The mediastinum is divided into superior and inferior portions, each further subdivided based on anatomical relationships and structures contained within. Here are the main divisions of the mediastinum:
1. Superior Mediastinum:
- Location:
- Extends from the thoracic inlet (superior thoracic aperture) to the upper border of the pericardium.
- Contents:
- Structures in the superior mediastinum include:
- Trachea
- Esophagus
- Thymus gland (particularly in childhood)
- Major blood vessels:
- Arch of the aorta
- Brachiocephalic veins
- Vagus and phrenic nerves
- Thoracic duct
- Structures in the superior mediastinum include:
2. Inferior Mediastinum:
- Location:
- Extends from the upper border of the pericardium to the diaphragm.
- Subdivisions:
- Further divided into three compartments based on anatomical relationships:
- Anterior Mediastinum
- Middle Mediastinum
- Posterior Mediastinum
- Further divided into three compartments based on anatomical relationships:
a. Anterior Mediastinum:
- Location:
- Located between the sternum and the pericardium.
- Contents:
- Structures in the anterior mediastinum include:
- Connective tissue
- Lymph nodes
- Fat
- Structures in the anterior mediastinum include:
b. Middle Mediastinum:
- Location:
- Contains the pericardium and heart.
- Contents:
- Structures in the middle mediastinum include:
- Heart
- Pericardium
- Roots of the great vessels (aorta, pulmonary arteries, superior and inferior vena cava)
- Main bronchi
- Phrenic nerves
- Structures in the middle mediastinum include:
c. Posterior Mediastinum:
- Location:
- Located posterior to the pericardium, extending from the posterior surface of the heart to the vertebral column.
- Contents:
- Structures in the posterior mediastinum include:
- Esophagus
- Thoracic aorta
- Thoracic duct
- Azygos and hemiazygos veins
- Sympathetic trunks
- Vagus nerves
- Thoracic splanchnic nerves
- Structures in the posterior mediastinum include:
Clinical Significance:
- Understanding the divisions of the mediastinum is crucial for clinicians, radiologists, and surgeons when evaluating and diagnosing conditions affecting structures within this region.
- Pathological conditions such as tumors, infections, or abnormalities often manifest in specific compartments of the mediastinum, guiding diagnostic and therapeutic approaches.
The divisions of the mediastinum provide a framework for organizing the complex anatomy of the thoracic cavity, facilitating the clinical assessment of structures in this central compartment.