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Anatomy BMSC > Week 3- superior and posterior mediastinum > Flashcards

Week 3- superior and posterior mediastinum Flashcards

1
Q

The mediastinum can be divided up into?

A

Superior and inferior.

Inferior is then further subdivided into anterior, middle and posterior.

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2
Q

What line divides the superior and inferior mediastinum?

A

Transverse thoracic plane- between T4 and T5.

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3
Q

What are the boundaries of the superior mediastinum?

A

Bodies of T1-T4 vertebrae posteriorly
Anteriorly- manubrium of the sternum
Inferiorly- transverse thoracic plane
Superiorly- thoracic inlet and parietal pleura

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4
Q

What is contained within the superior mediastinum?

A 
Order from anterior to posterior
Thymus
Brachiocephalic veins and SVC
Arch of the aorta
Trachea
Oesophagus
Phrenic and vagus nerves
Lymphatics
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5
Q

Which two veins draining the head and neck anastomose to form the superior vena cava?

A

Right and left brachiocephalic veins (also the inferior thyroid vein- but its tiny).

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6
Q

What are the branches of the arch of the aorta?

A

Right brachiocephalic trunk- splits into right subclavian and right common carotid.
Left common carotid
Left subclavian

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7
Q

Describe the course of the right vagus nerve?

A

Runs anterior to the right subclavian artery.

Right recurrent laryngeal loops under right subclavian artery.

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8
Q

Describe the course of the left vagus nerve?

A

Runs between left common carotid and left subclavian artery

Loops around the arch of aorta to form recurrent laryngeal nerve.

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9
Q

Where would you find the cardiac plexus? Which nerve forms this?

A

Underneath the arch of the aorta

The vagus nerve forms this

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10
Q

Which other plexi does the vagus nerve form?

A

It forms plexuses on the right and left bronchus forming the pulmonary plexus’s.
Also forms the oesophageal plexus.

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11
Q

How does the vagus nerve enter the abdominal cavity?

A

It continues into the abdomen as the anterior and posterior vagal trunks (one sits anterior to the oesophagus, one sits posterior).

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12
Q

Which vagal trunk is mainly formed by the left vagus nerve?

A

Anterior vagal trunk is mainly formed by the left vagus nerve.

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13
Q

Which vagal trunk is mainly formed by the right vagus nerve?

A

The posterior vagal trunk is mainly formed by the right vagus nerve.

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14
Q

Which spinal nerve roots form the phrenic nerve?

A

Anterior rami of C3, 4 and 5.

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15
Q

Which nerve supplies the diaphragm

A

Phrenic nerve

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16
Q

Describe the course of the right phrenic nerve?

A

Runs alongside the right brachiocephalic vein, superior vena cava and then onto the pericardium. It runs anterior to the root of the right lung and pierces the diaphragm near the caval opening.

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17
Q

Describe the course of the left phrenic nerve?

A

Lies between the left subclavian artery and vein. It runs to the left of the arch of the aorta anterior to the vagus nerve.
It runs anterior to the root of the left lung and runs along the pericardium over the left atrium and ventricle.
Pierces the diaphragm to the left of the pericardium.

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18
Q

Where does the trachea begin?

A

At C5/6 (below the larynx).

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19
Q

What level is the carina at? What is the significance of the carina?

A

Carina at T4/T5. Where the trachea divides into the left and right main bronchi.

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20
Q

Which muscle is found posteriorly to the trachea to allow expansion of the oesophagus?

A

Trachealis muscle.

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21
Q

At what level does the oesophagus begin?

A

C6

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22
Q

Describe the position of the oesophagus with regards to the aorta?

A

Initially it lies to the right of the aorta, prior to piercing the diaphragm at T10.

23
Q

In which areas will the oesophagus be constricted?

A

Constrictions in three areas-
Arch of the aorta
Left bronchus
Diaphragm.

24
Q

What are the boundaries of the posterior mediastinum?

