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MEDIASTINUM
MEDIASTINUM <ul><li>Central compartment of the thoracic cavity </li></ul><ul><li>Covered by mediastinal pleura </li></ul><...
MEDIASTINUM <ul><li>Surrounded by blood and lymphatic vessels </li></ul><ul><li>Lymph nodes, nerves and adipose tissues </...
Divisions of the Mediastinum <ul><li>SUPERIOR MEDIASTINUM </li></ul><ul><li>Superior  -  thoracic inlet </li></ul><ul><li>...
Divisions of the Mediastinum <ul><li>INFERIOR MEDIASTINUM </li></ul><ul><li>a.  ANTERIOR MEDIASTINUM </li></ul><ul><li>  -...
Superior Mediastinum <ul><li>Contents: (Anterior – Posterior) </li></ul><ul><li>1.  Thymus gland </li></ul><ul><li>- prima...
 
 
Superior Mediastinum <ul><li>Contents: </li></ul><ul><li>Arch of the Aorta </li></ul><ul><li>-  starts behind 2 nd  right ...
Superior Mediastinum <ul><li>Contents: </li></ul><ul><li>3.  Nerves </li></ul><ul><li>Vagus & Phrenic Nerves </li></ul><ul...
 
 
 
 
 
Anterior Mediastinum <ul><li>Smallest subdivision of the Inferior Mediastinum </li></ul><ul><li>Boundaries: </li></ul><ul>...
Posterior Mediastinum <ul><li>Boundaries: </li></ul><ul><li>Anterior -  Pericardium & Diaphragm </li></ul><ul><li>Posterio...
Thoracic Aorta <ul><li>Branches: </li></ul><ul><li>1. Bronchial Arteries 5.  Esophageal Arteries </li></ul><ul><li>2. Peri...
Esophagus <ul><li>Course: Superior to Posterior Mediastinum </li></ul><ul><li>Located behind: Arch of Aorta </li></ul><ul>...
Thoracic Duct <ul><li>Largest lymphatic channel in the body </li></ul><ul><li>Originates from Cisterna Chyle in the abdome...
Lymph Nodes of the  Posterior Mediastinum <ul><li>Posterior Mediastinal Lymph Nodes </li></ul><ul><li>- receives lymph fro...
Azygos Venous System of the Posterior Mediastinum <ul><li>Drains the back & thoracoabdominal walls and the mediastinal vis...
Azygos Venous System  of Posterior Mediastinum <ul><li>Hemiazygos Vein </li></ul><ul><li>- arises on left side of the vert...
Nerves of Posterior Mediastinum <ul><li>Thoracic Sympathetic Trunks </li></ul><ul><li>- lie against  heads of ribs in supe...
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Mediastinum

