3-4 Superior And Posterior Mediastinum

Front 1

superior mediastinum
(location, contents)

Back 1

inferior to thoracic outlet
superior to transverse thoracic plane
Contents:
thymus
veins
arteries
airways
alimentary canal
lymphatic trunks

Front 2

thymus
(location, # of lobes, type of tissue, role, what happens to it, _ in adults)

Back 2

located b/w manubrium and heart
two lobes
lymphoid tissue
plays role in immunity
shrinks after puberty
fatty in adults

Front 3

thymus
(blood supply, drainage, lymphatics)

Back 3

branches of internal thoracic arteries
venous drainage into left brachiocephalic vein
lymphatic vessels to parasternal, brachiocephalic, and tracheobronchial nodes

Front 4

Superior Mediastinum
Great Vessels
(name)

Back 4

SVC
R brachiocephalic vein
L brachiocephalic vein
Arch of aorta

Front 5

SVC
(formed by, location, enters what, enters at what location, receives blood from)

Back 5

formed by union of right and left brachiocephalic veins
descends on right border of sternum
enters right atrium
enters RA at level of 3rd costal cartilage
receives blood from azygos vein

Front 6

Right and Left brachiocephalic veins
(formed by union of, comparative sizes, why diff sizes, location of left relevant to branches of aortic arch

Back 6

formed by union of internal jugular and subclavian veins
left is twice as long b/c it crosses the midline to pass anterior to branches of the aortic arch

Front 7

left brachiocephalic vein collects lymph from

Back 7

thoracic duct

Front 8

right brachiocephalic vein collects lymph from

Back 8

right lymphatic duct

Front 9

arch of aorta
(continuation of, location, begins at, ends at)

Back 9

continuation of ascending aorta
above pericardial sac
begins at sternal angle (2nd sternocostal joint)
ends at sternal angle (2nd sternocostal joint)

Front 10

Arch of aorta
(pathway, passes under, passes over, descends lateral to, and to left of _ and _)

Back 10

arches superior, posterior and to the left
passes under left brachiocephalic vein
passes over right pulmonary artery and left main bronchus
descends lateral to T4
and to left of trachea and esophagus

Front 11

Branches of aortic arch
(name them in order of branching)

Back 11

brachiocephalic trunk (1st branch)
left common carotid (2nd branch)
left subclavian (3rd branch)

Front 12

largest branch of aortic arch

Back 12

brachiocephalic trunk

Front 13

brachiocephalic trunk
(branch of, divides into, divides at what level, vessels supply)

Back 13

1st and largest branch of aortic arch
divides into right common carotid and
right subclavian
at level of sternoclavicular joint
vessels supply blood to right head & neck and right upper limb

Front 14

left common carotid artery
(branch of, ascends along, vessels supply blood to)

Back 14

2nd branch of aortic arch
ascends along left side of trachea
vessels supply blood to left side of head and neck

Front 15

left subclavian artery
(branch of, ascends lateral to, blood supply to)

Back 15

3rd branch of aortic arch
ascends lateral to trachea
blood supply to left upper limb

Front 16

ligamentum arteriosum
(remnant of)

Back 16

ductus arteriosus

Front 17

ductus arteriosus
(formed passageway for, why)

Back 17

formed passageway for blood from pulmonary trunk directly into the arch of the aorta
bypasses the lungs in fetus

Front 18

Superior Mediastinum
Nerves
(name)

Back 18

Vagus nerve
Phrenic nerve

Front 19

Vagus nerves
(descend thru, give rise to)

Back 19

descend thru superior and posterior mediastinum
give rise to recurrent laryngeal nerves
and pulmonary, cardiac & esophageal plexuses

Front 20

Right Vagus
(descends anterior to, gives off _ which loops under _ to ascend on the right side of _)

Back 20

descends anterior to right subclavian artery
gives off right recurrent laryngeal nerve
which loops under right subclavian
to ascend on right side of trachea

Front 21

Left Vagus
(descends b/w, gives off _ which loops under _ lateral to _, and ascends on the left side of _)

Back 21

b/w left subclavian & left common carotid
gives off left recurrent laryngeal nerve
which loops under aortic arch - lateral to ligamentum arteriosum
ascends on left side of trachea

Front 22

Right Vagus
after giving off _, it descends _ to root of right lung, and divides to give rise to _

