Superior and Posterior Mediastinum Flashcards Preview

S&F III: Exam 1 > Superior and Posterior Mediastinum > Flashcards

Flashcards in Superior and Posterior Mediastinum Deck (83):
1

Location of Superior Mediastinum

A/P: Manubrium to T1-T4
S/I: Thoracic inlet to level of sternal angle

2

Location of Posterior Mediastinum

A/P: pericardium to T5-T12
S/I: sternal angle to sloping diaphragm

3

Anterior & Superior Mediastinum

thymus gland

4

Middle & Superior Mediastinum

large vessels

5

Posterior & Superior Mediastinum

tubular structures (aorta, trachea, etc.)

6

Superior Mediastinum Structures

LR brachiocephalic vv.; Aortic Arch; Braciocephalic A; LCCA; L Subclavian A; Trachea; L recurrent Laryngeal N;

**Esophagus; Thoracic Duct; Phrenic nn.; Vagus nn.; Thymus; SVC

7

Anterior Inferior Mediastinum Structures

Mediastinal lymph nodes
**Thymus

8

Middle Inferior Mediastinum Structures

Pericardium, Heart, AA, PA, Pvv, IVC, Arch of Azygos V

**Phrenic nn.; SVC

9

Posterior Inferior Mediastinum Structures

Hemiazygos V; Accessory Hemiazygos V.; DA; Thoracic Splanchic Nn.

**Vagus, Thoracic Duct, Esophagus, Azygos

10

Aortic Arch

@ level of sternal angle (Rib 2); superior m.
courses from R2L, A2P

11

Brachiocephalic Artery

lgst branch of aortic arch
ant. and rt. of trachea; medial to SVC and rt BCV
branches at right sternoclavicular joint

12

Right Common Carotid

BCA branch; rt side of head and neck

13

Rt Subclavian Artery

BCA branch; right upper extremity
superior and posterior to corresponding vein

14

Left CCA

aortic arch branch
supplies lt head and neck
left side of trachea

15

left Subclavian Artery

supplies left upper extremity
left side of trachea and esophagus

16

DA (thoracic aorta)

passes thru aortic hiatus in diaphragm at level of T12 (anterior)

17

Posterior Intercostal Arteries

9 Paired parietals of DA
ICS 3-11

18

Superior Intercostal Branch

costocervical trunk branch (subclavian origin)
ICS 1-2

19

Subcostal Arteries

1 paired parietal of DA
below rib 12, above diaphragm

20

Superior Phrenic Arteries

1 paired parietal of DA
upper side of diaphragm

21

Left Bronchial Arteries

2 unpaired branches of DA
to viscera

22

Esophageal Arteries

2 unpaired branches of DA
to viscera

23

Brachiocephalic Veins

formed by union of internal jugular veins and subclavian veins @ post. sternoclavicular joints

24

Rt brachiocephalic Vein

rt sternoclav join to right costal cartilage of rib 1

25

Lt brachiocephalic vein

OBLIQUELY crosses to join RBCV to form SVC
located between thymus and BCT/LCCA

26

SVC

formed by union of BCVs
right costal cartilages of ribs 1-3
receives azygos at sternal angle

27

Azygos vein

empties at SVC at level of Sternal Angle, superior to root of lung!
drains blood from: rt. PIV, hemi/accessory, esophageal v, bronchial v, vertebral venous plexus

28

Posterior intercostal veins

right thoracic wall

29

hemiazygos and accessory hemiazygos

left thoracic wall

30

esophageal veins

...

31

bronchial veins

...

32

vertebral venous plexus

vertebral column and spinal cord

33

bronchogenic tumors

metastasize from lungs to SC thru azygos vein path

34

right ascending lumbar vein

drains right posterolateral ab wall into IVC
and cont. as azygos

35

left ascending lumbar vein

left posterolateral ab wall into IVC
and cont. as hemiazygos

36

hemiazygos vein

drains lower left ICS through left posterior ICS vv. and then joins azygos (~8th ICS)

37

accessory hemiazygos vein

drains middle left ICS (5-7), crosses midline to join azygos vein

38

Rt superior intercostal vein

upper right intercostal spaces into arch of azygos

*not in post. mediastinum*

39

Lt superior intercostal vein

upper left ICS into left BCV
*not in post. mediastinum*

40

SVC syndrome

blocked off by tumor, can't get blood away from upper body.
**distended Jugulars***
bypass blockage thru azygos emptying into IVC

