Organization of the thoracic viscera
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| show | Superior Thoracic Outlet
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| show | Trachea, esophagus, vessels and nerves
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| show | Manubrium, T1 vertebra, First pair of ribs and cartileges
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| What is the bottom opening of the thorax called? | show 🗑
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| show | T12 vertebra, coastal margin (ribs 7-10), and the xiphosternal joint; bound at the bottom by the diaphragm and the abdominal viscera
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| What are the major areas of the thoracic cavity? | show 🗑
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| What prevents the lungs from bulging out through the superior thoracic outlet? | show 🗑
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| show | Thin sereous membrane covering the surface of the lungs and lining the walls, roof, and floor of the pleural cavities
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| show | mesothelium (simple squamous epithelium) and connective tissue
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| What pleura lines the walls, roof, and floor of the pleural cavities? | show 🗑
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| show | Visceral pleura
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| show | At the root of the lung
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| show | Costal pleura (thoracic wall), cervical pleura (through thoracic inlet into neck), diphragmatic pleura (covers diaphragm), mediastinal pleura (mediastinum of the pleural sac)
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| What is the pulmonary ligament and where is it located? | show 🗑
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| show | They are sharp lines of reflection where the pleura becomes continous with the mediastinal and the diaphragmatic pleura
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| Trace the path of the right pleura | show 🗑
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| show | Anterior reflection deviates laterally at the level of the 4th rib; lateral to the sternum at the level of 5th and 6h intercostal spaces; swings out and down along 7th costal cartilage; cardiac notch
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| Where is the cardiac notch located? | show 🗑
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| show | The mediastinum
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| What are the divisions of the mediastinum? | show 🗑
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| Where does the superior mediastinum become the inferior mediastinum (e.g. major landmark/border?) | show 🗑
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| show | The pericardial sac and its contents
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| Where are most of the structures of the superior mediastinum located? | show 🗑
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| show | Thymus, brachiocephalic veins and superior vena cava, aortic arch and its three branches, the vagus and the phrenic nerves, cardiac plexus of nerves, left recurrent laryngeal nerve (not the right), trachea, esophagus, thoracic duct, lymph nodes
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| show | Thoracic aorta, thoracic duct, Azygous veins, esophagus and esophageal plexus, thoracic sympathetic trunks, thoracic splanchnic nerves
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| What vertebrae does the posterior mediastinum span? | show 🗑
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| show | In the anterior mediastinum; immediately behind the manubrium, though it may extend to the base of the neck
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| show | Behind the sternal angle
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| What two structures lie immediately to the left and right of the esophagus and the trachea above the root of the lung? | show 🗑
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| show | To the right border of the sternal angle
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| What path does the (arch of the) aorta follow? | show 🗑
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| show | The right pulmonary artery and the left principal bronchus
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| show | Brachiocephalic trunk, left common carotid artery, left subclavian artery
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| What is the path of the brachiocephalic trunk? | show 🗑
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| What is the path of the left common carotid artery? | show 🗑
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| What is the path of the left subclavian artery? | show 🗑
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| show | All are crossed anteriorly by the left brachiocephalic trunk.
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| What is the coarctation of the aorta? | show 🗑
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| show | Subclavian arteries-->internal thoracic arteries-->anterior intercostal arteries-->posterior intercostal arteries (backward flow)-->descending aorta
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| show | Intercostal space pulse felt, lack of femoral pulse, notching of the inferior border of the ribs (on X-ray); these occur because of increased pressure-->dilation of arteries
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| What two veins come together to give the brachiocephalic vein? Where do they join up? | show 🗑
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| Where does the superior vena cava enter the right atrium of the heart? | show 🗑
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| Describe the position of the vagus nerves in the 1) root of the neck, 2) at the level of the root of the lung | show 🗑
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| show | arise from vagus nerves and ascend to supply larynx; LEFT: hooks around left side of the arch of aorta BEHIND ligament arteriosum and ascends groove between trachea + esophagus; RIGHT: hooks around right subclavian in root of neck (not in mediastinum)
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| What nerves supply tributaries to the Phrenic nerves? | show 🗑
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| What is the path of the Phrenic nerves? | show 🗑
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| What functions do the phrenic nerves supply? | show 🗑
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| show | From pharynx (C6), enters superior mediastinum (between trachea and vert. column and behind left principal bronchus); enters post. medias. to right of aorta behind pericardium and left atrium; turns left crossing front of aorta; crosses diaphragm at T10
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| show | At pharynx/esophageal joint (C6), contact with arch of the aorta, contact with left principal bronchus, esophageal hiatus of diaphragm; runs directly behind the left atrium
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| What is the esophageal plexus? | show 🗑
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| Where does the descending thoracic aorta begin? What path does it follow? | show 🗑
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| What are the thoracic branches of the aorta? | show 🗑
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| What is the primary purpose of the azygous venous system? | show 🗑
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| What are the left/right assymetries of the azygous venous system? | show 🗑
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| What are the major tributaries of the azygous vein? | show 🗑
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| show | Begins in abdomen as dilated sac (aka Cysterna chyli); ascends through aortic hiatus --> goes upward o the right of the aorta, between aorta and azygous vein; at T5, crosses to left and reaches border of esophagus at sternal angle
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| Where does the thoracic duct empty? | show 🗑
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