|
2. Right and left brachiocephalic veins and superior vena cava
3. Arteries - arch of aorta, brachiocephalic artery, left common carotid, left subclavian
4. Trachea - bifurcation at junction between superior and inferior mediastinum
Relations - anterior - brachiocephalic artery, left common carotid artery, aortic arch, left brachiocephalic vein
- posterior - esophagus
- left - aortic arch, left common carotid, left subclavian, left recurrent
laryngeal nerve, pleur
- right - azygos vein, pleura
5. Esophagus
6. Thoracic duct - will end in left subclavian vein
7. Azygos vein
8. Vagus nerves
9. Left recurrent laryngeal nerve
10. Phrenic nerves
Anterior mediastinum - fat, connective tissue, lymph nodes - between sternum and pericardium
Middle mediastinum - area within pericardium, extends from costal cartilage 2-6 and T5-T8
 Pericardium - a fibroserous sac surrounding heart
A. Fibrous pericardium
1. Fibrous outer layer of pericardium
2. Adheres to underlying parietal layer of
serous pericardium
3. Attached to central tendon of diaphragm
inferiorly
4. Blends with outer coat of great vessels
superiorly
B. Serous pericardium - forms closed sac covering heart and lining fibrous
pericardium
1. Parietal pericardium - serous layer which lines fibrous pericardium
2. Visceral pericardium (epicardium)
a. Serous layer which adheres to myocardium and covers beginning
of great vessels
b. Continuous with parietal pericardium where it is reflected from
great vessels
3. Pericardial cavity
a. Potential space between visceral and parietal pericardium
b. Contains film of pericardial fluid
4. Pericardial sinuses - formed by reflections of serous pericardium,
subdivisions of sac
a. Transverse sinus - posterior to aorta and pulmonary trunk
anterior to superior
vena cava and pulmonary veins
b. Oblique sinus - cul-de-sac, posterior to heart, bounded by
pulmonary veins on either side
Heart - see heart handout
Posterior mediastinum
Boundaries - posterior - vertebral column
- anterior - pericardium
- lateral - mediastinal pleura
- superior - superior mediastinum
- inferior - diaphragm (to T12)
Contents - anterior to posterior
1. Descending aorta
Branches - bronchial (left-2), esophageal, pericardial, mediastinal,
posterior intercostal, subcostal, superior phrenic
2. Esophagus
Relations - anterior - trachea, left main bronchus, pericardium
(left atrium),diaphragm
- posterior - thoracic vertebrae, thoracic duct,
azygos system, descending aorta (inferiorly)
- 3 constrictions
- pharynx/esophageal junction
- crossing of aorta and left bronchus
- passage through diaphragm
3. Vagus nerve - plexus forms on anterior and posterior surfaces
4. Thoracic duct - on right side of aorta, crosses to left at T5
- drains lymphatic system from below diaphragm and on left side
5. Azygos system - from lumbar veins
azygos vein - hemiazygos and accessory hemiazygos veins,
 important collateral circulation
6. Other structures - sympathetic chains
- splanchnic nerves
 | 
