The mediastinum is the central compartment of the chest, lying between the two pleural sacs. It contains the heart and great vessels, the trachea and oesophagus, the thymus and many nerves and lymph nodes. It is divided by a horizontal plane at the sternal angle into superior and inferior parts, and the inferior part is subdivided into anterior, middle and posterior.
| Location | From the thoracic inlet above to the diaphragm below, and from the sternum in front to the bodies of the thoracic vertebrae behind, between the right and left mediastinal pleura. |
|---|---|
| Parts | |
| Blood Supply | Mediastinal branches of the thoracic aorta; Mediastinal branches of the internal thoracic arteries |
| Lymphatic drainage |
|
Houses and supports the heart, great vessels, central airways, oesophagus and major nerves and lymphatic channels while allowing them to move with breathing and heartbeat.
Mediastinal masses are classified by compartment because each has a typical set of causes. Widening of the mediastinum on chest X-ray after trauma raises concern for aortic injury. Spontaneous pneumomediastinum, air escaping from ruptured alveoli into the mediastinum, can occur in healthy young people after intense exertion, coughing or repeated breath-holding and usually settles on its own.
Infection of the mediastinum, usually from oesophageal perforation or after cardiac surgery. It is serious and needs urgent treatment.
Air in the mediastinum, causing chest pain and sometimes a crackling feeling under the skin of the neck. It may be spontaneous or follow trauma or oesophageal rupture.
Any tumour, cyst or enlarged node within the mediastinum. Symptoms come from pressure on airways, vessels or nerves.
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