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Posterior mediastinum Flashcards

1
Q

what is the lateral border of the posterior mediastinum?

A

Mediastinal pleura (part of the parietal pleural membrane)

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2
Q

what is the anterior border of the posterior mediastinum?

A

pericardium

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3
Q

what is the posterior border of the posterior mediastinum?

A

T5-T12 vertebrae

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4
Q

what is the roof of the posterior mediastinum?

A

Imaginary line extending between the sternal angle (the angle formed by the junction of the sternal body and manubrium) and the T4 vertebrae

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5
Q

what is the floor of the posterior mediastinum?

A

Diaphragm

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6
Q

what does the posterior mediastinum contain?

A 
a number of major organs, blood vessels and nerves:
Thoracic Aorta
Oesophagus
Thoracic Duct
Azygos System of Veins
Sympathetic Trunks
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7
Q

what is the thoracic (descending) aorta a continuation of?

A

the arch of the aorta

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8
Q

where does the thoracic (descending) aorta begin?

A

at the lower edge of the T4 vertebra

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9
Q

where does the thoracic (descending) aorta descend through? (course of travel)

A

the posterior mediastinum to the left of the vertebrae, becoming more medially located as it moves

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10
Q

where does the thoracic aorta end? where does it pass through?

A

At the inferior border of T12, the thoracic aorta becomes the abdominal aorta, and passes through the aortic hiatus of the diaphragm

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11
Q

what arises from the thoracic aorta in the posterior mediastinum?

A

A number of branches arise from the thoracic aorta in the posterior mediastinum. . The major branches are

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12
Q

how do the branches of the thoracic aorta tend to arise in the posterior mediastinum?

A

These tend to arise in three vascular planes

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13
Q

where do the unpaired branches of the thoracic aorta extend?

A

unpaired branches to viscera extend anteriorly

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14
Q

where do the paired branches of the thoracic aorta extend?

A

paired branches to viscera extend laterally

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15
Q

where do the paired segmental parietal branches of the thoracic aorta extend?

A

paired segmental parietal branches extend mostly posterolaterally

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16
Q

what are the major branches of the thoracic aorta?

A

Posterior intercostal arteries
Bronchial arteries
Oesophageal arteries
Superior phrenic arteries

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17
Q

what type of branches are the posterior intercostal arteries of the thoracic aorta?

A

Paired parietal branches

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18
Q

how many paired parietal branches of posterior intercostal arteries arise from the thoracic aorta?

A

Nine such pairs branch from the posterior aspect of the aorta

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19
Q

what do the 9 pairs of parietal branches of posterior intercostal arteries supply? except what?

A

supplying the intercostal spaces (except the first two)

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20
Q

where do the 9 pairs of parietal branches of posterior intercostal arteries pass?

A

Pass laterally and laterally, in parallel with the ribs

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21
Q

what type of branches of the thoracic aorta are bronchial arteries?

A

Paired visceral branches, usually one or two

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22
Q

where does the left bronchial artery always arise from?

A

always arise directly from the thoracic aorta

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23
Q

where do the right bronchial arteries arise from?

A

usually branch indirectly from a right posterior intercostal artery

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24
Q

what do the left and right bronchial arteries normally go onto supply?

A

They go on to supply the tracheobronchial tree

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25
Q

what type of branches are the oesophageal arteries?

A

Unpaired visceral branches

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26
Q

where do the oesophageal arteries arise?

A

from the anterior aspect of the aorta

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27
Q

how many oesophageal arteries are there in most individuals?

A

In most individuals there are two, but there can up to five

28
Q

what do the oesophageal arteries go onto supply?

A

the oesophagus

29
Q

where do the superior phrenic arteries arise from?

A

the anterior aspect of the thoracic aorta at the aortic hiatus, varying in number

30
Q

how many superior phrenic arteries are there?

A

varying in number

31
Q

what do the superior phrenic arteries supply?

A

the superior aspect of the diaphragm

32
Q

what is the oesophagus?

