Anatomy: Mediastinum

The mediastinum lies between the right and left pleuræ in and near the median sagittal plane of the chest. It extends from the sternum in front to the vertebral column behind, and contains all the thoracic viscera excepting the lungs. It may be divided for purposes of description into two parts: an upper portion, above the upper level of the pericardium, which is named the superior mediastinum; and a lower portion, below the upper level of the pericardium. This lower portion is again subdivided into three parts, viz., that in front of the pericardium, the anterior mediastinum; that containing the pericardium and its contents, the middle mediastinum; and that behind the pericardium, the posterior mediastinum.

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The Superior Mediastinum (Fig. 967) is that portion of the interpleural space which lies between the manubrium sterni in front, and the upper thoracic vertebræ behind. It is bounded below by a slightly oblique plane passing backward from the junction of the manubrium and body of the sternum to the lower part of the body of the fourth thoracic vertebra, and laterally by the pleuræ. It contains the origins of the Sternohyoidei and Sternothyreoidei and the lower ends of the Longi colli; the aortic arch; the innominate artery and the thoracic portions of the left common carotid and the left subclavian arteries; the innominate veins and the upper half of the superior vena cava; the left highest intercostal vein; the vagus, cardiac, phrenic, and left recurrent nerves; the trachea, esophagus, and thoracic duct; the remains of the thymus, and some lymph glands.