12/11 - Superior And Posterior Mediastinum

Front 1

Divisions of the mediastinum

Back 1

Superior
Inferior - Anterior, middle, posterior

Front 2

Clinical conditions affecting relationships within mediastinum

Back 2

Sucking, tension pneumothorax
Lymphoma - lymphadenopathy
CHF
Hemorrhage

Front 3

Contents of sup[erior mediastinum (A-P)

Back 3

Thymus
Great vessels related to heart, pericardium
Brachiocephalic veins
SVC
Arch of aorta, roots of major branches
Vagus and phrenic nerves
Cardiac plexus of nerves
Left recurrent laryngeal nerve
Trachea
Esophagus
Thoracic duct

Front 4

Arterial supply to thymus

Back 4

Branches of internal thoracic arteries

Front 5

Venous supply to thymus

Back 5

Inferior thyroid veins
Internal thoracic veins

Front 6

"Venous angle"

Back 6

Junction of left and right brachiocephalic veins

Front 7

Lymph drainage into left brachiocephalic vein (left venous angle)

Back 7

From thoracic duct (3/4 of body)

Front 8

Lymphatic drainage into right brachiocephalic vein (right venous angle)

Back 8

lymph from right lymphatic duct (drains upper right quadrant of body)

Front 9

Veins that drain into the venous angle.

Back 9

Upper - inferior thyroid vein
Lower - internal thoracic, left superior intercostal veins

Front 10

Source of blood in left brachiocephalic vein

Back 10

Head, neck, left upper limb to (SVC) right atrium

Front 11

Source of blood in right brachiocephalic vein

Back 11

head, neck, right upper limb to (SVC) right atrium

Front 12

SVC receives blood from...

Back 12

All structures superior to diaphragm except lung and heart
Arch of the azygous vein (structures in posterior body wall)

Front 13

Redirection of blood when SVC is occluded

Back 13

Retrograde, through azygos system

Front 14

Origin of right phrenic nerve

Back 14

Anterior rami of C3-C5 nerves

Front 15

Location (course) of right phrenic nerve

Back 15

Superior thoracic aperture
Between superior vena cava and mediastinal pleura

Front 16

Source of motor fibers to right half of diaphragm

Back 16

Right phrenic nerve

"C3, 4, and 5 keep the diaphragm alive"

Front 17

Distinguishing between vagus and phrenic nerves

Back 17

Phrenic passes anterior to root of lung
Vagus passes posterior

Front 18

Location of arch of the aorta

Back 18

Begins at level of sternal angle
Ascends anterior to pulmonary artery, bifurcation of trachea
Arches over root of left lung
Becomes descending aorta posterior to sternal angle (2nd left sternocostal joint)

Front 19

Direction of aortic arch

Back 19

Superposteriorly and to the left

Front 20

Branches of the aortic arch.

Back 20

Brachiocephalic trunk
Left common carotid
Left subclavian

Front 21

Patent ductus arteriosus

Back 21

Small opening in lumen of ductus arteriosus remains after birth.

Front 22

Coarctation of the aorta

Back 22

Arch or the descending aorta has an abnormal narrowing (stenosis)

Front 23

Ligamentum arteriosum

Back 23

Remnant of fetal ductus arteriosus

Front 24

What does the ligamentum arteriosum connect

Back 24

root of left pulmonary artery to inferior surface of arch of aorta

Front 25

Source of the vagus nerve

Back 25

Medulla of the brain

Front 26

Cranial nerve corresponding to vagus nerve

Back 26

X (10)

Front 27

Course of vagus nerve

Back 27

Exits cranium
Descend through neck posterolateral to common carotid arteries
Enters superior mediastinum posterior to sternoclavicular joints and brachiocephalic veins

Front 28

Nerve that gives rise to recurrent laryngeal nerves

Back 28

Vagus nerves

Front 29

Vagus nerve contributes to which neural plexuses?

Back 29

Cardiac Plexus
Esophageal plexus
Pulmonary plexus

Front 30

Contents of anterior mediastinum

Back 30

fat or inferior portion of thymus (in children)

Front 31

Relative location of anterior mediastinum

Back 31

Posterior to the sternum and the transverse thoracic muscles
Anterior to the fibrous pericardium
Limited by the diaphragm inferiorly

Front 32

This tissue defines the middle mediastinum

Back 32

Fibrous pericardium

Front 33

Location of posterior mediastinum

Back 33

Anterior to vertebrae T5-T12
Posterior to pericardium and diaphragm

Front 34

Contents of posterior mediastinum

Back 34

Main bronchi
Vagus nerve
Thoracic aorta
Thoracic duct
Azygos/hemiazygos venous system
(Sympathetic trunk)
(Thoracoabdominal splanchnic nerves)

Front 35

Branches of the thoracic aorta

Back 35

Bronchial arteries
Posterior intercostal arteries
Esophageal arteries

Front 36

3 normal constrictions of esophageal lumen

Back 36

Pharyngoesophageal constriction/junction - superior esophageal sphincter
Thoracic (broncho-aortic) constriction
Diaphragmatic constriction (diaphragm) - inferior esophageal sphincter at T10 level

Front 37

Innervation of the esophagus

Back 37

Upper 1/3rd – recurrent laryngeal
Lower 2/3rds - esophageal plexus (parasympathetic), cardiopulmonary splanchnic (sympathetic)

Front 38

Origin of the thoracic duct

Back 38

Chyle cistern in abdomen

Front 39

Lymph nodes of the trachea

Back 39

Pulmonary nodes
Inferior tracheobronchial nodes
Right or left sueprior tracheobronchial lymph nodes
Paratracheal Trunks

Front 40

The azygos system drains...

Back 40

Back, thoracoabdominal walls and mediastinal viscera

Front 41

The hemiazygos vein arises from...

Back 41

Renal vein and left ascending lumbar vein

Front 42

Vein that drains intercostals level T3-T6

Back 42

Accessory hemiazygos vein

Front 43

3 different thoracic splanchnic nerves

Back 43

Greater, lesser, least

Front 44

Contents of thoracic splanchnic nerves (abdominopelvic splanchnic nerves)

Back 44

Presynaptic sympathetic fibers, visceral afferent fibers

Front 45

Relative locations of vagal trunks

Back 45

Right --> posterior esophageal trunk
Left --> anterior vagal trunk
"LARP" - Left goes Anterior, Right goes Posterior

It twists clockwise

Front 46

Site of synapse for abdominopelvic splanchnic nerves

Back 46

Prevertebral ganglia

Front 47

Sympathetic fibers carried in cardiopulmonary splanchnic nerves

Back 47

Postsynaptic sympathetic fibers

Front 48

Site of synapse for sympathetic fibers carried by cardiopulmonary splanchnic nerves

Back 48

Paravertebral ganglia