Post on 30-Sep-2018
transcript
1
Superior and Posterior
Mediastinum• Surface anatomy and heart sounds
-Dry lecture
-Gray’s 169, 203-205
• Mediastinum
-Gray’s pp. 181-199
-Gray’s dissector pp. 102-112
• Review
-Gray’s dissector pp. 44-45
-Gray’s dissector pp. 113-114
Review of the Subdivisions of the Mediastinum
Syllabus p. 50
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Superior Mediastinum:Thymus
Arch of the Aorta
Syllabus p. 51
3
Arch of the Aorta
Aortic Angiogram
4
Brachiocephalic Veins and Superior Vena Cava
*key feature – left brachiocephalic vein is twice as long as the right brachiocephalic vein
Brachiocephalic Veins and Superior Vena Cava
Syllabus p. 106
5
A central venous line is required to administer large amounts of
fluid to a patient. The line is introduced in the left internal jugular
vein and the tip is subsequently passed to the right atrium. Identify
the correct course of the venous line.
Lef
t inte
rnal
jugula
r v.,.
..
Lef
t inte
rnal
jugula
r v.,.
..
Lef
t inte
rnal
jugula
r v.,.
..
Lef
t inte
rnal
jugula
r v.,.
..
Lef
t inte
rnal
jugula
r v...
.
20% 20%
40%
20%
0%
A. Left internal jugular v., left subclavian v., leftbrachiocephalic v., superior vena cava, rightatrium
B. Left internal jugular v., left subclavian v.,superior vena cava, right atrium
C. Left internal jugular v., left brachiocephalic v.,superior vena cava, right atrium.
D. Left internal jugular v., left axillary v., leftsubclavian v., left brachiocephalic v., superiorvena cava, right atrium
E. Left internal jugular v., superior vena cava, rightatrium
A surgeon needs to close a patent ductus arteriosus.
The surgeon needs to avoid the ________ nerves that
course around the patent ductus arteriosis.
right v
agus
and re
cu...
right p
hrenic
and re
c...
C. l
eft v
agus
and p
hr...
D. l
eft v
agus
and re
cu...
E. l
eft p
hrenic
and re
c...
20% 20%
40%
0%
20%A. right vagus and recurrent laryngeal
B. right phrenic and recurrentlaryngeal
C. left vagus and phrenic
D. left vagus and recurrent laryngeal
E. left phrenic and recurrent laryngeal
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Nerves of the Superior Mediastinum
Syllabus p. 52
Trachea and Esophagus
Syllabus p. 108
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Nerves of the Posterior Mediastinum
Syllabus p. 53
Vasculature of the Posterior Mediastinum
Syllabus p. 54
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Thoracic Duct and Azygos System of Veins
Posterior Mediastinum (Thoracic Aorta)
Syllabus p. 55
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During surgery in the left abdomen the lymphatics that
drain to the thoracic duct are accidentally damaged. The
thoracic duct drains into the ____________
junct
ion o
f the
right i
n...
left
brach
ioce
phalic
v.
C. r
ight b
rach
ioce
pha...
D. j
unctio
n of t
he le
ft ...
E. j
unctio
n of t
he ao
rt..
20% 20% 20%20%20%
A. junction of the right internaljugular and subclavian vv.
B. left brachiocephalic v.
C. right brachiocephalic v.
D. junction of the left internaljugular vein and subclavian vv.
E. junction of the aortic arch andleft common carotid a.
Putting It All Together
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Putting It All Together
To The Students
You will remember a little of what you hear,
some of what you read,
considerably more of what you see,
but almost all of what you understand
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Screen 2
Review of the Subdivisions of the Mediastinum
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Arch of the Aorta
Aortic Angiogram
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Brachiocephalic Veins and Superior Vena Cava
Left Vagus Nerve
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Right Vagus Nerve
Trachea and Esophagus
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Thoracic Duct and Azygos System of Veins
Posterior Mediastinum (Thoracic Aorta)
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Putting It All Together
Putting It All Together