A

Pericardium anteriorly
Bodies of T5- T12 posteriorly
Trans-thoracic plane superiorly
Diaphragm inferiorly with the parietal pleura.

25
Q

What vessels will be found in the posterior mediastinum?

A

The thoracic aorta

The azygous, hemiazygous and accessory azygous system.

26
Q

At what level does the thoracic aorta start?

A

At T4/5

27
Q

When does the thoracic aorta become the abdominal aorta?

A

After passing through the aortic hiatus of the diaphragm at T12.

28
Q

What does the thoracic aorta give branches to?

A 
Oesophagus
Pericardium
Bronchi
Thoracic Wall
Diaphragm
29
Q

Which vein does the azygous venous system drain into?

A

Drains into the SVC.

30
Q

What forms the azygous vein?

A

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

31
Q

Where does the azygous vein enter the abdomen (which hole in the diaphragm)?

A

Enters at the aortic hiatus.

32
Q

What forms the hemiazygous vein?

A

The left lumbar and left subcostal vein.

33
Q

Where does the hemiazygous vein enter the abdomen (which hole in the diaphragm?)

A

Enters through the left crus of the diaphragm.

34
Q

At what level does the hemiazygous vein join the azygous vein?

A

At T8.

35
Q

What forms the accessory hemiazygous vein?

A

Formed by the union of the fourth to the eighth intercostal veins.

36
Q

Which veins drain into the azygous vein?

A

Posterior intercostal veins 2-11 and subcostal vein.

37
Q

Where does the first right posterior intercostal vein drain to?

A

The right brachiocephalic vein.

38
Q

What drains to the hemiazygous vein?

A

Left posterior intercostal veins from ribs 9-11 and the subcostal vein.

39
Q

What drains to the accessory hemiazygous vein?

A

Left posterior intercostal veins of ribs 5-8.

40
Q

Where do the left posterior intercostal veins from ribs 1-4 drain to?

A

The left brachiocephalic vein.

41
Q

Where does the thoracic duct drain to?

A

The left venous angle (junction between the left subclavian vein and the left internal jugular vein.

42
Q

Which nerves supply the sympathetic supply to the abdominal viscera?

A

Greater splanchnic
Lesser Splanchnic
And least splanchnic nerves.

43
Q

Which ganglia form the greater splanchnic nerve?

A

T5-T9 ganglia

44
Q

Which ganglia form the lesser splanchnic nerve?

A

T10-T11 ganglia

45
Q

Which ganglia form the least splanchnic nerve?

A

T12 ganglia.

46
Q

What modality do the splanchnic nerves carry?

A

They carry presynaptic sympathetic fibres.

47
Q

Which ganglia does the greater splanchnic nerve communicate with?

A

Coeliac and the superior mesenteric ganglia.

48
Q

Which ganglia does the lesser splanchnic nerve communicate with?

A

The superior mesenteric and aorticorenal ganglia.

49
Q

Which ganglia does the least splanchnic nerve communicate with?

A

Aorticorenal ganglia

50
Q

At what level does the oesophagus enter the diaphragm?

What goes with it? What is the opening called?

A

T10.
The vagus nerve trunks.
Oesophageal hiatus.

51
Q

At what level does the thoracic aorta enter the diaphragm? What is the foramen called?What goes with it?

A

Crosses at T12 (aortic hiatus is 12 letters)
Foramen is called the aortic hiatus
Crosses with the azygous vein and thoracic duct.

52
Q

At what level does the inferior vena cava enter the diaphragm? What is the opening called?

A

T8 (vena cava= 8 letters therefore T8).

Called the caval opening.

53
Q

Where do the greater and lesser splanchnic nerves cross the diaphragm?

A

Openings in the crura.

54
Q

Where do the least splanchnic nerve and sympathetic trunks cross the diaphragm at?

A

Posterior to the medial arcuate ligament.

Anatomy BMSC (20 decks)

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