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69 Cards in this Set
- Front
- Back
in what is all of the thoracic viscera contained, with the exception of the lungs?
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mediastinum
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a line between what two points divides the mediastinum into superior and inferior mediastina?
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sternal angle (of Louis)
intervertebral disc between T4 and T5 |
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what are the subdivisions of the inferior mediastinum?
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anterior - fatty and thymic tissues
middle - heart and great vessels posterior - viscera traversing thorax (to abdomen) |
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from where is the thymus derived?
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third pharyngeal pouch
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from where are the inferior parathyroid glands derived?
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third pharyngeal pouch
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where is the thymus?
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retrosternal
between two costomediastinal recesses anterior to left brachiocephalic vein and aortic arch |
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what forms the left brachiocephalic vein?
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left internal jugular vein
left subclavian vein posterior to left sternoclavicular joint |
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what forms the superior vena cava?
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right brachiocephalic vein
left brachiocephalic vein at 1st right intercostal space |
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in relationship to the three great branches of the aortic arch, where does the left brachiocephalic vein pass?
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anterior and superior to the three great branches
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what forms the right brachiocephalic vein?
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right internal jugular vein
right subclavian vein posterior to right sternoclavicular joint |
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where does the superior vena cava enter the right atrium?
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3rd right costal cartilage
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where does the arch of the azygos system empty?
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posterior surface of the superior vena cava
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with what does the right phrenic nerve run?
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superior vena cava
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posterior to what does the esophagus lie?
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trachea
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where does the trachea begin?
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below larynx
below cricoid cartilage at C6 |
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what is the bifurcation of the trachea?
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carina (at level of T4/5)
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what is to the right of the trachea?
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brachiocephalic artery
right vagus azygos arch |
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what is to the left of the trachea?
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left common carotid artery
left subclavian artery left vagus nerve left recurrent laryngeal nerve |
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where are lymph nodes found on the trachea? where do they drain?
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all three bifurcation angles
drain into right lymphatic duct and thoracic duct |
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in relation to the trachea, where is the cardiac plexus?
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anterior to the bifurcation of the trachea
also inferior to bifurcation of pulmonary trunk and arch of aorta |
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what are the extensions of the cardiac plexus?
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right and left pulmonary plexus
plexus of the thoracic aorta |
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where do the preganglionic sympathetic nerves from the cardiac plexus originate?
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T1-T4 lateral horn of spinal cord
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through what do the preganglionic sympathetic nerves enter the paravertebral sympathetic chain of ganglia?
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white rami communicantes
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where do the sympathetic nerves to the cardiac plexus synapse?
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upper thoracic ganglia
cervical ganglia |
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what is the effect of sympathetic nerves on the heart?
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tachycardia
vasodilation of coronary arteries |
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where are the cell bodies of the visceral sensory fibers of the heart?
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dorsal root ganglion, axons entering spinal cord at T1-T2
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from where does the vagus nerve arise?
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cell bodies in the brainstem
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what is the effect of parasympathetic innervation of the heart?
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bradycardia
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what is the purpose of afferent vagal fibers from the heart?
efferent vagal fibers? |
afferent - chemo- and baroreception
efferent - induce bradycardia |
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where are the cell bodies for the afferent vagal fibers from the heart, aorta and great vessels?
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inferior ganglion of the vagus nerve
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where does the inferior aspect of the aortic arch lie?
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on a line from sternal angle through the T4/5 intervertebral disc
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where does the arch of the aorta become the descending aorta?
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to the left of the T5 vertebral body
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from where do the branches arise from the arch of the aorta?
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superior aspect
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what are the branches of the arch of the aorta?
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from right to left, brachiocephalic trunk, left common carotid artery, left subclavian artery
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into what does the brachiocephalic trunk divide?
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right subclavian artery
right common carotid artery posterior to right sternoclavicular joint |
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what is the ligamentum arteriosum?
