Mediastinum and Pericardiums

University:
The University Of Western Ontario
Course:
ANAT 2200B | Systemic Anatomy of the Human Body
Academic year:

2022
Views:

180

Pages:

6
Author:

Kyuwon J.

Mediastinum ● Central compartment with thoracic cavity ● Between pleural sacs ○ Superiorly ■ Thoracic inlet ○ Inferiorly ■ Diaphragm ○ Anteriorly ■ Sternum ○ Posteriorly ■ Vertebral bodies ● Division of Mediastinum ○ Transverse thoracic planes ■ Sternal angels ● T4/T5 ● Carnia ● Beginning and end of aortic arches ● Compartment ○ Superior mediastinum ○ Inferior mediastinum ■ Anterior ■ Middle ■ Posterior Superior Mediastinum ● Structures ○ Anterior ⇒ posterior ○ Thymus ○ Great veins ■ SVC ■ Branchiocephalic veins ○ Arch of aorta and its branches ■ Branchiophalic trunk ■ Left common carotid ■ Left subclavian ○ Vagus nerves ○ Phrenic nerves ○ Left recurrent laryngeal nerve ○ Trachea ○ Esophagus ○ Thoracic duct Cx ● Left recurrent laryngeal nerves ○ Loop under aortic arches ○ Compressed through aneurysm ○ Hoarseness ● SVC ○ Compression ○ Facial swelling and venous distensions Inferior Mediastinum ● Anterior Mediastinum ○ Sternum ○ Pericardium ● Fat ● Lymph nodes ● Thymus remnants ○ Adults ● 4Ts ● Thymoma Classical path ● 4 Ts ● Thymoma ● Teratoma ● Thyroid mass ● Terrible lymphoma Pericardiums ● Fibro-serous sac ● Enclosure of heart ○ Proximal great vessels ● Functions ○ Fixtures on heart in the mediastinum ○ Limitation of acute ⇒over distensions ○ Providing low friction once beating ● Layers ○ Fibrous pericardium ■ Inelastic ■ Strong ■ Adventitia ⇒ Greater vessels ○ Attachment ■ Central tendon diaphragm ■ Posterior sternum ● Sternopericardial ligaments ○ Serous pericardium ■ Inner ■ Parietal layer ● Lines inside the fibrous pericardiums ■ Visceral layers ● Epicardium ● On heart surface ■ Pericardial cavity ● Between the parietal and visceral serous layers ● Containing thin lubrication of film Innervations ● Fibrous and parietal pericardiums ○ Phrenic nerves ○ C3-C5 ○ Shoulder ■ C4 dermatomes ○ Visceral pericardiums ■ Epicardium ■ Autonomic ■ Less pain sensitive Pericardial Sinuses ● Surgical anatomy ● Transverse pericardial sinus ○ Passage behind ascending aorta and pulmonary trunk ○ Anterior of SVC and atria regions ○ Cx ■ Surgeons pass clamps and finger through control outflow vessels ○ Oblique pericardial sinus ■ Blind recess posterior to left atrium ■ Bounded by reflection of pulmonary veins and IVC ○ Pericardial blood supply + drainage ■ Arterial ● Mainly pericardiophrenic ● From internal thoracic ■ Venous ● Pericardiophrenic veins ● Branchiocephalic systems ● Others ■ Lymphatics ● Tracheobronchial ● Mediastinal nodes