Back 22

right recurrent laryngeal
posterior to root of right lung
divides to give rise to:
right pulmonary
esophageal plexus
cardiac plexus

Front 23

Left Vagus
after giving off _, descends _ to root of left lung

Back 23

left recurrent laryngeal
descends posterior to root of left lung

Front 24

injury to recurrent laryngeal nerves

Back 24

p. 175

Front 25

Right recurrent laryngeal nerve
(branch of, loops under, ascends on _ side of trachea)

Back 25

branch of right vagus nerve
loops under right subclavian
right

Front 26

left recurrent laryngeal nerve
(branch of, loops under, ascends on _ side of trachea)

Back 26

branch of left vagus nerve
**loops under aortic arch lateral to ligamentum arteriosum**
left

Front 27

phrenic nerve
(type of innervation, to diaphragm and _ and _, pass _ to vagus nerves and _ to root of lung, travel with _ thru _)

Back 27

sensory and motor to diaphragm
sensory for pericardium and part of pleura
pass lateral to vagus nerves
and anterior* to root of lung
travel with pericardiocophrenic vessels thru middle mediastinum

Front 28

right phrenic nerve
(descends on _)

Back 28

right side of pericardium

Front 29

left phrenic nerve
(descends _ to arch of aorta and left side of _)

Back 29

**anterior to arch of aorta
left side of pericardium

Front 30

What is anterior to root of lung?

Back 30

phrenic nerve

Front 31

What descends anterior to arch of the aorta?

Back 31

left phrenic nerve

Front 32

Trachea
(anterior to _, to the _ of midline, ends at _ where it _)

Back 32

*anterior to esophagus
to right of midline
ends at sternal angle
bifurcates to form right and left main bronchi

Front 33

Bifurcations
C4
T4
L4

Back 33

C4 = carotid artery
T4 = trachea
L4 = aorta

Front 34

Esophagus
(composed of, extends from _ to _, posterior to _)

Back 34

fibromuscular tube
extends from pharynx to stomach
posterior to trachea

Front 35

lymphatics thru superior mediastinum

Back 35

thoracic duct thru posterior region of superior mediastinum

Front 36

Anterior Mediastinum
(size compared to other subdivs)

Back 36

smallest of the subdivs found b/w the sternum & transverse thoracic muscles and the pericardium

Front 37

Anterior Mediastinum
(contents)

Back 37

fat
lymph vessels
lymph nodes
vessels
and in children a large thymus

Front 38

Posterior Mediastinum
(inferior to, superior to, anterior to, lateral to, posterior to)

Back 38

inferior to transverse thoracic plane
superior to diaphragm
anterior to bodies of T5-T12
lateral to pleura
posterior to pericardium

Front 39

Posterior Mediastinum
(contents)

Back 39

Aorta and 5 birds:
Thoracic aorta
esophagus
azygos system of veins
vagus nerve
thoracic duct
right lymphatic duct
In addition:
lymph nodes, vessels, sympathetic nerves

Front 40

Thoracic aorta
(continuation of, descends on _ side of vertebral bodies from T_ to T_; _ to root of left lung, moves _, after passing thru _ it becomes _)

Back 40

continuation of aortic arch
descends on left side of vertebral bodies from T5-T12
posterior to root of left lung
moves medially
becomes abdominal aorta after passing thru aortic hiatus at T12

Front 41

What descends on left side of vertebral bodies?

Back 41

thoracic aorta

Front 42

What passes thru aortic hiatus at T12?
What does it become after passing thru?

Back 42

thoracic aorta
abdominal aorta

Front 43

Thoracic aorta
(branches)

Back 43

*posterior intercostals (9 pair)
subcostal
bronchial
esophageal
pericardial
mediastinal
superior phrenic

Front 44

Esophagus
(descends on, posterior to _ and _, to _ of aorta)

Back 44

descends on thoracic vertebral bodies
posterior to pericardium and left atrium
to right of aorta

Front 45

Esophagus
(pathway)

Back 45

descends on thoracic vertebral bodies
posterior to pericardium and left atrium
to right of aorta
near diaphragm it crosses to the left and anterior to the aorta - passes thru diaphragm at the esophageal hiatus - T10- anterior to aortic hiatus

Front 46

Esophagus descends in posterior mediastinum to _ of aorta. Near diaphragm it crosses to the left and _ to the aorta - passes thru diaphragm at _ at level of _, and _ to aortic hiatus

