Thoracic Cavity 1 Flashcards

1
Q

What is contained in the thoracic cavity?

A

lungs and chest wall lined by pleura

heart covered with pericardium

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2
Q

What lines body cavities?

A

serous membrane

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3
Q

What is the function of serous membrane?

A
  • allows movement, expansion and contraction of organs
  • compartmentalisation
  • layer of fluid to allow frictionless movement
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4
Q

Where is the superior mediastinum found?

A

behind the manubrium, between the thoracic inlet and the plane through the sternal angle (T4/5 intervertebral disc level)

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5
Q

Where is the inferior mediastinum found?

A

inferior to the transverse plane through the sternal angle and the diaphragm

subdivided into anterior, middle and posterior mediastinum

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6
Q

Relations of the right side of the mediastinum

A
  • right atrium and veins
  • superior vena cava
  • arch of the azygos
  • inferior vena cava
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7
Q

Relations of the left side of the mediastinum

A
  • left ventricle and arteries
  • left common carotid artery
  • left subclavian artery
  • arch of aorta
  • thoracic aorta
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8
Q

What is contained in the middle mediastinum?

A
  • heart
  • pericardium
  • origins of great vessels (aorta pulmonary trunk)
  • terminal parts of IVC and SVC
  • phrenic nerves
  • branches of vagus
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9
Q

What are the functions and the different layers of the pericardium?

A
  • anchors the heart and prevents overexpansion of the heart
  • 2 layers:
  • fibrous pericardium externally
  • serous pericardium internally
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10
Q

Relations and attachments of the fibrous pericardium

A
  • anteriorly related and attached by the sterno-pericardial ligament to the body of sternum and 3rd-6th CC
  • posteriorly related and attached by the pericardiovertebral ligaments to 5th-8th thoracic vertebrae
  • inferiorly blends with the central tendon of the diaphragm by the pericardiophrenic ligament
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11
Q

What does the attachment of fibrous pericardium to the diaphragm do?

A

Stops the diaphragm from everting the ribs medially reducing the pressure on them

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12
Q

Explain the composition of serous pericardium

A
  • 2 layers, parietal and visceral
  • parietal: lines inner aspect of fibrous pericardium and reflects on itself around roots of great vessels to continue as the visceral layer
  • visceral layer: epicardium
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13
Q

Where is the pericardial cavity found?

A

between parietal and visceral layers of serous pericardium

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14
Q

What is the purpose of the transverse pericardial sinus?

A

to separate the arterial and venous ends of the heart tube

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15
Q

Describe the position and relations of the transverse pericardial sinus

A

posterior to the ascending aorta and pulmonary trunk, anterior to the superior vena cava
superior to the left atrium and pulmonary veins

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16
Q

What is the importance of the transverse pericardial sinus?

A

Important in cardiac surgery. A finger can make a ligature through the sinus to stop circulation

17
Q

Other name for transverse pericardial sinus

A

sinus of Theile

18
Q

Other name for oblique pericardial sinus

A

Haller’s cul-de-sac

19
Q

Describe the relations of the oblique pericardial sinus

A

surrounded by the reflection of the serous pericardium around the right and left pulmonary veins and the IVC

20
Q

What is the nerve supply to the pericardium?

A
  • sensory fibres from phrenic nerve
  • parasympathetic vasomotor fibres from the vagus nerve
  • sympathetic cardiopulmonary vasomotor fibres from cardiopulmonary splanchnic nerves
21
Q

Describe the journey of the phrenic nerve

A

Arises from ventral rami of C3,4,5 (mainly 4) and travels over the scalenus anterior muscle and enters mediastinum between venous and arterial planes (subclavian artery and vein) between the fibrous pericardium and parietal pleura

22
Q

What is an identifiable feature of the phrenic nerve?

A

It passes anterior to the root of the lung

23
Q

Where does the right phrenic nerve pass?

A

adjacent to the SVC then IVC and through the caval opening to enter the diaphragm

24
Q

Where does the left phrenic nerve pass?

A

crosses the aortic arch and over the left ventricle and pierces diaphragm

25
Q

What nerve is the sole motor supply to the diaphragm?

A

phrenic nerve

26
Q

Where can pericardial pain be referred to?

A
  • C4 dermatome

- back of the neck, supraclavicular region, shoulder tip

27
Q

What are the boundaries of the anterior mediastinum?

A
  • sternal body and xiphoid process
  • pericardium
  • lungs with pleura
28
Q

What are the contents of the anterior mediastinum?

A
  • thymus (or its remnants in adults)
  • internal mammary vessels
  • lymph nodes
  • connective tissue
  • fat tissue
  • lower pole of thyroid
29
Q

What are the possible pathologies for the anterior mediastinum?

A

4 tumours

  • thymoma (thymus)
  • thyroid tumour
  • lymphoma
  • teratoma
30
Q

Explain the position and relations of the thymus

A
  • between manubrium, sternum and pericardium
  • related to pericardium, SVC, left and right brachiocephalic veins, pleura, phrenic nerves, trachea
  • from jugular notch to 4 CC
31
Q

What forms the brachiocephalic veins?

A

internal jugular and subclavian veins

32
Q

What froms the SVC?

A

left and right brachiocephalic veins

33
Q

What are the 3 branches of the aortic arch?

A
  • brachiocephalic trunk
  • left common carotid artery
  • left subclavian artery
34
Q

What position of the mediastinum is the pulmonary arteries found?

A

Within the pericardium so in the middle mediastinum