for thoracic surgery anatomy of mediastinum is utmost and your need to learn it.

1. Mediastinum Anatomy
Dr Ibrahim Baloch
Resident, Thoracic surgery
department
Combined Military Hospital
Rawalpindi, Pakistan

2. Mediastinum
• The Mediastinum is a compartment located between
two pleural sacs.
• It is a thick, broad, midline, bulky partition between
two lungs.
• It goes from the sternum anteriorly to the thoracic
vertebrae posteriorly.
• Also it goes from the superior thoracic aperture to
the inferior thoracic aperture.

5. Superior Mediastinum:
Boundaries
• Ant: 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

6. Superior Mediastinum:
contents
• Muscles:
Sternohyoid
Sternothyroid
• Thymus: in childhood & puberty
• Trachea & Esophagus
• Thoracic Duct

7. • Veins
o SVC
o Lt & Rt brachiocephalic veins
o Supreme intercostal veins
o Lt Superior Intercostal vein
• Arteries:
o Arch of Aorta
o Brachiocephalic artery
o Lt Common carotid
o Lt subclavian artery
Superior Mediastinum:
contents

8. • Nerve
• Vagus
• Left recurrent nerve
• Phrenic
• Cardiac plexus
• Lymph node
• Brachiocephalic
• tracheobronchial
Superior Mediastinum:
contents

9. SUPERIOR MEDIASTINUM

10. SUPERIOR MEDIASTINUM

11. SUPERIOR MEDIASTINUM

12. Anterior Mediastinum:
Boundaries
• Ant: Body of sternum
• Post: pericardium
• Sides: Mediastinal pleura
• Sup: Imaginary line separating sup & inf
mediastinum
• Inf: Diaphragm

13. Anterior Mediastinum:
contents
• Thymus (Children)
• Sternopericardial ligaments
• Internal thoracic artery &
branches
• Lymphatics & Lymph nodes

14. Middle Mediastinum:
Boundaries
• Anterior:
– Anterior margin of the pericardium.
• Posterior:
– Posterior border of the pericardium.
• Laterally:
– pleura of the lungs.
• Superiorly:
– Line extending between the sternal angle (the angle formed
by the junction of the sternal body and manubrium) and the
T4 vertebrae.
• Inferiorly:
– Superior surface of the diaphragm.

15. Middle Mediastinum:
contents
• Heart enclosed in pericardium
• Arteries: Ascending Aorta,
Pulmonary trunk with its
branches
• Veins: SVC, Termination of
Azygos, Pulmonary veins
• Nerves: Phrenic, Deep cardiac
plexus
• Bifurcation of Trachea with two
principal bronchi
• Tracheobronchial lymph nodes

16. Posterior
Mediastinum:
Boundaries
Ant. Pericardium, Bifurcation of
trachea
Post. T5 to T12
sup. Line extending between the sternal and
theT4 vertebrae
Inf. diaphragm
Sides: Mediastinal pleura

17. Posterior
Mediastinum:
contents
• Esophagus
• Thoracic duct
• Arteries : Descending Aorta with its brs
• Veins: Azygos, Hemiazygos & Accessory
hemiazygos
• Nerves: Vagus & Splanchnic nerves
• Lymph nodes: Posterior mediastinal

18. POSTERIOR MEDIASTINUM

19. POSTERIOR MEDIASTINUM

20. POSTERIOR MEDIASTINUM

21. POSTERIOR MEDIASTINUM

22. POSTERIOR MEDIASTINUM