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67 Cards in this Set

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Where is the thymus located?
anterior part of the superior mediastinum
What is the role of the thymus?
develop immune system, becomes adipose in adult life
What arteries supply the thymus? Where do they branch from?
inferior thyroid and anterior intercostals
both branch from internal thoracic arteries
Where does the blood from the thymus drain?
left brachiocephalic vein, internal thoracic veins and inferior thyroid vein
What is a tumor of the thymus called? What can its growth affect?
thymoma
can affect trachea, superior vena cava
What forms the brachiocephalic vein on each side of the body?
internal jugular and subclavian vein
What is the course of the R brachiocephalic vein?
runs from behind the medial end of the right clavicle and descends along the right border of the manubrium
What is the course of the L brachiocephalic vein?
runs behind the medial end of the L clavicle and passes obliquely behind the manubrium to its R side
Where do the L & R brachiocephalic veins meet? What do they form
at the right border of the manubrium to form the superior vena cava
Which brachiocephalic vein is longer?
L
What does the superior vena cava receive just prior to entering the pericardial sac?
azygos vein
What are the 3 parts of the thoracic aorta?
ascending aorta
arch of the aorta
descending aorta
Describe the path of the ascending aorta.
It begins within the pericardial sac at the aortic valve and ascends behind the sternum to the sternal angle
Describe the path of the arch of the aorta.
lies behind the manubrium and in front of the trachea
arches over R pulmonary artery and L main bronchus
What branches off of the arch of the aorta?
brachiochephalic artery
L common carotid
L subclavian
Describe the path of the descending aorta.
begins at the sternal angle and descends just anterior to the vertebral bodies
Where is the path of the trachea?
trachea extends from the neck, passes through the superior mediastinum to reach the lungs
Where is the trachea located w/ respect to the esophagus and superior mediastinum?
anterior to esophagus
R of the median plane of the superior mediastinum
At what level does the trachea branch into R&L primary bronchus?
@ sternal angle (T4-5)
Where is the arch of the aorta w/ respect to the trachea?
initially anterior, but then turns to the L side of trachea as the arch becomes the descending aorta
What does the esophagus connect the stomach w/?
pharynx
What are the segments of the esophagus?
cervical, thoracic, and short abdominal segments
The esophagus enters the superior mediastinum between what two things?
trachea and vertebral column
What is the esophageal hiatus? Where is it located?
where the esophagus passes through the diaphragm at vertebral level T10
Where is the esophagus located w/ regards to the descending aorta?
just to the right, but slowly angles to the left and crosses anteriorly over the descending aorta
Phrenic nerves arise from which ventral rami?
C3,4,5
Phrenic nerves descend in the neck along the lateral border of the internal jugular vein and enter the superior mediastinum between what two things?
subclavian artery and the origin of the brachiocephalic vein
What do phrenic nerves run within on the way to innervating the diaphragm?
fibrous pericardium
Are phrenic nerves anterior or posterior to the lungs as they reach the diagphragm?
anterior
Describe the path of the right phrenic nerve.
descends along the lateral border of the right brachiocephalic vein and then the superior vena cava to reach the pericardium of the right atrium
Describe the path of the left phrenic nerve.
descends along the left subclavian and left common carotid arteries
crosses left surface of aortic arch and passes over left superior intercostal vein to reach pericardium on L side of heart
Which nerve is the vagus nerve?
Cranial nerve X
Is the vagus nerve a sympathetic or parasympathetic nerve?
parasympathetic
The vagus nerve supplies which organs?
all thoracic and upper 2/3 of abdominal organs
Where does the vagus nerve originate? What is its path? What does it enter?
the medulla of the brain and descends through the neck to reach the superior mediastinum where it enters the thorax
Where are preganglionic parasympathetc motor neruuons located? postganglionic nerve bodies?
in the medulla
terminal organs
Both the right and left vagal nerves descend through the neck between what 2 things? What are they encased in?
common carotid arteries and internal jugular veins
encased in a CT membrance called the carotid sheath
Describe the path of the right vagus nerve. Is it anterior or posterior to the lung? What does it enter?
