Mediastinum

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TS: Mediastinum

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CS: Mediastinum

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Mediastinum: Lateral view

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Divisions of Mediastinum

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• Parts of mediastnum on a chest xray7

Superior Mediastinum

BoundariesAnt: Manubrium sterni

Post: T-1 to T-4

Sides: Mediastinal pleura

Sup: Plane of thoracic inlet

Inf: Imaginary line joining sternal angle and lower border T-4

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Superior Mediastinum

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SUP & MIDDLE MEDIASTINUMSUP & MIDDLE MEDIASTINUM

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Superior Mediastinum: Contents:

Muscles: • Sternohyoid• Sternothyroid • Longus colliThymus: (in childhood

& puberty) Veins: • SVC• Lt & Rt

brachiocephalic veins, • Lt Sup Intercostal vein Arteries:• Arch of Aorta • Brachiocepalic artery• Lt Common carotid • Lt subclavian artery

Trachea & EsophagusNerves:• Vagus • Phrenic • Cardiac & • Lt recurrent laryngeal

nerve (b/w trachea & oesophagus)

Thoracic DuctLymph nodes:• Brachiocephalic,• Tracheobronchial,

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SECTION at T-4

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Anterior Mediastinum-(narrowest)BoundariesAnt: Body of sternumPost: PericardiumSides: Mediastinal pleuraSup: Imaginary planeInf: Diaphragm

Contents• Thymus (in children)• Sternopericardial lig.• Internal thoracic artery &

branches• Lymphatics & Lymph nodes

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Middle Mediastinum: Boundaries

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Middle MediastinumContents:

Heart enclosed in pericardium

Arteries: Ascending Aorta, Pulmonary trunk with its Lt & Rt branches

Veins: SVC, Termination of Azygos, Pulmonary veins

Nerves: Phrenic, Deep cardiac plexus

Bifurcation of Trachea with two principal bronchi

Tracheobronchial lymph nodes

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Posterior Mediastinum

Boundaries:

Ant. Pericardium, Bifurcation of trachea

Post. T5 to T12

sup. Transverse thor plane

Inf. diaphragm

Sides: Mediastinal pleura

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Posterior MediastinumContents: Oesophagus Arteries • Descending Aorta with

its brs Veins • Azygos• Hemizygos • Accessory hemizygos Nerves: • Vagus• Splanchnic nervesThoracic ductlymph nodes• Posterior mediastinal

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Applied Anatomy:Applied Anatomy:

MediastinitisFrom infections of neckPus under prevertebral fascia reach Pus under prevertebral fascia reach till T4 only, not beyond it, as PV fascia till T4 only, not beyond it, as PV fascia is attached hereis attached here

Pus b/w pretracheal and prevertebral Pus b/w pretracheal and prevertebral fascia seeps through sup. fascia seeps through sup. Mediastinum to reach post. Mediastinum to reach post. MediastinumMediastinum In front of pretracheal fascia to ant In front of pretracheal fascia to ant mediastinummediastinum

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Mediastinal syndrome-•Engorgment of veins•Dyspnea•Dysphagia•Hoarseness of voice

Mediastinal widening

Mediasinal shift

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THANK YOU

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