Mediastinum

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The mediastinum contains a group of non~~-deliniated~~-delineated organs and their surrounding connective tissue. It lies in the midline of the chest between the pleural surfaces of each lung and extends from the sternum to the vertebral column.

AnatomyGross 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 pericardium:

superior mediastinum - above the upper level of the ~~pericarcium~~pericardium, which is at the level of the sternoclavicular notch and clavicles
anterior mediastinum - anterior to the pericardium
middle mediastinum - within the pericardium
posterior mediastinum - posterior to the pericardium

Anatomic relationsRelations

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> contains a group of non-deliniated organs and their surrounding <a href="/articles/connective-tissue" title="connective tissue">connective tissue</a>. It lies in the midline of the <a href="/articles/chest" title="chest">chest</a> between the <a href="/articles/pleural-surfaces" title="pleural surfaces">pleural surfaces</a> of each <a href="/articles/lung" title="lung">lung</a> and extends from the <a href="/articles/sternum" title="sternum">sternum</a> to the <a href="/articles/vertebral-column" title="vertebral column">vertebral column</a>. </p><h4>Anatomy</h4><p>The mediastinum contains all the thoracic viscera except the lungs: <a href="/articles/heart_and_great_vessels" title="Heart and Great vessels">heart and great vessels</a>, <a href="/articles/oesophagus" title="oesophagus">oesophagus</a>, <a href="/articles/trachea" title="trachea">trachea</a>, <a href="/articles/phrenic-nerve" title="phrenic nerve">phrenic nerve</a>, <a href="/articles/cardiac-nerve" title="cardiac nerve">cardiac nerve</a>, <a href="/articles/thoracic-duct" title="thoracic duct">thoracic duct</a>, <a href="/articles/thymus" title="Thymus">thymus</a>, and <a href="/articles/mediastinal-lymph-nodes" title="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" title="pericardium">pericardium</a>:</p><ul>
~~-<li>~~
-<a href="/articles/superior-mediastinum" title="superior mediastinum">superior mediastinum</a> - above the upper level of the pericarcium which is at the level of the <a href="/articles/sternoclavicular-notch" title="sternoclavicular notch">sternoclavicular notch</a> and <a href="/articles/clavicles" title="clavicles">clavicles</a>
~~-</li>~~
~~-<li>~~
~~-<a href="/articles/anterior-mediastinum" title="anterior mediastinum">anterior mediastinum</a> - anterior to the pericardium</li>~~
~~-<li>~~
~~-<a href="/articles/middle-mediastinum" title="middle mediastinum">middle mediastinum</a> - within the pericardium</li>~~
~~-<li>~~
~~-<a href="/articles/posterior-mediastinum" title="posterior mediastinum">posterior mediastinum</a> - posterior to the pericardium</li>~~
~~-</ul><h5>Anatomic relations</h5><ul>~~
~~-<li>superiorly - continuous with the loose connective tissue of the neck</li>~~
~~-<li>anteriorly - chest wall</li>~~
~~-<li>laterally - lungs and pleura</li>~~
~~-<li>posteriorly - thoracic spine</li>~~
~~-<li>inferiorly - diaphragm</li>~~
-</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" title="Pneumomediastinum">pneumomediastinum</a>.</p><p>The differential diagnosis of a focal <a href="/articles/mediastinal-mass" title="mediastinal mass">mediastinal mass</a> is highly dependant on its location within the mediastinum, resulting in specific differential lists for</p><ul>
~~-<li><a href="/articles/thoracic-inlet-masses" title="thoracic inlet masses">thoracic inlet masses</a></li>~~
~~-<li><a href="/articles/anterior-mediastinal-masses" title="anterior mediastinal masses">anterior mediastinal masses</a></li>~~
~~-<li><a href="/articles/middle-mediastinal-masses" title="middle mediastinal masses">middle mediastinal masses</a></li>~~
~~-<li><a href="/articles/posterior-mediastinal-masses" title="posterior mediastinal masses">posterior mediastinal masses</a></li>~~