A

The oesophagus is a muscular tube

33
Q

what does the oesophagus connect?

A

the pharynx to the stomach

34
Q

what does the oesophagus allow?

A

allowing swallowed food to pass into the digestive system

35
Q

where does the oesophagus pass into? where from?

A

It passes into the posterior mediastinum from the superior mediastinum, descending posteriorly to the arch of the aorta and the heart

36
Q

where does the oesophagus descend to?

A

descending posteriorly to the arch of the aorta and the heart

37
Q

where is the oesophagus originally positioned? where does it deviate to? when?

A

Whilst initially positioned to the right, the oesophagus deviates to the left as it moves downwards

38
Q

via what does the oesophagus leave the mediastinum?

A

It leaves the mediastinum via the oesophageal hiatus of the diaphra

39
Q

what is the oesophageal plexus?

A

a network of nerves surrounding the oesophagus as it descends

40
Q

what does the oesophageal plexus comprise of?

A

branches from the left and right vagus nerves

41
Q

what happens immediately above the diaphragm to the oesophageal plexus?

A

the fibres of the plexus converge to form the anterior vagal trunk and posterior vagal trunk

42
Q

where do the anterior and posterior vagal trunk travel along?

A

the surface of the oesophagus as it exits the thorax

43
Q

what is the thoracic duct?

A

The thoracic duct is the largest lymphatic vessel in the body

44
Q

what does the thoracic duct allow?

A

allowing return of lymph from most of the body (all but the right superior quadrant) into the venous system

45
Q

where does the thoracic duct originate from?

A

the cisterna chyli in the abdomen

46
Q

where does the thoracic duct enter the mediastinum through?

A

the aortic hiatus

47
Q

where does the thoracic duct ascend to lie?

A

It ascends to lie directly anterior to the T6-T12 vertebrae

48
Q

what happens after the thoracic duct has ascended to lie directly anterior to the T6-T12 vertebrae?

A

before deviating left as it ascends into the superior mediastinum

49
Q

whilst located in the posterior mediastinum, where does the thoracic duct receives its lymphatic drainage from?

A

the intercostal spaces and neighbouring anatomical structures through a number of branches

50
Q

what is the Azygos System of Veins?

A

This venous network drains blood from the body walls and mediastinal viscera

51
Q

where do the Azygos System of Veins empty into?

A

superior vena cava

52
Q

what does the Azygos System of Veins consist of?

A

3 major veins:
Azygos vein
Hemiazygos vein
Accessory hemiazygos vein

53
Q

what is the azygos vein formed by?

A

the union of the right lumbar vein and the right subcostal vein

54
Q

what does the azygos vein enter the mediastinum via?

A

the aortic hiatus

55
Q

where does the azygos vein drain into?

A

superior vena cava

56
Q

what is the hemiazygos vein formed by?

A

Formed by the union of the left lumbar vein and left subcostal vein

57
Q

where does the hemiazygos vein enter the mediastinum through? where does it ascend?

A

through the left crus of the diaphragm, ascending on the left side

58
Q

what does the hemiazygos vein combine with? where?

A

At the level of T8, it turns to the right and combines with the azygos vein

59
Q

what is the accessory hemiazygos vein formed by?

A

the union of the fourth to eighth intercostal veins

60
Q

where does the accessory hemiazygos vein drain into?

A

the azygos vein at T7

61
Q

what are the sympathetic trunks?

A

paired bundles of nerves

62
Q

where do the sympathetic trunks extend from to?

A

extend from the base of the skull to the coccyx

63
Q

what are the sympathetic nerve bundles in the thoracic region known as?

A

In the thoracic region, these nerve bundles are known as the thoracic sympathetic trunks

64
Q

what happens as the sympathetic nerve bundle descend through the thorax?

A

they lie within the posterior mediastinum

65
Q

what arises from the sympathetic trunks?

A

the lower thoracic splanchnic nerves

66
Q

where do the lower thoracic splanchnic nerves continue? what do they supply?

A

they continue inferiorly to supply the viscera of the abdomen

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