MEDIASTINUM 3.

posterior mediastinum
lies between pericardium
 Movable and vertebral column
 Extends
 superiorly;
To the thoracic
outlet ANTERIOR MEDIASTINUM
Root of the neck
 inferiorly;  contains;
To the diaphragm 1. thymus gland
 anteriorly; 2. pericardium
Sternum 3. heart
 posteriorly ; 4. ascending aorta
Vertebral column 5. arch of aorta and branches
6. pulmonary trunk
7. superior vena cava
 Contains; 8. phrenic nerve
1. remains of the thymus
2. heart and large blood
vessels THYMUS
3. trachea  flattened
4. oesophagus  bi lobed and pink
5. thoracic duct  between sternum and pericardium
6. lymph nodes  in anterior mediastinum
7. vagus nerve
 in new born , reaches largest size
8. phrenic nerve
relative to body
9. sympathetic trunks
 may extend through superior
 divided to superior and inferior
mediastinum
mediastinum by imaginary plane
 front of great vessels
 passing from sternal angle
 into the root of neck
 anteriorly to the lower body of the
 grows till puberty
4th thoracic vertebra posteriorly
 after puberty involution
 site for development of T
lymphocytes
 Inferior mediastinum is divided to;
1. middle mediastinum
heart and pericardium
 blood supply;
inferior thyroid artery
internal thoracic artery
2. anterior mediastinum
space between pericardium
venous supply;
and sternum
left and right brachiocephalic veins
first part of superior vena cava

nerve supply;
right phrenic nerve descends in the
thorax along the right side of right
brachiocephalic vein and superior
vena cava
passes in front of the root of the
lung
runs along right side of the
pericardium (separates nerve from
the right atrium)
left phrenic nerve descends in the
thorax along the left side of the left
subclavian artery
crosses left side of arch of aorta
PERICARDIUM
 fibrous sac
 in the middle mediastinum
 posterior to body of sternum and
2nd to 6th costal cartilages
 anterior to 5th to 8th thoracic
vertebrae
 encloses heart and root of great
vessels
 restrict excessive movements of
heart as a whole
 serves as a lubricated container
where different parts of the heart
can contract
FIBROUS PERICARDIUM
3. superior and inferior vena
cava
4. pulmonary veins
respectively
 attached to the sternum in front by
sternopericardial ligaments
SEROUS PERICARDIUM
 Lines fibrous pericardium
 Coats the heart
 Divides to;
1. Parietal layer
Lines fibrous pericardium
Reflected around roots of
great vessels
Thereby continuous with
visceral layer of serous
pericardium
2. Visceral layers
Closely applied to heart
Also called epicardium
Pericardial cavity is the slit like space
between visceral and parietal layers
It has small amount of pericardial (tissue)
fluid acting as a lubricant

 fibrous pericardium is firmly

attached below the central tendon
of the diaphragm
 fuses with outer coat of great
blood vessels passing;
1. aorta
2. pulmonary trunk
PERICARDIAL SINUSES

 Formed by layers of pericardium Paracentesis;

and by walls of pericardium
Removal of excess amount of pericardial
 3 sinuses
fluid
1. Oblique sinus
Posterior surface of heart Needle can be introduced between xiphoid
Reflection of pericardium process of sternum and 7th coastal
around large veins forms a cartilage
recess
Due to presence of cardiac notch pleura
Limited;
and lung are not damaged (safety triangle)
anteriorly by posterior wall
of left atrium
posteriorly by the posterior
Pericarditis;
wall of pericardium
Inflammation of pericardium
2. Transverse sinus
Tamponade
Posterior surface of heart
Short passage between Compression of the heart
reflection of pericardium
Also occur when gunshots and wounds
around aorta and
penetrating chambers of heart
pulmonary trunk anteriorly
Reflection around the
superior vena cava
posteriorly

3. Anterior inferior sinus

Formed in the passage of
anterior part of the
pericardium into inferior
part
Puncture of pericardium is
made here

Nerve supply;

 Phrenic nerves;
Fibrous pericardium parietal layer
of the serous pericardium
 Branches of sympathetic trunk and
vagus verve;
Visceral layer of serous
pericardium