CHAPTER 25

Question 1

definition (basic)

• the mediastinum is the space between the _____ and _____ of the thorax
• -from latin media = middle and intstinum = intestine
• -thus, it is the _____
• -this space contains all organs of the _____ with the exception of the _____
• -to understand the concept of the mediastinum, the _____, you must first describe the pleura itself

Answer 1

right pleura 
left pleura 
interplerual space 
thorax
lungs
interpleural space

Question 2

pleura

• the pleura is a _____, _____ located within the _____ on both the right side and the left side
• -histologically, a serous membrane is a _____ membrane composed of an _____ and an _____ layer
• -the pleura is subdivided, according to _____, into _____ and _____ pleura
• visceral pleura
• -the visceral pleura covers the _____ of the lungs at all points except the _____ (the location where all structures that enter or leave the lung pass)
• -it dips into the fissures that separate the _____ of the lung
• -visceral pleura is _____ to pain, containing few _____
• -visceral pleura does have sufficient blood supply via the _____, which are direct branches of the _____

Answer 2

thin
serous membrane
thoracic cavity 
double layered
inner mesothelium
outer connective tissue
location 
parietal pleura
visceral surface
hilus
lobes
insensitive 
nerve fibers
bronchial arteries
descending thoracic aorta

Question 3

parietal pleura

• the parietal pleura is the pleura lining the _____ surface of the _____, _____, and _____
• unlike the visceral pleura, the parietal pleura has a rich _____ and is _____ to pain
• like the visceral pleura, the parietal pleura also has rich _____, derived from the following:
• -_____ arteries
• -_____ arteries
• the parietal pleura is subdivided into four parts:
• -the _____ is the portion of the parietal pleura that lines the sternum, ribs, and intercostal muscles
• -the _____ is the portion of the parietal pleura that courses over the _____ of the lungs; it reaches as high as the _____ of the _____ rib
• -the _____ is the portion of the parietal pleura covering the upper surface of the diaphragm
• -the _____ is the portion of the parietal pleura that forms the lateral boundaries of the mediastinum. it lines the _____ and _____ surfaces of the pericardium
• areas where two parts of the parietal pleura join (areas not usually occupied by the lung) are referred to as _____; two such recesses exist
• -the _____ is the reflection of parietal pleura at the junction of _____ and _____; the _____ border of the lung fills this recess during _____ breathing
• -the _____ is the reflection of parietal pleura at the junction of _____ and _____; the _____ border of the lung fills this recess during _____ breathing

Answer 3

internal 
thoracic wall
diaphragm 
mediastinum
nerve supply 
sensitive 
blood supply
posterior intercostal 
internal thoracic 
costal parietal pleura 
cupolas (cervical) parietal pleura 
apex
neck
first
diaphragmatic parietal pleura
mediastinal parietal pleura 
outer
lateral
recesses 
costomediastinal recess
costal pleura
mediastinal pleura 
anterior
strenuous 
costodiaphragmatic recess
costal pleura 
diaphragmatic pleura
inferior strenuous

Question 4

pleural cavity

• the pleural cavity is the space between the _____ and the _____
• this space is of _____ thickness and is filled with a think film of _____
• this cavity is maintained in a state of continuous _____
• -this negative pressure keeps the _____ and the _____ adjacent to the _____ (and thus to the thoracic wall and diaphragm
• -thus, any movement in the thoracic wall and diaphragm is reflected in a corresponding movement of the lung
• -this is the basis of _____
• if for any reason the negative pressure is lost such as because of a chest wound, the lung would _____ because of its inherent _____ (_____ would _____)
• -collapse of a lung is called _____, and the presence of air in the pleural cavity is called _____

Answer 4

parietal pleura
visceral pleura
capillary 
fluid
negative pressure
visceral pleura 
lung
parietal pleura 
breathing
collapse
elasticity
internal elastic fibers 
shorten
atelectasis
pneumothorax

Question 5

definition (expanded)

• the mediastinum can now be accurately defined as the space between the _____ and the _____
• it extends from the _____ anteriorly to the _____ posteriorly
• it extends from the level of the _____ superiorly to the _____ inferiorly
• the mediastinum is further subdivided into four mediastina:
  1. _____
  2. _____
  3. _____
  4. _____

Answer 5

right mediastinal pleura
left mediastinal pleura 
sternum
vertebral column
thoracic inlet
diaphragm
anterior mediastinum 
superior mediastinum 
middle mediastinum
posterior mediastinum

Question 6

contents of the mediastina

• anterior mediastinum
• -_____
• -_____
• superior mediastinum
• -_____
• -great vessels (_____, _____, _____)
• -_____
• -_____ (_____ cm long, conduit for food from the _____ to the stomach)
• -_____
• -_____ and _____
• -_____
• -_____ (drains blood from the posterior thoracic wall; drains into the _____)
• middle mediastinum
• -_____
• -great vessels (_____, _____, _____)
• -_____
• -_____
• posterior mediastinum
• -_____
• -_____
• -_____
• -_____
• -_____
• -_____
• general notes
• -certain structures are located in both the _____ and _____ mediastina
• -the _____ are the only thoracic structures not within he mediastina

Answer 6

loose connectie tissue
thymus
thymus 
aorta 
SVC
pulmonary trunk
brachiocephalic veins
trachea
esophagus 
25
pharynx 
thoracic duct 
vagus nerve 
recurrent laryngeal nerve 
phrenic nerve 
azygos vein 
SVC
heart
SVC
aorta
pulmonary trunk 
pericardium
phrenic nerve
thoracic aorta
esophagus 
thoracic duct 
vagus nerve
azygos vein
sympathetic trunk
posterior 
superior 
lungs

Question 7

diaphragm

• the diaphragm forms the _____ boundary of the thorax
• openings:
• -_____: caval opening for inferior vena cava
• -_____: esophageal hiatus for the esophagus and CN X, vagus nerve
• -_____: aortic hiatus for the aorta

Answer 7

inferior
TV8
TV10
TV12