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G25 Lungs and Mediastinum
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Published
11/02/2024
The thoracic cavity contains {{c1::two pleural sacs}} and the {{c1::mediastinum}}
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What is the mediastinum?
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Is the posterior thoracic wall part of the mediastinum?
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Boundaries of the Mediastinum:- bounded superiorly by the {{c1::superior thoracic aperture}} and inferiorly by the {{c1::diaphragm}}- extends from the…
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Transverse Thoracic Plane
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Where is the Superior mediastinum located? What are its contents?
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The inferior mediastinum extends inferiorly from the {{c1::transverse thoracic plane}} to the {{c1::thoracoabdominal diaphragm}}
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The Inferior mediastinum is subdivided into:
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Thymus
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The {{c1::right}} brachiocephalic v. descends vertically and is shorter than the {{c1::left}} brachiocephalic v., which courses obliquely anterior to …
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What 3 vessels branch off the aortic arch?
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The aortic arch is connected to the left pulmonary a. by the {{c1::ligamentum arteriosum}}, a cord-like remnant of the fetal {{c1::ductus arteriosus}}
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Trachea- a membranous tube extending from the {{c1::larynx}} to the level of the {{c1::T4/5 IV disc}}- terminates by bifurcating into {{c1::R/L primar…
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What 4 structures are restricted to the superior mediastinum?
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Esophagus
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Where does the esophagus lie in the superior v.s. posterior mediastinum?
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The thoracic duct enters the thorax via the {{c1::aortic hiatus}} and drains into the venous system at the junction of the left subclavian and interna…
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Where does the thoracic duct lie in the superior and posterior mediastinum?
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What two structures are continuous b/w the superior and posterior mediastinum?
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What vessels branch off the descending aorta?
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What is the azygos system?
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Azygos Vein- at the {{c1::T4}} vertebral level, the arch of the azygos v. passes {{c1::anteriorly}} superior to the root of the right lung to drain in…
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What posterior intercostal vv. does the azygos v. receive?
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{{c1::Azygos}} v. is a vertical venous channel that ascends on the {{c2::right}} of the vertebral column, while the {{c1::Hemiazygos and accessory hem…
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Hemiazygos and Accessory hemiazygos vv.- Hemiazygos v. receives posterior intercostal vv. {{c1::9-12}} on the left before crossing anterior to the ver…
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What lymph vessels does the thoracic duct receive superior to the diphragm?
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Right lymphatic duct receives the {{c1::right bronchomediastinal trunk}} draining the right lung and bronchial tree, mediastinum, and anterior thoraci…
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Phrenic Nerve- derived from {{c1::C3-5}} ventral rami- provides motor and sensory innervation to the {{c1::thoracoabdominal diaphragm}}- provides sens…
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Course of the Phrenic nerve in superior mediastinum:- the left phrenic n. courses inferiorly posterior to the {{c1::left brachiocephalic v.}} and ante…
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In the inferior mediastinum, the phrenic nn. lie {{c1::between}} the pericardium and mediastinal pleura and {{c1::anterior}} to the roots of the lungs
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What provides motor and sensory innervation to the larynx?
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Left Vagus Nerve- in the superior mediastinum, the left vagus n. courses {{c1::anterior}} and {{c1::lateral}} to the arch of the aorta- the left recur…
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Right Vagus Nerve- the right recurrent laryngeal n. arises in the root of the neck and loops around the {{c1::right subclavian a.}}- in the superior m…
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Cardiac and pulmonary branches of the right and left vagus nerves contribute to the {{c1::cardiac}} and {{c1::pulmonary}} autonomic plexuses
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Esophageal plexus and Vagal trunks- fibers of the right and left vagus nn. join the {{c1::esophageal plexus}}- these fibers subsequently reassemble to…
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The thoracic sympathetic chain (trunks) are formed by the thoracic {{c1::sympathetic (paravertebral) ganglia}}
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What are the thoracic branches of the sympathetic chain?
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What are the 3 thoracic splanchnic nerves? What ganglia are they from?
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Pleura
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Visceral Pleura lines what? is innervated by what?
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What are the subdivisions of the Parietal pleura of the pleural sacs?
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Parietal pleura is supplied by somatic afferent fibers carried by the {{c1::intercostal}} and {{c1::phrenic}} nn. and is {{c1::highly sensitive}} to p…
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Pleural cavity
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What are Pleural reflections?
