Mediastinum
Updates to Article Attributes
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, and mediastinal lymph nodes.
Anatomical division
The mediastinum can 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
An alternative ITMIG classification has been proposed based on cross-sectional imaging 2.
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:
- thoracic inlet masses
- anterior mediastinal masses
- middle mediastinal masses
- posterior mediastinal masses
Diffuse mediastinal disease can be separated into groups depending on whether the mediastinal disease is smooth or lobulated:
-</ul><p>An alternative <a title="ITMIG classification of mediastinal compartments" href="/articles/mediastinum-itmig-classification">ITMIG classification</a> has been proposed based on cross-sectional imaging <sup>2</sup>. </p><h5>Relations</h5><ul>- +</ul><p>An alternative <a href="/articles/mediastinum-itmig-classification">ITMIG classification</a> has been proposed based on cross-sectional imaging <sup>2</sup>. </p><h5>Relations</h5><ul>
-</ul><h4>Related pathology </h4><p>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 <a href="/articles/pneumomediastinum">pneumomediastinum</a>.</p><p>The differential diagnosis of a focal <a href="/articles/mediastinal-mass">mediastinal mass</a> is highly dependant on its location within the mediastinum, resulting in specific differential lists for</p><ul>- +</ul><h4>Related pathology </h4><p>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 <a href="/articles/pneumomediastinum">pneumomediastinum</a>.</p><p>The differential diagnosis of a focal <a href="/articles/mediastinal-mass">mediastinal mass</a> is highly dependant on its location within the mediastinum, resulting in specific differential lists for:</p><ul>
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