Anatomy clinical correlates: Mediastinum
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Anatomy clinical correlates: Mediastinum
Subspeciality surgery
Cardiothoracic surgery
Valvular heart disease: Clinical (To be retired)
Chest trauma: Clinical (To be retired)
Anatomy clinical correlates: Thoracic wall
Anatomy clinical correlates: Heart
Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Mediastinum
ENT (Otolaryngology)
Anatomy clinical correlates: Bones, fascia and muscles of the neck
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Trigeminal nerve (CN V)
Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves
Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves
Anatomy clinical correlates: Ear
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck
Anatomy clinical correlates: Viscera of the neck
Neurosurgery
Traumatic brain injury: Clinical (To be retired)
Brain tumors: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Vertebral canal
Anatomy clinical correlates: Spinal cord pathways
Anatomy clinical correlates: Cerebral hemispheres
Anatomy clinical correlates: Anterior blood supply to the brain
Anatomy clinical correlates: Cerebellum and brainstem
Ophthalmology
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Eye conditions: Retinal disorders: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves
Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves
Anatomy clinical correlates: Eye
Orthopedic surgery
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Axilla
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Plastic surgery
Burns: Clinical (To be retired)
Urology
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Testicular tumors: Pathology review
Kidney stones: Clinical (To be retired)
Renal cysts and cancer: Clinical (To be retired)
Urinary incontinence: Pathology review
Testicular and scrotal conditions: Pathology review
Anatomy clinical correlates: Male pelvis and perineum
Anatomy clinical correlates: Other abdominal organs
Androgens and antiandrogens
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Vascular surgery
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Aortic aneurysms and dissections: Clinical (To be retired)
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Anatomy clinical correlates: Mediastinum
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Transcript
Contributors
Anca-Elena Stefan, MD
Evan Debevec-McKenney
Ursula Florjanczyk, MScBMC
We all know how important the heart is, but everyone forgets about the mediastinum, which is the area between the two lungs where the heart actually sits!
The mediastinum doesn't just house the heart, but many important structures in the thoracic cavity from the superior thoracic aperture down to the diaphragm.
So let's take a closer look at the clinical conditions that can affect the mediastinum and the structures within it.
First up, there is widening of the mediastinum, which can be seen on a chest x-ray.
Since the mediastinum contains so many structures, each of them can contribute to pathological widening.
It can be observed after a trauma that causes laceration or dissection of the great-vessels, typically the aorta, which can cause hemorrhaging into the mediastinum.
Other times, malignant tumors such as lymphomas can produce massive enlargement of mediastinal lymph nodes and widening of the mediastinum.
Another cause of mediastinal widening is heart hypertrophy due to congestive heart failure.
Now, next up, there’s the esophagus.
The esophagus may have up to four normal anatomic constrictions as it descends, however there are three sites of constriction that can occur specifically in the posterior mediastinum caused by three structures it meets on its way down: two thoracic constrictions with the first being where the esophagus is crossed by the arch of the aorta, and second where it is crossed by the left main bronchus, and one diaphragmatic constriction where it passes through the esophageal hiatus of the diaphragm.
The fourth site of constriction occurs in the cervical region before the esophagus enters the mediastinum, where constriction may be caused by the cricopharyngeus muscle.
At these locations, there’s a slower passage of substances and is where foreign objects that are swallowed are most likely to lodge.
These narrowings can be seen in chest radiographs of a person who underwent a barium swallow study.
These areas are also at risk of stricture after ingesting caustic liquids such as cleaning products.
Sources
- "Comprehensive Cytopathology E-Book: Expert Consult: Online and Print" Saunders (2007)
- "Gray's Anatomy for Students" Churchill Livingstone (2004)
- "The Epiaortic Ultrasound Diagnosis of Iatrogenic Subadventitial Hematoma" A&A Practice (2020)
- "An unexpected finding late after repair of coarctation of the aorta" Netherlands Heart Journal (2008)
- "Management of acute aortic dissection" The Lancet (2015)
- "Risk Factors for Aneurysm Rupture in Patients Kept Under Ultrasound Surveillance" Annals of Surgery (1999)
- "Prevalence and Impact of the Subclavian Steal Syndrome" Annals of Surgery (2010)
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