Mediastinum

Question 1

Superior mediastinum borders

Answer 1

extends from an oblique plane thru the jugular notch and T1 vertebra to a horizontal plane thru sternal angle and T4/5 IV disc inferiorly

Question 2

Inferior mediastinum border

Answer 2

From sternal angle and t4/5 IV disc to the diaphragm. It is subdivided into the anterior middle and posterior regions

Question 3

Superior mediastinum contents

Answer 3

Thymus, GREAT vessels, vagus and phrenic nerves, Trachea, Esophagus, Thoracic Duct.

Question 4

Thymus location?

Answer 4

Root of neck superior and anterior mediastinum. Its the most anterior part of the superior mediastinum

Question 5

Great arteries

Answer 5

Arch of aorta, from right to left they are the:
Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

Question 6

Great Veins

Answer 6

R and L Brachiocephalic vein (come off of SVC) and SVC

Question 7

Where is the aorta

Answer 7

it begins at the level of the sternal angle, posterior to 2nd right sternocostal joint. (not covered by pericardium)

Question 8

Where does the aortic arch ascend to before being directed posteriorly?

Answer 8

anterior to the right pulmonary artery and trachea

Question 9

What is the aortic arch continuous with? It passes posterior to root of left lung

Answer 9

With the descending thoracic aorta

Question 10

What does the Brachiocephalic trunk branch into?

Answer 10

right common carotid artery and right subclavian artery

Question 11

What does the left common carotid artery branch into?

Answer 11

it doesn’t

Question 12

Does the left subclavian branch?

Answer 12

no

Question 13

What forms the Left and Right brachiocephalic veins?

Answer 13

The union of the internal jugular and subclavian veins

Question 14

Where does the union of the internal jugular vein and subclavian vein happen?

Answer 14

posterior to the Sternoclavicular joints

Question 15

Brachiocephalic veins unite to form the ____ at the level of the 1st costal cartilage (right)

Answer 15

Superior Vena cava

Question 16

The SVC terminates at the level of the 3rd costal cartilage, but where does it pass into the middle mediastinum?

Answer 16

At the sternal angle

Question 17

where does the SVC take blood from?

Answer 17

From structures superior to the diaphragm, except not the heart and lungs

Question 18

Does the left vagus in the superior mediastinum pass posterior or anterior to the L Brachiocephalic vein?

Answer 18

Posterior

Question 19

Does the left vagus pass anterior or posterior to the aortic arch?

Answer 19

anterior

Question 20

Does the left vagus pass anterior or posterior to the root of the lung?

Answer 20

posterior

Question 21

The left vagus contributes to

Answer 21

pulmonary plexus, esophageal plexus, and anterior vagal trunk

Question 22

Where does the left recurrent laryngeal nerve go?

Answer 22

it passes around aortic arch, then ascends between the trachea and esophagus to reach the larynx

Question 23

Does the RIGHT vagus pass anterior or posterior to the brachiocephalic vein?

Answer 23

posterior

Question 24

Does the RIGHT vagus descend posterior or anterior to the SVC as it runs along the right margin of the trachea?

Answer 24

posterior

Question 25

Does the RIGHT vagus pass posterior or anterior to the root of the lung while it is in the posterior mediastinum?

Answer 25

posterior

Question 26

In the posterior mediastinum what does the RIGHT vagus contribute to?

Answer 26

pulmonary plexus, esophageal plexus, posterior vagal trunk

Question 27

Where is the right recurrent laryngeal nerve?

Answer 27

its a branch in the neck

Question 28

Where do sensory branches of the phrenic nerve go?

Answer 28

pericardium, mediastinal pleura and diaphragm

Question 29

Do R and L p hrenic nerves pass anterior or posterior to the subclavian artery

Answer 29

anterior

Question 30

do the R and L phrenic nerves pass anterior or posterior to the subclavian vein before entering the superior mediastinum?

Answer 30

posterior

Question 31

Pericardiacophrenic vessels travel with the phrenic nerves, they are 3 structures, do they pass anterior or posterior to the root of the lung before descending thru the middle mediastinum between the fibrous pericardium and mediastinal pleura?

Answer 31

anterior

Question 32

Where do trachea and esophagus originate?

Answer 32

at C6

Question 33

where do trachea and esophagus go after passing thru the neck?

Answer 33

to the superior mediastinum

Question 34

The trachea courses anterior to the esophagus and ends at the sternal angle, does it extend to the inferior mediastinum?

Answer 34

no

Question 35

Where does the esophagus start and end

Answer 35

It starts at C6, goes to superior mediastinum, to the inferior mediastinum to reach the diaphragm, it ends at T11

Question 36

What does the thoracic duct do?

Answer 36

conveys most lymph of body to the venous system(but not upper right quadrant)

Question 37

The thoracic duct extends from the cisterna chyli (T12) to the

Answer 37

root of the neck

Question 38

The thoracic duct ascends through the posterior mediastinum posterior to the esophagus, between the ____ and the ___

Answer 38

descending thoracic aorta and the azygous vein

Question 39

Along its course the thoracic duct takes an oblique course to the left, enters the superior mediastinum, where it passes to the junction of the _____ and _____ where it terminates

Answer 39

left subclavian vein, and left IJV

Question 40

Is the anterior mediastinum the largest or smallest subdivision?

Answer 40

smallest

Question 41

What are the anterior and posterior boundaries of the anterior mediastinum?

Answer 41

The body of the sternum and the pericardium

Question 42

What are the contents of the superior mediastinum?

Answer 42

thymus (which also extends into anterior) loose connective tissue and fat, lymphatic vessels and lymph nodes, mediastinal branches of the internal thoracic vessels

Question 43

what are the contents of the posterior mediastinum?

Answer 43

Thoracic duct, esophagus and esophageal plexus, thoracic aorta, azygous and hemiazygous vein, sympathetic chain, greater, lesser and least splanchnic nerves

Question 44

Where does the thoracic aorta begin and terminate?

Answer 44

begins at T4/T5 IV disc, and terminates at T12 vertebral level (where it enters abomen thru aortic hiatus)

Question 45

What are the significant branches of the Thoracic aorta?

Answer 45

Posterior intercostal arteries, esophageal arteries, bronchial arteries, mediastinal branches, pericardial branches, superior phrenic arteries

Question 46

Is the thoracic aorta to the left or right of the esophagus as it courses down?

Answer 46

to the left

Question 47

Where do the azygous veins receive blood from?

Answer 47

From Body wall and mediastinal viscera

Question 48

where does the azygous vein generally start?

Answer 48

At L1 level

Question 49

As the azygous vein ascends through posterior mediastinum, is it positioned to the right or left of the thoracic duct?

Answer 49

to the right

Question 50

What does the Azygous vein arch over to get to the SVC?

Answer 50

over the root of the right lung?

Question 51

What the fukc is up with the hemiazygous vein and accessory hemiazygous vein?

Answer 51

they are on the left, and usually empty into the azygous vein but they are variable

Question 52

The R and L sympathetic chain pass along the length of the ______ mediastinum

Answer 52

posterior

Question 53

What are the three thoracic splanchnic nerves?

Answer 53

Greater, lesser and Least

Question 54

Greater splanchnic nerve spinal levels?

Answer 54

T5-T9

Question 55

Lesser Splanchnic nerve spinal level?

Answer 55

T10-T11

Question 56

Least splanchnic nerve spinal levels?

Answer 56

T 12