Back 46

right of aorta
anterior to aorta
passes thru diaphragm at esophageal hiatus at T10
anterior to aortic hiatus

Front 47

Posterior mediastinum
Lymphatics
(contents)

Back 47

thoracic duct
right lymphatic duct
lymph nodes

Front 48

Posterior mediastinum
Lymphatics
Thoracic Duct
(size, originates from, passes thru, drains lymph from)

Back 48

largest thoracic channel
originates from cistern chyli in abdomen
passes thru aortic hiatus
drains lymph from all but the right superior quadrant of body

Front 49

Posterior mediastinum
Lymphatics
Thoracic Duct
(ascends b/w, posterior to on vertebral bodies _ to _, empties into junction b/w _ and _ ("_"), thickness of walls, color, other characteristics)

Back 49

ascends b/w azygous and aorta
posterior to esophagus
on vertebral bodies T6-T12
empties into junction b/w left internal jugular and left subclavian
"left venous angle"
thin walled
dull white
beaded (valves)

Front 50

Posterior mediastinum
Lymphatics
right lymphatic duct
(size, drains lymph from, empties to)

Back 50

short
drains lymph from right upper quadrant
empties into right venous angle

Front 51

Posterior mediastinum
Lymphatics
lymph nodes
(name them, receive lymph from)

Back 51

posterior mediastinal nodes
receive lymph from esophagus, posterior pericardium, and diaphragm

Front 52

lacerations of thoracic duct

Back 52

pg. 175

Front 53

Azygos System of Veins
(characteristics, drains blood from, components)

Back 53

highly variable
drain venous blood from the back, thoracoabdominal walls and viscera of the mediastinum
azygos vein
hemiazygos vein
accessory hemiazygos

Front 54

Azygos Vein
(form collateral pathway b/w, drains, ascends on _ side of vertebral bodies _, lateral to _)

Back 54

forms collateral pathway b/w SVC & IVC
drains posterior wall of thorax and abdomen
ascends on right side of vertebral bodies T5-T12
lateral to thoracic duct

Front 55

Hemiazygos Vein
(formed by union of, ascends on _ side of vertebral bodies to _ where it crosses to drain into _)

Back 55

formed by union of left ascending lumbar and subcostal vein - ascends on left side of vertebral bodies to T9 where it crosses to drain into azygos

Front 56

Accessory Hemiazygos
(crosses posterior to _ and _ to join _ at _)

Back 56

crosses posterior to aorta and thoracic duct to join azygos at T7 or T8

Front 57

Nerves of the posterior mediastinum
(parasympathetic - name them)

Back 57

Vagus nerve
Anterior vagal trunk
Posterior vagal trunk

Front 58

Vagus nerves
(form what plexuses, prior to descending thru _ hiatus in diaphragm, they form _)

Back 58

form pulmonary, cardiac, and esophageal plexuses
goes thru esophageal hiatus
form anterior and posterior vagal trunks

Front 59

Anterior vagal trunk
(mainly fibers from)

Back 59

left vagus

Front 60

posterior vagal trunk
(mainly fibers from)

Back 60

right vagus

Front 61

nerves of posterior mediastinum
Sympathetic
(name)

Back 61

Thoracic sympathetic trunks
-greater splanchnic nerve
-lesser splanchnic nerve
-least splanchnic nerve

Front 62

Thoracic sympathetic trunks
(continuous with, lie on, have _ ganglia with _ that pass to spinal nerves)

Back 62

continuous with cervical and lumbar trunks
lie on heads of ribs
have 11 to 12 ganglia with white and gray rami communicans that pass to spinal nerves

Front 63

Thoracic Sympathetic Trunks
(ganglia 1-5 supply)

Back 63

supply postganglionic neurons to heart, aorta, lungs and esophagus

Front 64

Thoracic Sympathetic trunks
(ganglia 5-12)

Back 64

supply pregang to abdominal viscera via splanchnic nerves which synapse with postgang in abdominal ganglia

Front 65

Greater splanchnic nerve
(fibers from)

Back 65

fibers from 5th to 9th thoracic ganglia

Front 66

lesser splanchnic nerve
(fibers from)

Back 66

fibers from 10th & 11th thoracic ganglia

Front 67

least splanchnic nerve
(fibers from)

Back 67

fibers from 12th thoracic ganglia