-enters the superior mediastinum on the right side of the trachea and passes posterior to the R brachiocephalic vein and inferior vena cava
-stays posterior to the root of the lungs
-descends along the esophagus to enter the abdominal cavity
Describe the path of the left vagus nerve. Is it anterior or posterior to the lung? What does it enter?
-enters the superior mediastinum by descending along the left surface of the arch of the aorta
-stays posterior to the root of the lung
-descends along the esophagus to reach the abdominal cavity
What three things receive contributions from the R&L vagus?
pulmonary plexus
esophageal plexus
cardiac plexus
What forms from both R&L vagus nerves and is needed to control the voice box in the neck?
recurrent laryngeal nerves
Where does the R recurrent laryngeal nerve run?
under the R subclavian artery
Where does the L recurrent laryngeal nerve run?
under the ligamentum arteriosum
What connects the pulmonary trunk to the underside of the aorta just under the arch?
ligamentum arteriosum
What are the 3 autonomic plexi of the thorax? Do they contain sympathetic or parasympathetic fibers?
cardiac
pulmonary
esophageal plexus
all contain both SNS and PNS fibers
What do parasympathetic fibers of the autonomic plexi arise from? Sympathetic?
PNS-R&L vagus
SNS-R&L sympathetic chain ganglion
What contributes sympathetic preganglionic nerves that synapse in the paravertebral sympathetic chain ganglia?
T1-T5
Visceral afferent nerve fibers from the cardiac, pulmonary and espohageal plexi come back to the spinal cord at what level? What does this mean for pain?
T1-5
pain from the heart, lungs and esophagus can refer pain back to T1-5 dermatomes
Preganglionic visceral motor nerves withing the lateral horn of the spinal cord from T5-12 skip the paravertebral sympathetic chaing ganglia and instead synapse where?
in prevertebral ganglia on their way to innervate abdominal organs
Which nerves are from T5-9? T10-11? T12?
greather thoracic splanchnic
lesser
least
What leads to the aortic sac from which six pairs of aortic arches arise?
truncus arteriosus
What do aortic arches fuse with?
paired dorsal aortae
What leads to the formation of the great vessels exiting the heart?
modifications to the tuncus arteriosus, aortic sac, and dorsal aortae
What are the great vessels? (10)
ascending aorta, aortic arch, descending aorta, brachiocephalic artery, common carotids, internal and external carotids, subclavians, pulmonary arteries, and ductus arteriosus
What part of the aortic arch degenerates?
right 5th and 6th braches
The left 6th aortic arch remains as what? What does this causes w/ regards to the recurrent laryngeal nerves?
ductus arteriosus
causes right recurrent laryngeal nerve to branch from the R vagus @ the level of the R subclavian artery while the L recurrent laryngeal nerve branches from the L vagus at the level of the ductus arteriosus (L 6th aortic arch)
Where does the thoracic duct begin?
in abdomen as cisterna chyli (level L1-2)
What does the thoracic duct receive lymph from? Where does it empty?
-from both sides of thoracic cavity and abdomen
-empties into the junction of the L subclavian and L internal jugular veins
Describe the path of the thoracic duct.
runs anterior to the vertebral bodies, may wander from L to R and back to L side as it moves cranially towards the L side of the superior mediastinum
What is chylothorax? What usually causes it?
accumulation of lymph in the posterior mediastinum or either R or L pleural cavity due to rupture of the thoracic duct-it is usu a complication of surgery
What drains venous blood from the thoracic wall?
azygos system
What is the path of azygos? What does it connect to?
runs cranially/caudally along the R side of the verebral bodies
connects to superior and inferior vena cava
What is the vein on the inferior aspect along the L side of the thoracic vertebrae that is part of the azygos system of veins?
hemiazygos
What is the vein on the superior aspect of the L side of the thoracic vertebrae that is part of the azygos sytem?
accessory hemiazygos
How do the hemiazygos and accessory hemiazygos connect to the azygos?
by crossing the midline on the top of the vertebral bodies
What syndrome is an apical bronchogenic carcinoma that can impinge on adjacent anatomical structures?
pancoast syndrome
Which syndrome is an interruption of sympathetic innervation to the head and neck, myosis, and anhydrosis unilaterally?
Horner's syndrome