Mediastinum

Question 1

Boundaries

Answer 1

Pulmonary cavity, sternum and vertebral column

Question 2

Mediastinal changes

Answer 2

Widen with tumors, effusions
Narrow with lung masses, pleural effusionsI

Question 3

Inferior mediastinum

Answer 3

Anterior - contains fat, vessels, remnants of thymus
Middle - contains heart, great vessels, arch of azygos, phrenic n, main bronchi
Posterior

Question 4

Heart coverings

Answer 4

Fibrous pericardium, serous pericardium

Question 5

Serous pericardium

Answer 5

Parietal, visceral
Separated by sinuses

Question 6

Visceral pericardium

Answer 6

Endo - mto - endo

Question 7

Transverse sinus

Answer 7

Between aorta/pulm trunk and SVC/IVC

Question 8

Oblique sinus

Answer 8

Behind left atrium, allows It expand

Question 9

Beck’s triad

Answer 9

Cardiac tamponade - due to blood accumulation in pericardium
Hypotension, jugular v. distension, muffled heart sounds

Question 10

Pericarditis

Answer 10

Inflammation of pericardium
Friction rub
Nerve that radiates pain is phrenic

Question 11

Pericardial effusion

Answer 11

Fluid in pericardium

Question 12

Hemopericardium

Answer 12

Blood in pericardium

Question 13

Pericardiocentesis

Answer 13

Remove fluid in pericardial effusion and hemopericardium, in left 5th or 6th ICS, infrasternally or laterally

Question 14

Arterial supply of pericardium

Answer 14

Pericardiacophrenic artery
Cononary arteries (on visceral pericardium)

Question 15

Venous supply of pericardium

Answer 15

Pericardiacophrenic veins
Azygous veins

Question 16

Innervation of pericardium

Answer 16

Sensory - phrenic n.
Sympathetic - cardiopulmonary splanchnic n. (T1-T4)
Parasympathetic - vagus nerve

Question 17

Superior mediastinum

Answer 17

Above sternal angle
Contains brachiocephalic veins, SVC, azygos, arch of aorta, brachiocephalic trunk, cc and subclavian, thymus, thoracic duct, trachea, esophagus, vagus and phrenic n

Question 18

Thymus

Answer 18

Lymphoid organ
2 lobes
Involutes after puberty
Thymoma = tumor

Question 19

Left brachiocephalic vein

Answer 19

Longer and runs diagonally over aortic arch
Unites with right at 1st costal cartilage - svc

Question 20

Azygos arch

Answer 20

Loops superiorly around root of right lung, empties into SVC

Question 21

SVCS

Answer 21

Obstruction of SVC, swelling in face, neck, upper body, arms, SOB

Question 22

Arch of aorta

Answer 22

Begins and ends over sternal angle
ABCS
Arch, brachiocephalic trunk, cc, subclavian

Question 23

Coarctation of aorta

Answer 23

Narrowing stenosis, often near ligaments arteriosum

Brachial artery pressure increased, femoral pressure decreased, femoral pulses delayed

Question 24

Aortic arch aneurysm

Answer 24

Left recurrent laryngeal nerve stretches, hoarseness

Question 25

Phrenic nerve

Answer 25

Anterior to root of lung

Question 26

Vagus nerve

Answer 26

Posterior to root of lung, gives off recurrent laryngeal

Question 27

Left recurrent laryngeal

Answer 27

Loops under arch of aorta/ligamentum arteriosum Between esophagus and trachea

Question 28

Right recurrent laryngeal

Answer 28

Hook under subclavian artery

Question 29

Ligamentum arteriosum

Answer 29

Connects aorta to left pulmonary artery

Question 30

Trachea

Answer 30

Begins at C6, cricoid cartilage Bifurcates at sternal angle Lies more right

Question 31

Esophagus

Answer 31

Fibromascular tube Posterior to trachea Lies more to the left Narrows at aortic arch and esophageal hiatus

Question 32

Descending thoracic aorta

Answer 32

T4 down Gives off esophageal, pericardial, bronchial, posterior intercostal and subcostal a

Question 33

Chylothorax

Answer 33

Accumulation of lymph from lymph escaping vulnerable thoracic duct Differentiate from effusion by testing triglycerides

Question 34

Virchow's node

Answer 34

Enlarged lymph node in supraclavicular fossa Associated with testicular, GI, gastric cancer metastasis

Question 35

Accessory hemiazygous

Answer 35

T5-T8 Left, crosses to right side

Question 36

Hemiazygous

Answer 36

T9-T11 Left, crosses to right side

Question 37

Azygous drainage

Answer 37

T1 drains into brachiocephalic vein T2-T4 drain into left superior intercostalS vein

Question 38

SVC obstruction

Answer 38

Collateral circulation helps

Question 39

Thoracic duct

Answer 39

Between azygos and esophagus

Question 40

Sternal angle

Answer 40

T4/T5 Arch of aorta Arch of azygos vein Superior lobe of the right lung Superior vena cava