-</ul><p><a href="/articles/diffuse-mediastinal-disease" title="Diffuse mediastinal disease">Diffuse mediastinal disease</a> can be separated into groups depending on whether the mediastinal disease is smooth or lobulated:</p><ul>
+<p>The <strong>mediastinum</strong> 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>
+<li>
+<a href="/articles/superior-mediastinum">superior mediastinum</a> - above the upper level of the <a title="Pericardium" href="/articles/pericardium">pericardium</a>, which is at the level of the <a href="/articles/sternoclavicular-notch">sternoclavicular notch</a> and <a href="/articles/clavicles">clavicles</a>
+</li>
+<li>
+<a href="/articles/anterior-mediastinum">anterior mediastinum</a> - anterior to the pericardium</li>
+<li>
+<a href="/articles/middle-mediastinum">middle mediastinum</a> - within the pericardium</li>
+<li>
+<a href="/articles/posterior-mediastinum">posterior mediastinum</a> - posterior to the pericardium</li>
+</ul><h5>Relations</h5><ul>
+<li>superiorly - continuous with the loose connective tissue of the neck</li>
+<li>anteriorly - chest wall</li>
+<li>laterally - lungs and pleura</li>
+<li>posteriorly - thoracic spine</li>
+<li>inferiorly - <a title="Diaphragm" href="/articles/diaphragm">diaphragm</a>
+</li>
+</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>
+<li><a href="/articles/thoracic-inlet-masses">thoracic inlet masses</a></li>
+<li><a href="/articles/anterior-mediastinal-masses">anterior mediastinal masses</a></li>
+<li><a href="/articles/middle-mediastinal-masses">middle mediastinal masses</a></li>
+<li><a href="/articles/posterior-mediastinal-masses">posterior mediastinal masses</a></li>
+</ul><p><a href="/articles/diffuse-mediastinal-disease">Diffuse mediastinal disease</a> can be separated into groups depending on whether the mediastinal disease is smooth or lobulated:</p><ul>
~~-<li><a href="/articles/mediastinal-lipomatosis" title="mediastinal lipomatosis">mediastinal lipomatosis</a></li>~~
~~-<li><a href="/articles/mediastinal-malignant-infiltration" title="mediastinal malignant infiltration">mediastinal malignant infiltration</a></li>~~
~~-<li><a href="/articles/mediastinal-haemorrhage" title="mediastinal haemorrhage">mediastinal haemorrhage</a></li>~~
~~-<li><a href="/articles/mediastinitis" title="mediastinitis">mediastinitis</a></li>~~
+<li><a href="/articles/mediastinal-lipomatosis">mediastinal lipomatosis</a></li>
+<li><a href="/articles/mediastinal-malignant-infiltration">mediastinal malignant infiltration</a></li>
+<li><a href="/articles/mediastinal-haemorrhage">mediastinal haemorrhage</a></li>
+<li><a href="/articles/mediastinitis">mediastinitis</a></li>
~~-</li>~~
+</li>
~~-<li><a href="/articles/mediastinal-lymphadenopathy" title="mediastinal lymphadenopathy">mediastinal lymphadenopathy</a></li>~~
~~-<li><a href="/articles/thymic-mass" title="thymic mass">thymic mass</a></li>~~
~~-<li><a href="/articles/germ-cell-neoplasm" title="germ cell neoplasm">germ cell neoplasm</a></li>~~
~~-<li><a href="/articles/mediastinal-vascular-abnormality" title="mediastinal vascular abnormality">mediastinal vascular abnormality</a></li>~~
~~-<li><a href="/articles/mediastinal-neurofibromatosis" title="mediastinal neurofibromatosis">mediastinal neurofibromatosis</a></li>~~
+<li><a href="/articles/mediastinal-lymphadenopathy">mediastinal lymphadenopathy</a></li>
+<li><a href="/articles/thymic-mass">thymic mass</a></li>
+<li><a href="/articles/germ-cell-neoplasm">germ cell neoplasm</a></li>
+<li><a href="/articles/mediastinal-vascular-abnormality">mediastinal vascular abnormality</a></li>
+<li><a href="/articles/mediastinal-neurofibromatosis">mediastinal neurofibromatosis</a></li>
~~-</li>~~
+</li>

Images Changes:

Image 2 CT (Volume rendering) ( update )

Caption was changed:

~~CT of~~Case 1: normal paediatric mediastinal anatomy (CT)

Image 5 Diagram ( update )

Caption was added:

Figure 1

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