THE MIDDLE

MEDIASTINUM
INTRODUCTION
• The middle mediastinum is one of those divisions of
the space between both plurae and lungs.
• It mostly houses the heart,great vessels, and
related nerves and lymphatics.
• The Inferior mediastinum is divided into anterior,
middle, and posterior mediastina.
• The anterior mediastinum is anterior to the middle
mediastinum, and the posterior mediastinum is
found posterior to the middle mediastinum..
• In this article,we shall look into detail,the middle
mediastinum.
BORDERS
• The middle mediastinum is bordered by the
following thoracic structures:
• Anterior: Anterior margin of the pericardium.
• Posterior: Posterior border of the pericardium.
• Laterally: Mediastinal pleura of the lungs.
• Superiorly: Imaginary 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.
CONTENTS
• Organs
• The middle mediastinum contains the heart, and its
protective sheath, the pericardium. It also contains
the tracheal bifurcation and the left and right main
bronchi.
CONTENTS
• VESSELS
• The middle mediastinum is associated with the origins of the great
vessels that run to and from the heart:
• Ascending aorta – the first part of the aorta, which arises from the
aortic orifice. It moves upwards, exiting the fibrous pericardium and
entering the superior mediastinum – where it then becomes the aortic
arch. The ascending aorta gives rise to two branches; the left and right
coronary arteries.
• Pulmonary trunk – gives rise to the left and right pulmonary arteries.
The trunk itself is relatively short and wide, allowing a large volume of
blood to pass through it.
• Superior vena cava – returns deoxygenated blood from the upper half
of the body. It is formed by the right and left brachiocephalic veins.
CONTENTS
• Nerves
• The cardiac plexus and the phrenic nerves are both located within
the middle mediastinum.
• Cardiac plexus – a network of nerves located at the base of the
heart, containing sympathetic and parasympathetic fibres. The
sympathetic nerves are derived from the T1-T4 segments of the
spinal cord, and the parasympathetic innervation is supplied by
the vagus nerve. The plexus can be subdivided into superficial and
deep components.
• Phrenic nerves (left and right) – mixed nerves that provides motor
innervation to the diaphragm. They arise in the neck, and
descend through the middle mediastinum to reach the
diaphragm.
CONTENTS
• Lymphatics
• The tracheobronchial lymph nodes are located
within the middle mediastinum. They are a group
of nodes associated with the trachea and bronchi of
the respiratory tract – and are characteristically
enlarged in certain lung pathologies. They form
from the gathering of bronchial nodes within the
hila of the lungs. Individual groups of nodes are
connected via fine lymphatic channels.
CLINICAL
CORRELATES
MEDIASTINITIS:Is the
inflammation of the tissues in the
mediastinum, usually bacterial
and due to rupture of organs in
the mediastinum. As the
infection can progress very
quickly, this is a serious
condition.
CLINICAL
CORRELATES
PNEUMOMEDIASTINUM:Is the
presence of air in the
mediastinum, which in some
cases can lead to pneumothorax,
pneumoperitoneum, and
pneumopericardium if left
untreated. However, that does
not always occur and sometimes
those conditions are actually the
cause, not the result, of
pneumomediastinum. These
conditions frequently accompany
Boerhaave syndrome, or
spontaneous esophageal
rupture.
FROM NONI (DOA
NAUBAMSSA)✍️
FOR NAUBAMSSA❤️(And other students who might
have access to this)