Hae 4

Front 1

mediastinum

Back 1

central region of thoracic cavity, between two pleural cavities

Front 2

borders of mediastinum
-superior
-inferior
-lateral
-anterior
-posterior

Back 2

superior thoracic aperature
diaphragm
pleural cavities and lungs
sternum
thoracic vertebrae

Front 3

anterior and posterior landmarks that divide the mediastinum into superior and inferior portions

Back 3

TRANSTHORACIC PLANE formed by:
sternal angle
disc between T4/T5

Front 4

What subdivides the inferior portion of the mediastium into anterior, middle and posterior parts?

Back 4

pericardium divides inferior mediastium into what subdivisions?

Front 5

thymus

Back 5

-one of the most anterior structures in the mediastinum (anterior to great vessels and pericardium)
-lymphoid organ
-involved in development of the immune system
-most active in childhood
-replaced with fat after puberty

Front 6

layers of pericardium

Back 6

-fibrous pericardium- tough outer layer does not stretch
-visceral serous layer- applied to surface of heart
-parietal serous layer- lines the internal sufrace of the fibrous pericardium
-pericardial cavity- potential space between the visceral and parietal serous layers

Front 7

great vessels

Back 7

large arteries and veins that are attached to the heart:
-aorta
-pulmonary trunk
-superior vena cava (SVC)
-pulmonary veins

Front 8

superior vena cava

Back 8

formed by the convergence of left and right brachiocephalic veins (enters the RA of heart)

Front 9

ascending aorta

Back 9

arises from the left ventricle of the heart and immediately gives off the left and right coronary arteries, then arches to the left and posteriorly (AORTIC ARCH) and gives off three branches

Front 10

aortic arch

Back 10

begins and ends at the tranverse thoracic plane (T4/T5) begins after it exits heart and arches to the left and posteriorly, gives off 3 branches, then descends anterolateral aspect of the vertebral column on the left side of the body.

Front 11

branches off aortic arch

Back 11

-brachiocephalic trunk (BT)
-left common carotid
-left subclavian arteries

Front 12

pulmonary trunk

Back 12

arises from the right ventricle of the heart and bifurcates into the right and left pulmonary arteries (carry deoxygenated blood to the lungs)

Front 13

pulmonary veins

Back 13

4 veins that carry oxygenated blood from the lungs to the left atrium

Front 14

ductus arteriosus

Back 14

channel between pulmonary trunk and aortic arch during fetal circulation, allows blood to bypass the non-functioning lungs in the fetus

Front 15

ligamentum arteriosum

Back 15

remnant of the ductus arteriosus in adults- between pulmonary trunk and aortic arch

Front 16

position of trachea in mediastinum

Back 16

found posterior to great vessels in the midline, bifurcates into the primary bronchi at approximately the T4 vertebral level

Front 17

esophagus

Back 17

located directly posterior to the trachea, exits the thoracic cavity through a hole in the diaphragm (the esophageal hiatus)

Front 18

phrenic nerves

Back 18

originate from C3-C5 ventral primary rami in the neck (KEEP THE DIAPHRAGM ALIVE)
-enter the mediastinum through the superior thoracic aperature
-travel anterior to the roots of the lungs
-descend to the diaphragm along the lateral aspects of the pericardium
-provide somatic motor fibers to the diaphragm
-provide sensory fibers to the diaphragm, pericardium, and mediastinal pleura

Front 19

vagus nerves

Back 19

-arise from the brainstem
-travel in the neck near the carotid arteries
-enter throax via superior thoracic aperature
-right vagus travels along lateral aspect of trachea
-left vagus travels on the anterolateral surface of the aortic arch
-both nerves travel posterior to the root of the lung before entering a plexus on the esophagus
-vagus nerves provide parasympathetic fibers to the heart, bronchial tree and esophagus via the visceral plexuses in the thorax (cardiac, pulmonary, and esophagueal plexuses)
-afferent fibers are also found in the vagus nerve which are involved in visceral reflexes

Front 20

left recurrent laryngeal nerve

Back 20

branch of the vegus, found in the mediastinum
-arises from the vagus on the aortic arch
-travels through the aortopulmonary window posterior to the ligamentum arteriosum
-ascends back into the neck along the lateral aspect of the trachea
-innervates the larynx

Front 21

right recurrent laryngeal nerve

Back 21

branch of vegas, but UNLIKE LEFT, not in the mediastinum
travels around the right subclavian artery in the neck

Front 22

thoracic duct

Back 22

-largest lymphatic vessel in the body
-receives lymph from the entire lower half of body and upper left quadrant
-reutrns this fluid to the venous system
-in medastinum, it travels on the anterior aspect of the thoracic vertebrae on the right side of the thoracic aorta

Front 23

tracheobronchial lymph nodes

Back 23

large group of nodes
surrounding the tracheal bifurcation
receive lymphatic drainage from the lungs

Front 24

right coronary artery

Back 24

emerges from ascending aorta, near tip of right auricle
travels in the coronary sulcus (bt right atrium and ventricle)
3 important branches

Front 25

3 important branches of right coronary artery

Back 25

sinuatrial nodal branch (supplies SA node)
marginal branch (travels along the inferior margin of the right ventricle)
posterior interventricular branch (travels in the posterior interventricular sulcus and supplies both ventricles)
-ALSO small AV nodal branch

Front 26

left coronary artery

Back 26

originates- from ascending aorta posterior to the pulmonary trunk
-almost immediately bifurcates into two branches:

anterior interventricular branch or left anterior descending (LAD)

circumflex branch- travels in the coronary sulcus on the left side of the heart and terminates before raching the posterior interventricular sulcus

Front 27

right dominant pattern

Back 27

typical pattern of coronary circulation, where right coronary artery supplise more territory than the left

Front 28

left dominate pattern

Back 28

posterior interventricular artery arises from the circumflex branch (rather than the right coronary artery)

Front 29

myocardial infarction (MI)

Back 29

death of heart tissue due to lack of blood flow

Front 30

coronary sinus

Back 30

sac-like structure on the posterior side of the heart that empties into the right atrium, where most venous blood from heart tissue connects

Front 31

3 major coronary veins

Back 31

great cardiac vein
middle cardiac vein
small cardiac vein

Front 32

great cardiac vein

Back 32

originates near the apex of the heart and travels in the anterior interventricular sulcus with teh anterior interventricular artery
-near the origin of the anterior interventricular artery- it enters the coronary sulcus and travels with the circumflex artery to the posterior side of the heart, hear it merges with the coronary sinus

Front 33

middle cardiac vein

Back 33

travels in the posterior interventricular sulcus with the posterior interventricular artery
terminates in the coronary sinus

Front 34

small cardiac vein

Back 34

runs along the inferior margin of the heart with the marginal branch of the right coronary artery
travels in the coronary sulcus to the coronary sinus