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3. Mediastinum

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What is the mediastinum?
The median portion of the thoracic cavity, between the left/right parietal pleura.
What borders the mediastinum superiorly and inferiorly?
Sup: Thoracic inlet

Inf: Diaphragm
What line separates sup and inf portions of the mediastinum?
Horizontal line passing thru Sternal Angle and T4/T5 space.
What organs are NOT in the mediastinum?
Lungs
What are the 4 structures in the Superior mediastinum?
-Arch of aorta
-Trachea
-Esophagus
-Superior Vena Cava
(ATES)
What is the Inferior mediastinum divided into?
3 subdivisions:
-Anterior
-Middle
-Posterior
What are the borders of the anterior mediastinum?
Post: Pericardium
Ant: Body of Sternum
Inf: Diaphragm
Sup: Superior mediastinum
What important structures are within the anterior mediastinum?
-Internal thoracic artery/vein
-Lymphatics
-Thymus (in children)
Where is the Middle Mediastinum located?
Inside the pericardium
What important structures are in the middle mediastinum?
-Heart
-Origin of major blood vessels (Aorta, pulm trunk/veins, S/IVC
What are the borders of the Posterior Mediastinum?
Ant: Pericardium
Post: T5-T12 vertebrae
What structures are contained in the Post mediastinum? (RDAVE)
-R/L mainstem bronchi
-Descending thoracic aorta
-Azygos/hemiazygos v. systems
-Vagus nerve branches
-Esophagus
3 layers of fascia in the neck:
-Investing
-Pretracheal
-Prevertebral
What does the Investing fascia surround?
Superficial muscles in the neck
What does the Pretracheal fascia contain?
Visera of the neck - thyroid gland, esophagus, etc.
What does the Prevertebral fascia invest?
Deep muscles of the back
What do all three fascia layers form?
Carotid sheath
Where can an infection anterior to the pretracheal fascia go?
Thru superior mediastinum to anterior mediastinum
Where can an infection posterior to the pretracheal fascia go?
Thru superior mediastinum to posterior mediastinum.
At what vertebral level does each transverse the diaphragm:
-IVC
-Esophagus
-Abdominal Aorta
IVC = T8, most anterior
Esophagus = T10, middle
Aorta = T12, posterior

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