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What are the 3 lines of pleural reflection?
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Sternal Line- line of pleural reflection- marks the anterior reflection of {{c1::costal}} pleura to {{c1::mediastinal}} pleura
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Costal Line- line of pleural reflection- marks the reflection of {{c1::costal}} pleura to {{c1::diaphragmatic}} pleura as well as the inferior extent …
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What are Pleural recesses? What are the two pleural recesses?
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What is the most inferior point in the pleural cavity?
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Because the lungs do not fully occupy the pleural sacs, a needle can be inserted into the {{c1::costodiaphragmatic recess}} to draw off fluid ({{c1::p…
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What are the 4 surfaces of the Lungs?
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Describe the lobes and fissures of the Right lung:
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Describe the lobes and fissures of the Left lung:
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What two extra features does the left lung have that the right does not?
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Hilus of the Lung
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Root of the Lung
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Pleural sleeve of the lung
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Pulmonary ligament
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The walls of the primary bronchi contain {{c1::C-shaped cartilage rings}} similar to those of the trachea
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Why are aspirated objects more likely to pass into the right lung?
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At the {{c1::hilus}}, primary bronchi divide into {{c1::secondary (lobar) bronchi}}, each of which supplies a {{c1::single lobe}}
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Where do secondary bronchi divide into tertiary (segmental) bronchi?
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What is a bronchopulmonary segment?
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the right lung has {{c1::10}} BP segments, the left lung has {{c1::8}}
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Where are pulmonary arteries and veins located relative to bronchi at the hilus?
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Pulmonary veins- usually two per side, {{c1::superior}} and {{c1::inferior}}- return well oxygenated blood to the left atrium of the heart - indi…
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What is the difference b/w pulmonary and bronchial vessels (a/v)?
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Bronchial aa. follow the branching of the bronchial tree and are direct branches of the {{c1::descending aorta}}, and Bronchial vv. drain to the {{c1:…
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Lymphatics of the Lungs:- intrapulmonary lymph nodes drain to {{c1::bronchopulmonary}} nodes at the hilus of the lung- {{c1::bronchopulmonary}} nodes …
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Enlargement of the {{c1::inferior tracheobronchial}} lymph nodes can produce a {{c2::deviation of the carina}} that is visible on bronchoscopy. Enlarg…
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What does sympathetic innervation of the lungs cause?
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What does parasympathetic innervation of the lungs cause?
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Penetrating chest wounds that admit air into the pleural cavity ({{c1::pneumothorax}}) can equalize pleural and atmospheric pressures causing lung col…
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effect of sympathetic vs parasympathetic on smooth muscle in the pulmonary vessels?
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what is the carina? changes in the carina are signs of what?
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the great veins drain the {{c1::head}}, {{c1::neck}}, and {{c1::upper extremities}}
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the azygos vein drains {{c1::ipsilateral}} vessels on the right side
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are the thoracic sympathetic trunks considered to a part of the posterior mediastinum?{{c1::no}}
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the majority of lymph from the {{c1::inferior tracheobronchial}} nodes drains to the {{c2::right superior tracheobronchial nodes}}
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the inferior tracheobronchial (carinal) nodes receive lymph from both the {{c1::right and left inferior lobes}}
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the superior tracheobronchial nodes receive lymph from {{c1::ipsilateral}} lobes and from the {{c1::carinal}} nodes
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the right superior tracheobronchial nodes receive most drainage from the {{c1::inferior (carinal) tracheobronchial nodes}}
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the {{c1::paratracheal nodes}} ascend both sides of the trachea and receive lymph from the {{c1::superior tracheobronchial nodes}}
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any damage, impingement, or disorder that affects the {{c1::recurrent laryngeal nn.}} may damage a patient's voice
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because it is supplied by somatic intercostal and phrenic nn., irritation or damage to the {{c1::parietal pleura}} can produce local and referred pain…
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A {{c1::thoracentesis}} is a procedure where a needle is inserted through an intercostal space to sample or extract a foreign substance and is typical…
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A {{c1::pulmonary embolism}} is the blockage of a pulmonary artery
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Vertebral Line- line of pleural reflection- marks the reflection of {{c1::costal}} pleura to {{c1::mediastinal}} pleura posteriorly
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the bronchial vessels are primarily involved in supplying the {{c1::non-respiratory}} regions of the lungs
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