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central region of thoracic cavity, between two pleural cavities
borders of mediastinum
superior thoracic aperature
pleural cavities and lungs
thoracic vertebrae
anterior and posterior landmarks that divide the mediastinum into superior and inferior portions
sternal angle
disc between T4/T5
What subdivides the inferior portion of the mediastium into anterior, middle and posterior parts?
pericardium divides inferior mediastium into what subdivisions?
-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
layers of pericardium
-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
great vessels
large arteries and veins that are attached to the heart:
-pulmonary trunk
-superior vena cava (SVC)
-pulmonary veins
superior vena cava
formed by the convergence of left and right brachiocephalic veins (enters the RA of heart)
ascending aorta
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
aortic arch
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.
branches off aortic arch
-brachiocephalic trunk (BT)
-left common carotid
-left subclavian arteries
pulmonary trunk
arises from the right ventricle of the heart and bifurcates into the right and left pulmonary arteries (carry deoxygenated blood to the lungs)
pulmonary veins
4 veins that carry oxygenated blood from the lungs to the left atrium
ductus arteriosus
channel between pulmonary trunk and aortic arch during fetal circulation, allows blood to bypass the non-functioning lungs in the fetus
ligamentum arteriosum
remnant of the ductus arteriosus in adults- between pulmonary trunk and aortic arch
position of trachea in mediastinum
found posterior to great vessels in the midline, bifurcates into the primary bronchi at approximately the T4 vertebral level
located directly posterior to the trachea, exits the thoracic cavity through a hole in the diaphragm (the esophageal hiatus)
phrenic nerves
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
vagus nerves
-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
left recurrent laryngeal nerve
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
right recurrent laryngeal nerve
branch of vegas, but UNLIKE LEFT, not in the mediastinum
travels around the right subclavian artery in the neck
thoracic duct
-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
tracheobronchial lymph nodes
large group of nodes
surrounding the tracheal bifurcation
receive lymphatic drainage from the lungs
right coronary artery
emerges from ascending aorta, near tip of right auricle
travels in the coronary sulcus (bt right atrium and ventricle)
3 important branches
3 important branches of right coronary artery
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
left coronary artery
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
right dominant pattern
typical pattern of coronary circulation, where right coronary artery supplise more territory than the left
left dominate pattern
posterior interventricular artery arises from the circumflex branch (rather than the right coronary artery)
myocardial infarction (MI)
death of heart tissue due to lack of blood flow
coronary sinus
sac-like structure on the posterior side of the heart that empties into the right atrium, where most venous blood from heart tissue connects
3 major coronary veins
great cardiac vein
middle cardiac vein
small cardiac vein
great cardiac vein
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
middle cardiac vein
travels in the posterior interventricular sulcus with the posterior interventricular artery
terminates in the coronary sinus
small cardiac vein
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

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