19
Q

what are the vertebral levels of the oesophagus

A

C6 (same as trachea)-T10

(count letters of oesophagus)

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20
Q

what is a feature of the oesophagus that aids digestion

A

indentations

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21
Q

where are the indentations in the oesophagus

A

pharyngoesophagal jct
arch of aorta
transverse diaphragm

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22
Q

what do azygous and hemi-azygous veins provide

A

venous drainage to thoracic area

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23
Q

what relative space should the heart occupy on an x-ray

A

1/3 R, 2/3 L, no more than 50% of thoracic space

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24
Q

which arteries supply C1and C2

A

Costocervical arteries, directly from subclavian

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25
Q

where do the posterior intercostal arteries get their blood from?

A

descending aorta

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26
Q

where do coronary arteries get their blood from

A

first dibs from aorta

27
Q

how do coronary arteries get blood

A

after systole, blood falls back into aortic valve cusps and can trickle down into coronary arteries

28
Q

what supplies the anterior intercostal arteries

A

internal thoracic artery

29
Q

where does the internal thoracic artery originate

A

subclavian

30
Q

what goes in the little groove at the bottom of each rib?

A

one vein, one artery, one nerve “neurovascular bundle”

31
Q

where would you take a sample of pleural fluid?

A

T9/10

32
Q

why would you take a sample of pleural fluid there and what should you be aware of

A

lungs don’t go all the way down. Not diaphragm, not liver
go in teh middle/towards the bottom of the space to avoid the neurovascular bundle

33
Q

how would you reinflate a pneumothorax

A

needle in T9/10 space

34
Q

what are the functions of the pericardium

A

fixes heart in place
prevents heart stretching too much
lubrication
protects heart from infection (eg muck brought into lungs)

35
Q

what is a pericardial infusion called and what is it

A

tamponade, fluid/blood between visceral and parietal layers of pericardium

36
Q

what’s the difference between acute and chronic tamponade

A

acute very bad: 150ml=death
chronic: pericardium can stretch and accommodate up to 1l without death

37
Q

what are pulmonary crackles called

A

rales

38
Q

what happens in acute tamponade

A

RV collapse

39
Q

what is the thing between the atria and ventricles called and what is in it

A

atrioventricular sulcus - fat and coronary arteries

40
Q

what is the thing between the ventricles called and what’s in it

A

interventricular sulcus - fat and more coronary arteries. overlies internetricular septum

41
Q

where are auricles

A

inferior part of atria

42
Q

how many pulmonary veins feed into the L atrium

A

4

43
Q

what is the venous return of the coronary arteries

A

coronary sinus

44
Q

what feeds into the r atrium

A

IVC SVC coronary sinus

45
Q

what is the indentation in the atria

A

fossa ovale

46
Q

what does the fossa ovale allow in foeti

A

blood to pass between atria

47
Q

where is the SAN

A

jct between SVC and r atrium

48
Q

what is the dense band of connective tissue between the Purkinje fibres and the intervemtricular septum called

A

moderator band

49
Q

which is the smoothest chamber of the heart

A

LA

50
Q

what is the LAD

A

left coronary artery

51
Q

where do the majority of myocardial infarctions happen

A

LAD

52
Q

what can be a consequence of RCA myocardial infarction

A

SAN damage -> heart block

53
Q

what holds the heart together

A

fibrous skeleton; 2 figures of 8

54
Q

which vlavled are open during diastole

A

AV

55
Q

what happens in systole

A

papillary muscles contracted
chordae tendinae taut
A and P valves open
AV valves shut

56
Q

when is first heart sound

A

start of systole

57
Q

when is second heart sound

A

start of diastole

58
Q

when is second heart sound

A

start of diastole

59
Q

does the heart feel pain

A

no. only referred pain to relevant dermatomes and other sensory nerves

60
Q

does the heart feel pain

A

no. only referred pain to relevant dermatomes and other sensory nerves

61
Q

where do you get pain with posterior wall MI

A

epigastric T7,8,9

62
Q

what is ischaemia

A

decreased blood flow & therefore O2 to heart muscle

63
Q

what causes pain in MI

A

ischaemia and heart muscle damage

CR (12 decks)

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