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vestige of the ductus arteriosus, which shunted blood from the pulmonary system during prenatal life
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what does the left recurrent laryngeal nerve loop around?
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ligamentum arteriosum and arch of aorta
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between what two structures do both recurrent laryngeal nerves ascend into the neck?
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trachea
esophagus |
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around what does the right recurrent laryngeal nerve loop?
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right subclavian artery
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with what is the right phrenic nerve associated?
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upper course - SVC
pierces diaphragm with IVC |
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where do the phrenic nerves pierce the diaphragm?
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right phrenic nerve - IVC
left phrenic nerve - margin of fibrous pericardial attachment to the central tendon |
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through what does the descending aorta pass into the abdomen?
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aortic hiatus at T11/12, through the diaphragm
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with what do the greater splanchnic nerves from the sympathetic trunk join and enter the abdomen?
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descending aorta
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what are the visceral branches of the descending aorta?
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1-3 bronchial arteries
1-3 esophageal arteries branches to pericardium and diaphragm |
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what are the parietal branches of the descending aorta?
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right and left posterior intercostal arteries (3rd intercostal space to below rib 12)
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where does the thoracic duct begin?
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cisternal chyli (a series of lymph sacs), posterior to abdominal aorta, inferior to diaphragm
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through what does the thoracic duct enter the thorax?
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aortic hiatus, posterior to descending aorta
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on which side of the vertebral column does the thoracic duct lie?
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right side
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where does the thoracic duct end?
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at the junction between the left subclavian and left internal jugular veins
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from what areas does the thoracic duct NOT drain lymph?
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right thorax
right upper limb right side of head and neck (all other areas use thoracic duct) |
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into where does the right lymphatic duct drain?
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junction of right internal jugular vein and right subclavian vein
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what is drained by the hemiazygos vein?
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posterior intercostal veins on left side of body
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where does the hemiazygos vein join with the azygos vein?
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mid-thorax
(hemiazygos vein passes anterior to the vertebral column) |
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where does the azygos vein drain?
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posterior aspect of superior vena cava at level of costal cartilage of rib 3
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what does the right superior intercostal vein drain?
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second, third, fourth right intercostal spaces
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into what does the right superior intercostal vein drain?
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azygos vein
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into what does the left superior intercostal vein drain?
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left brachiocephalic vein
(crosses over anterior aspect of aortic arch first) |
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what is drained by the highest posterior intercostal veins?
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first intercostal space on each side
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into what do the highest posterior intercostal veins drain?
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brachiocephalic veins
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where do the anterior intercostal veins drain?
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internal thoracic veins, which empty into the subclavian veins
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on which side of the diaphragm does the esophagus pierce it?
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left dome at T10 (rib 7 costocartilage)
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in what four regions is the esophagus constricted?
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C6 - upper esophageal sphincter - voluntary (15*)
T2/3 - crossing of the aortic arch (22*) T4/5 - crossing of left primary bronchus (27*) T10 - diaphragm (40*) *-distance from the incisor teeth |
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what is the superior esophageal sphincter?
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cricopharyngeus - a voluntary muscle
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what innervates the inferior esophageal sphincter?
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vagus nerve - parasympathetic - opens
sympathetic fibers - close |
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inferior to the root of the lung, which vagus nerve lies anterior to the esophagus? which lies posterior?
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anterior - left vagus nerve
posterior - right vagus nerve |
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what forms the anterior and posterior esophageal plexuses?
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anterior - left vagus nerve
posterior - right vagus nerve |
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where do the fibers from the vagus nerves pierce the diaphragm?
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through esophageal hiatus
(as single nerves derived from the anterior and posterior esophageal plexuses) |
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what are the vagus nerves renamed below the diaphragm?
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left vagus nerve - anterior gastric nerve
right vagus nerve - posterior gastric nerve |
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what is the action of the vagus nerve on the esophagus?
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induce peristalsis
(secretomotor to mucous glands) |