Superior, Posterior Mediastinum

superior mediastinum starts

• starts at the superior thoracic aperature (T1)

• sternal angle

• junction (IV disc) of vertebrae T4 and T5

main contents of the superior mediastinum

• vagus and phrenic nerves

• recurrent laryngeal nerves

• trachea

• esophagus

• thoracic duct

superior mediastinum anterior to posterior

• veins

• arteries

• trachea

• esophagus

phrenic nerves innervation and location 

• innervates the diaphragm 

• located in both superior and middle mediastinum 

?

phrenic nerves

? and location

• vagus nerves

• both is superior and posterior mediastinum 

? location

• esophagus

• in both superior and posterior mediastinum 

• runs posterior to the trachea 

structures in the posterior mediastinum

• thoracic aorta

• thoracic duct 

• azygos and hemiazygos veins

• esophagus

• thoracic sympathetic trunk

• thoracic splanchnic nerves 

top to bottom 

• venal caval aperture

• esophageal hiatus

• aortic hiatus 

deep to esophagus and thoracic aorta

Sympathetic trunk

Azygos vein

Thoracic duct 

?

sympathetic trunk

? top to bottom 

• azygos vein

• posterior intercostal veins 

azygos system of veins

• venous drainage for thoracic cage

• azygos vein empties into posterior aspect of superior vena cava

? right to left top to bottom

• azygos vein

• accessory hemiazygos vein

• hemiazygos veins

thoracic duct

• anterior to vertebral bodies

• deep to esophagus

? location 

• venous angle

• internal jugular and subclavian veins meet

what side do we see the hemiazygos vein

left side

what side do we see azygos vein

right

top to bottom

• esophagus

• vagal esophageal plexus

? and divides what

• diaphragm

• divides abdomen and thorax

diaphragm sternal part origin and insertion 

origin

• xiphoid process of sternum 

insertion

• central tendon

diaphragm costal part origin and insertion

origin

• internal surfaces of lower six ribs (7-12)

• costal cartilages

insertions

• central tendon

diaphragm lumbar part origin and insertion

origin

• lumbar vertebrae

insertion

• central tendon

diaphragm action/function

inhalation and exhalation

nerve supply of nerves

• motor = phrenic nerves

• sensory = phrenic, intercostal and subcostal nerves

T8

caval opening

• inferior vena cava

• right phrenic nerve

T10

esophageal hiatus

• esophagus

• vagal trunks

T12

aortic hiatus

• descending aorta

• thoracic duct

• azygos vein