The superior mediastinum is the upper part of the central chest compartment, above an imaginary plane from the sternal angle to the T4-T5 disc. It is crowded with great vessels, the trachea, oesophagus, thymus remnant and important nerves.
| Location | Between the thoracic inlet above and the plane of the sternal angle below; sternal manubrium in front, T1-T4 vertebrae behind |
|---|---|
| Parts |
|
| Nerve Supply | Vagus nerves; Phrenic nerves; Sympathetic trunks; Left recurrent laryngeal nerve |
| Blood Supply | Branches of the aortic arch; Internal thoracic arteries |
| Venous drainage | |
| Lymphatic drainage |
|
Acts as the main corridor between the neck and the chest for airway, gut, vessels and nerves.
Masses here, such as thymoma, lymphoma, thyroid goitre extending down or aortic aneurysm, may compress the trachea, superior vena cava or recurrent laryngeal nerve. Widening of the mediastinum on chest X-ray after trauma raises concern for aortic injury.
Compression by tumour causing swelling of the face, neck and arms with distended neck veins.
A broad mediastinum on imaging that may signal aortic rupture, haematoma or a mass.
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