The document summarizes the anatomy of the mediastinum. It defines the sternal angle as the joint between the manubrium and sternum. The mediastinum is divided into superior, middle, and posterior sections. The middle mediastinum contains the heart enclosed by the pericardium as well as the great vessels attached to it like the aorta and pulmonary trunk. The document lists the structures found in each section of the mediastinum.

1. Anatomy practical 1
(Middle Mediastinum)
By : Osama Al-Zahrani
@OSAMA_Z96

2. Sternal angle
• The sternal angle (angle of Louis) is the synarthrotic joint formed by the
articulation of the manubrium and the body of the sternum.
• Marks the approximate level of the 2nd pair of costal cartilages, which attach to
the second ribs, and the level of the intervertebral disc between T4 and T5.

3. Structure of Sternal angle

4. Structure of Sternal angle

5. Mediastinum
• Is structure between the 2 lungs.
• The mediastinum contains the heart and its vessels, esophagus, trachea, phrenic, cardiac nerves,
thoracic duct, thymus, lymph nodes.
• The mediastinum is divided into an upper (or superior) and lower (or inferior) part.
• The lower (or inferior) part are divided into :
- The anterior mediastinum being in front of the pericardium,
- The middle mediastinum contains the pericardium and its contents,
- and the posterior mediastinum being behind the pericardium.

6. Mediastinum

7. Mediastinum

8. Lateral view of Mediastinum

9. Divisions of Mediastinum

10. Superior Mediastinum
(Contents)
1- Arteries:
• Arch of Aorta
• Brachiocepalic artery
• Left Common carotid
• Left subclavian artery
2- Veins:
• Superior vena cava.
• Left & Right brachiocephalic veins,
• Left Sup Intercostal vein
3- Trachea & Esophagus.
4- Nerves.
5- Lymph nodes.
6- Muscles.
7- Thymus.

11. Superior Mediastinum

12. Superior Mediastinum

13. Superior & Middle Mediastinum

14. • Thymus (in children)
• Sternopericardial ligamint.
• Internal thoracic artery & branches
• Lymphatics & Lymph nodes
Anterior Mediastinum
(Contents)

15. Middle Mediastinum
- The middle mediastinum is the area bounded by the pericardium which
contains the heart and the great vessels that attached to it .
- Contents :
• Heart : Enclosed in pericardium
• Arteries: Ascending Aorta, Pulmonary trunk with its Left & Right branches.
• Veins : Superior & Inferior vena cava, 4 Pulmonary veins.

16. Posterior Mediastinum

17. Structure of Middle Mediastinum
Middle
Mediastinum
Heart
Pericardium

18. Structure of Middle Mediastinum

19. - Esophagus.
- Arteries.
- Veins.
- Descending Aorta.
- Nerves.
- Thoracic duct.
- Lymph nodes.
- Posterior mediastinal.
Posterior Mediastinum
(Contents)

20. Posterior Mediastinum