41

Liver tumor

obstructs IVC
bypass thru azygos into SVC

42

right border of Superior Mediastinum

Rt BCV and SVC

43

where does azygos enter post. mediastinum

aortic hiatus of diaphragm (rt side)

44

thoracic duct

drains everything but right side of body lung up
several valves

45

cisterna chyli

immed. inferior to diaphragm, anterior to L1, on right of aorta

46

where does thoracic duct enter

aortic hiatus

47

thoracic duct in post. mediastinum

btwn azygos vein and thoracic aorta; posterior to esophagus

48

thoracic duct in super. mediastinum

posterior to left border of esophagus

49

thoracic duct in root of neck

drains into beginning of left brachiocephalic vein

50

what lymph trunks does thoracic duct receive

left jugular (head), left subclavian (upper limb), left bronchomedistinal (left lung)

51

Rt lymphatic duct

NOT in MEDIASTINUM; rt side of root of neck

drains into rt. brachiocephalic vein

52

what does right lymphatic duct receive?

right subclavian , right bronchomediastinal, right jugular

53

Can rt lymph trunks drain anywhere else?

yes right internal jugular or subclavian veins

54

Phrenic nerve

courses inferiorly in superior and middle mediastinum

55

Right phrenic nerve loc in superior med.

btwn right subclavian artery and vein;

in contact with lateral borders of rt BCV and SVC

56

left phrenic nerve loc in superior med

btwn lt subclavian a and vein
crosses arch of aorta ANTERIOR to left vagus nerve

57

phrenic nerve loc in middle med

btwn mediastinal parietal pleura and fibrous pericardium
ANT to root of lung!!

58

Right phrenic nerve exit

Caval opening of diaphragm with the IVC

59

Lt phrenic nerve exit

PIERCES diaphragm

60

vagus nerve innerv.

all thoracic viscera, most of gut (colic flex of lg intestine)

61

Lt vagus nerve in superior mediastinum

crosses left side of aortic arch and gives off recurrent laryngeal nerve

62

Left laryngeal nerve path

crosses underneath ligamentum arteriosum and aortic arch
ascends btwn esophagus and trachea

63

Rt vagus nerve in sup. mediastinum

anterior to right subclavian artery and descends lateral to trachea

64

rt recurrent laryngeal nerve

NOT in Mediastinum--> hooks around Rt. Subclavian A.

65

other vagus branches in superior mediastinum

cardiac and pulmonary nerves join the respective plexuses

66

vagus nerve in posterior mediastinum

passes posterior to root of lung and forms trunks that pass through diaphragm with esophagus
left anterior; right posterior

67

thymus

immediately posterior to manubrium
supplied by ITA and inferior thyroid arteries

68

Trachea

C6; anterior and right to esophagus;

69

where are principle bronchi located

middle mediastinum

70

food in trachea

goes into right main bronchi bc its shorter, wider, and vertical
goes into lower or middle lobe

71

left main bronchus

crosses anterior to esophagus and aorta (can constrict esophagus!!)

72

Carina

division of trachea into bronchi

cancer can cause distortion

73

esophagus superiorly

btwn trachea and SC

74

esophagus posteriorly

enters through esophageal hiatus at T10, anterior to DA
posterior to pericardium and LA

75

Constrictions of esophagus

were pharynx narrows to form it (C6)
arch of the aorta (disc of T4-T5)
left main bronchus (T5)
esophageal hiatus (diagphragm)

76

hypertrophy of left atrium

compresses and displaces the posterior esophagus

77

blood supply in thorax

esophageal (DA)
esophageal (azygos)

78

All structures at Sternal Angle (rib 2, disc of T4-T5)

arch of the aorta
demarcation of superior and inferior mediastinum
superior extent of fibrous pericardium
trachea division
azygos enters SVC

79

structures through diaphragm

Caval (T8): IVC and rt Phrenic
Esophageal (T10): Esophagus, Vagal nerve trunks
Aortic (T12): DA, thoracic duct, azygos vein (RWB)
Crura: Greater, Lesser, Least Splanchnic nerves

80

Caval Structures

T8: IVC and rt Phrenic

81

Esophageal Hiatus Structures

(T10): Esophagus, Vagal nerve trunks

82

Aortic hiatus structures

(T12): DA, thoracic duct, azygos vein (RWB)

83

Crura structures

Greater, Lesser, Least Splanchnic nerves