Mediastinum

Changed by Craig Hacking, 28 Nov 2016

Updates to Article Attributes

Body was changed:

Show markup changes

The mediastinum is a space in the thorax that contains a group of non-delineated organs and their surrounding connective tissue. It lies in the midline of the chest between the pleura of each lung and extends from the sternum to the vertebral column.

Gross anatomy

The mediastinum contains all the thoracic viscera except the lungs: heart and great vessels, oesophagus, trachea, phrenic nerve, cardiac nerve, thoracic duct, thymus, andmediastinal lymph nodes.

Anatomical division

The mediastinum can be be divided into parts based on their relationship to the fibrous pericardium:

superior mediastinum: above the upper level of the pericardium and plane of Ludwig
Inferior mediastinum: below the plane of Ludwig
- anterior mediastinum: anterior to the pericardium
- middle mediastinum: within the pericardium
- posterior mediastinum: posterior to the pericardium

Relations

superiorly: continuous with the loose connective tissue of the neck
anteriorly: chest wall
laterally: lungs and pleura
posteriorly: thoracic spine
inferiorly: diaphragm

Related pathology

Broadly, pathology that affects the mediastinum can be divided into those that result in a focal mass, or those that result in diffuse disease involving the mediastinum. Additionally, air may track into the mediastinum in pneumomediastinum.

The differential diagnosis of a focal mediastinal mass is highly dependant on its location within the mediastinum, resulting in specific differential lists for

Diffuse mediastinal disease can be separated into groups depending on whether the mediastinal disease is smooth or lobulated:

-<p>The <strong>mediastinum</strong> is a space in the thorax that contains a group of non-delineated organs and their surrounding <a href="/articles/connective-tissue">connective tissue</a>. It lies in the midline of the <a href="/articles/chest">chest</a> between the <a href="/articles/pleural-surfaces">pleural surfaces</a> of each <a href="/articles/lung">lung</a> and extends from the <a href="/articles/sternum">sternum</a> to the <a href="/articles/vertebral-column">vertebral column</a>. </p><h4>Gross anatomy</h4><p>The mediastinum contains all the thoracic viscera except the lungs: <a href="/articles/heart_and_great_vessels">heart and great vessels</a>, <a href="/articles/oesophagus">oesophagus</a>, <a href="/articles/trachea">trachea</a>, <a href="/articles/phrenic-nerve">phrenic nerve</a>, <a href="/articles/cardiac-nerve">cardiac nerve</a>, <a href="/articles/thoracic-duct">thoracic duct</a>, <a href="/articles/thymus">thymus</a>, and <a href="/articles/mediastinal-lymph-nodes">mediastinal lymph nodes</a>.</p><h5>Anatomical division</h5><p>The mediastinum can be divided into parts based on their relationship to the <a href="/articles/pericardium">pericardium</a>:</p><ul>
+<p>The <strong>mediastinum</strong> is a space in the thorax that contains a group of non-delineated organs and their surrounding <a href="/articles/connective-tissue">connective tissue</a>. It lies in the midline of the <a href="/articles/chest">chest</a> between the <a href="/articles/pleura">pleura</a> of each <a href="/articles/lung">lung</a> and extends from the <a href="/articles/sternum">sternum</a> to the <a href="/articles/vertebral-column">vertebral column</a>. </p><h4>Gross anatomy</h4><p>The mediastinum contains all the thoracic viscera except the lungs: <a href="/articles/heart_and_great_vessels">heart and great vessels</a>, <a href="/articles/oesophagus">oesophagus</a>, <a href="/articles/trachea">trachea</a>, <a href="/articles/phrenic-nerve">phrenic nerve</a>, <a href="/articles/cardiac-nerve">cardiac nerve</a>, <a href="/articles/thoracic-duct">thoracic duct</a>, <a href="/articles/thymus">thymus</a>, and <a href="/articles/mediastinal-lymph-nodes">mediastinal lymph nodes</a>.</p><h5>Anatomical division</h5><p>The mediastinum can be divided into parts based on their relationship to the fibrous <a href="/articles/pericardium">pericardium</a>:</p><ul>
~~-<a href="/articles/clavicles">Inferior mediastinum</a>: below the <a href="/articles/plane-of-ludwig">plane of Ludwig</a><ul>~~
+<a href="/articles/inferior-mediastinum">Inferior mediastinum</a>: below the <a href="/articles/plane-of-ludwig">plane of Ludwig</a><ul>

ADVERTISEMENT: Supporters see fewer/no ads

{"current_user":null,"inclusions":[{"imageId":32251005,"studyId":61515,"caseSlug":"great-vessels-grays-illustration","caption":"Figure 1: mediastinum (Gray's illustration)","thumbnail":"https://prod-images-static.radiopaedia.org/images/32251005/c48345fa1a23b11f65e5e9df0c5443_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":272817,"studyId":9369,"caseSlug":"normal-mediastinal-anatomy-ct-volume-rendering","caption":"Case 1: normal pediatric mediastinal anatomy (CT)","thumbnail":"https://prod-images-static.radiopaedia.org/images/272817/29d658354907ebcfe813d306c59bdb_big_gallery.jpg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":64969173,"studyId":147353,"caseSlug":"mediastinum-grays-illustrations","caption":"Figure 2: mediastinum (Gray's illustrations)","thumbnail":"https://prod-images-static.radiopaedia.org/images/64969173/8283a284ebc4b2858d794b270c9fa242b129ccdc04cde342eede40bb8657ad1a_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":35313247,"studyId":64820,"caseSlug":"mediastinal-compartments-annotated-ct","caption":"Figure 3: mediastinal compartments","thumbnail":"https://prod-images-static.radiopaedia.org/images/35313247/8c04dd3d85ce72403f8669ac8915df_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"not_applicable"},{"imageId":1296734,"studyId":14480,"caseSlug":"mediastinal-anatomy-grays-anatomy-illustration-1","caption":"Figure 4: compartments","thumbnail":"https://prod-images-static.radiopaedia.org/images/1296734/ab3be7328f818cb7a9c379277a0aae_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":23887708,"studyId":50742,"caseSlug":"cardiomediastinal-anatomy-on-chest-radiography-annotated-images","caption":"Figure 5: cardiomediastinal anatomy on CXR (annotated images)","thumbnail":"https://prod-images-static.radiopaedia.org/images/23887708/6b1a8784e5a5d217ee0e72e959fac8_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"not_applicable"},{"imageId":64969175,"studyId":147353,"caseSlug":"mediastinum-grays-illustrations","caption":"Figure 7: mediastinum (Gray's illustrations)","thumbnail":"https://prod-images-static.radiopaedia.org/images/64969175/9080e650964ede4bb381e1f4e43413560dfc1fc0f44d8e62ce55e89d35788cf8_big_gallery.jpeg","isStack":false,"diagnosticCertainty":"not_applicable"},{"imageId":23928192,"studyId":50772,"caseSlug":"cardiomediastinal-anatomy-on-chest-radiography-annotated-images","caption":"Figure 6: cardiomediastinal anatomy on CXR (annotated images)","thumbnail":"https://prod-images-static.radiopaedia.org/images/23928192/75c0ba95bcdc85c988eabdcc420258_big_gallery.jpeg","isStack":true,"diagnosticCertainty":"not_applicable"}],"ddx_inclusions":[],"lang":"us"}