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Mediastinum

  1. 1. www.Examville.com Online practice tests, live classes, tutoring, study guides Q&A, premium content and more .
  2. 2. MEDIASTINUM
  3. 3. MEDIASTINUM <ul><li>Central compartment of the thoracic cavity </li></ul><ul><li>Covered by mediastinal pleura </li></ul><ul><li>Contents: all thoracic viscera EXCEPT lungs </li></ul><ul><li>Extent: </li></ul><ul><li>Superior - thoracic inlet </li></ul><ul><li>Inferior - diaphragm </li></ul><ul><li>Anterior - sternum & costal cartilages </li></ul><ul><li>Posterior- bodies of thoracic vertebrae </li></ul>
  4. 4. MEDIASTINUM <ul><li>Surrounded by blood and lymphatic vessels </li></ul><ul><li>Lymph nodes, nerves and adipose tissues </li></ul><ul><li>Looseness of structures enable mediastinum to accommodate changes in movement, volume & pressure in the thoracic cavity </li></ul>
  5. 5. Divisions of the Mediastinum <ul><li>SUPERIOR MEDIASTINUM </li></ul><ul><li>Superior - thoracic inlet </li></ul><ul><li>Inferior - transverse thoracic plane </li></ul><ul><li>Anterior - sternal angle </li></ul><ul><li>Posterior - IV disc T4 & T5 </li></ul><ul><li>INFERIOR MEDIASTINUM </li></ul><ul><li>Superior – transverse thoracic plane </li></ul><ul><li>Inferior - diaphragm </li></ul>
  6. 6. Divisions of the Mediastinum <ul><li>INFERIOR MEDIASTINUM </li></ul><ul><li>a. ANTERIOR MEDIASTINUM </li></ul><ul><li> - contains thymus remnant, lymph nodes & fats </li></ul><ul><li>b. MIDDLE MEDIASTINUM </li></ul><ul><li> - contains the heart & great vessels </li></ul><ul><li>c. POSTERIOR MEDIASTINUM </li></ul><ul><li> - contains esophagus, great vessels,vagus nerves & symphathetic trunks </li></ul>
  7. 7. Superior Mediastinum <ul><li>Contents: (Anterior – Posterior) </li></ul><ul><li>1. Thymus gland </li></ul><ul><li>- primary lymphoid organ located behind manubrium </li></ul><ul><li>- puberty undergoes gradual involution </li></ul><ul><li>2. Great Vessels </li></ul><ul><li>Brachiocephalic Veins </li></ul><ul><li>Superior Vena Cava </li></ul><ul><li>- formed at level of 1 st right costal cartilage </li></ul><ul><li>- enters right atrium at level of 3 rd right costal cartilage </li></ul>
  8. 10. Superior Mediastinum <ul><li>Contents: </li></ul><ul><li>Arch of the Aorta </li></ul><ul><li>- starts behind 2 nd right SC joint </li></ul><ul><li>- ends at 2 nd left SC joint </li></ul><ul><li>Branches: </li></ul><ul><li>Brachiocephalic Trunk </li></ul><ul><li>Left Common Carotid Artery </li></ul><ul><li>Left Subclavian Artery </li></ul>
  9. 11. Superior Mediastinum <ul><li>Contents: </li></ul><ul><li>3. Nerves </li></ul><ul><li>Vagus & Phrenic Nerves </li></ul><ul><li>Cardiac Plexus of Nerves </li></ul><ul><li>Left Recurrent Laryngeal Nerve </li></ul><ul><li>4. Trachea </li></ul><ul><li>5. Esophagus </li></ul><ul><li>6. Thoracic Duct </li></ul><ul><li>7. Prevertebral Muscles </li></ul>
  10. 17. Anterior Mediastinum <ul><li>Smallest subdivision of the Inferior Mediastinum </li></ul><ul><li>Boundaries: </li></ul><ul><li>Anterior : body of sternum & trans thoracis muscles Posterior : pericardium </li></ul><ul><li>Contents: Loose CT (Sternopericardial Ligament) </li></ul><ul><li> Adipose tissue </li></ul><ul><li> Lymphatic Vessels & lymph nodes </li></ul><ul><li> Branches of Internal Thoracic Vessels </li></ul>
  11. 18. Posterior Mediastinum <ul><li>Boundaries: </li></ul><ul><li>Anterior - Pericardium & Diaphragm </li></ul><ul><li>Posterior - T5 to T12 vertebrae </li></ul><ul><li>Contents: </li></ul><ul><li>Thoracic Aorta Esophagus & Plexus </li></ul><ul><li>Thoracic Duct Thoracic Sympathetic Trunks </li></ul><ul><li>Post Mediastinal LN Thoracic Splanchnic Nerve </li></ul><ul><li>Azygos & Hemiazygos Veins </li></ul>
  12. 19. Thoracic Aorta <ul><li>Branches: </li></ul><ul><li>1. Bronchial Arteries 5. Esophageal Arteries </li></ul><ul><li>2. Pericardial Arteries 6. Mediastinal Arteries </li></ul><ul><li>3. Post. Intercostal Arteries 7. Subcostal Arteries </li></ul><ul><li>4. Superior Phrenic Arteries </li></ul><ul><li> </li></ul>
  13. 20. Esophagus <ul><li>Course: Superior to Posterior Mediastinum </li></ul><ul><li>Located behind: Arch of Aorta </li></ul><ul><li> Pericardium & Left Atrium </li></ul><ul><li>Enters Esophageal Hiatus of the Diaphragm at level of T10 </li></ul><ul><li>Anatomic Impressions or “Constrictions”: </li></ul><ul><li>1. Crossing with Aortic Arch </li></ul><ul><li>2. Crossing with Left Main Bronchus </li></ul><ul><li>3. Diaphragmatic Hiatus </li></ul>
  14. 21. Thoracic Duct <ul><li>Largest lymphatic channel in the body </li></ul><ul><li>Originates from Cisterna Chyle in the abdomen & passes thru aortic hiatus of diaphragm at level of T12 </li></ul><ul><li>Relations: Posterior : bodies of inferior 7 thoracic vertebrae </li></ul><ul><li> Anterior : Esophagus </li></ul><ul><li> Left : Thoracic Aorta </li></ul><ul><li> Right : Azygos Vein </li></ul><ul><li>Conveys lymph from: </li></ul><ul><li>Lower extremities Left side of thorax </li></ul><ul><li>Pelvic Cavity Left side of H & N </li></ul><ul><li>Abdominal Cavity Left upper limb </li></ul>
  15. 22. Lymph Nodes of the Posterior Mediastinum <ul><li>Posterior Mediastinal Lymph Nodes </li></ul><ul><li>- receives lymph from esophagus, posterior aspect of the pericardium & diaphragm & middle posterior ICS </li></ul>
  16. 23. Azygos Venous System of the Posterior Mediastinum <ul><li>Drains the back & thoracoabdominal walls and the mediastinal viscera </li></ul><ul><li>Azygos Vein </li></ul><ul><li>- forms a collateral pathway b/w SVC & IVC </li></ul><ul><li>- passes to the right side of inferior 8 thoracic vertebrae </li></ul><ul><li>- arches over the root of the right lung to enter the SVC </li></ul><ul><li>- receives posterior intercostal veins, mediastinal, esophageal & bronchial veins </li></ul>
  17. 24. Azygos Venous System of Posterior Mediastinum <ul><li>Hemiazygos Vein </li></ul><ul><li>- arises on left side of the vertebral column to level of T9 </li></ul><ul><li>- receives the inferior 3 PIV, inferior esophageal veins, </li></ul><ul><li>small mediastinal veins </li></ul><ul><li>Accessory Hemiazygos Vein </li></ul><ul><li>- starts at medial end of 4 th or 5 th ICS </li></ul><ul><li>- descends on left of VC from T5 thru T8 </li></ul><ul><li>- crosses to the right to join the Azygos Vein </li></ul><ul><li>- receives 4 th thru 8 th IC Veins </li></ul><ul><li>- communicates with Superior IC Vein which drains </li></ul><ul><li>1 st thru 3 rd ICS </li></ul>
  18. 25. Nerves of Posterior Mediastinum <ul><li>Thoracic Sympathetic Trunks </li></ul><ul><li>- lie against heads of ribs in superior thorax costovertebral joints in midthorax sides of vertebral bodies in lower thorax </li></ul><ul><li>Lower Thoracic Splanchnic Nerves </li></ul><ul><li>(Greater, Lesser and Least SN) </li></ul><ul><li>- presynaptic fibers from 5 th thru 12 th sympathetic ganglia </li></ul><ul><li>- sympathetic innervation for most abdominal viscera </li></ul>
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