1. Anatomy
    2. 1. Mediastinum
    2. The Heart Development
    3. Pericardium
    4. Features of the Heart
    5. Arterial Supply of Heart
    6. Venous Drainage of the Heart
    7. Conducting System of Heart
    8. Nervous System of Heart
    9. Foetal Circulation and Changes at Birth
    10. Microscopic Structure of Heart
    11. Arteries
    12. Arch of Aorta
    13. Descending Thoracic Artery
    14. Abdominal Aorta
    15. Subclavian Artery
    16. Axiallary Artery
    17. Internal Thoracic Artery
    18. Brachial Artery
    19. Radial Artery
    20. Ulnar Artery
    21. Palmar Arches
    22. External Iliac Artery
    23. Internal Iliac Artery
    24. Femoral Artery
    25. Popliteal Artery
    26. Posterior Tibial Artery
    27. Anterior Tibial Artery
    28. Dorsalis Pedia Artery
    29. Common Carotid Artery
    30. External Carotid Artery
    31. Internal Carotid Artery
    32. Veins
    33. Internal Jugular Vein
    34. External Jugular Vein
    35. Superior Venacava
    36. Inferior Venacava
    37. Brachiocephali vein
    38. Subclavian vein
    39. Axillary vein
    40. Cephalic vein
    41. Basilic vein
    42. Azygous vein
    43. Hemiazyous vein
    44. Accessory Hemiazyoug Vein
    45. Internal Hemiazygous Vein
    46. Internal Iliac Vein
    47. Femoral Vein
    48. Popliteal Vein
    49. Long Saphenous Vein
    50. Small or Short Saphenous Vein
    51. Hepato-portal System
    52. Lymphatic System
    53. Spleen
    54. Thymus
    55. Thoracic duct
  2. Pharmacology
    3. 56. Congestive Heart Failure
    57. Therapy of Arrhythmiasis
    58. Angina pectoris
    59. Therapy of Hypertension
    60. Therapy of Shock
    61. Haemostatic Agents
    62. Therapy of Thromboembolic Disorder
    63. Thrombolytic or Fibrinolytics
    64. Antifibrinolytics
    65. Antiplatelet Drugs
    66. Therapy of Iron Deficiency Anemia
    67. Therapy of Megaloblastic Anaemia
    68. Hypolipidemic Drugs and Plasma Expanders
  3. Physiology
    4. 69. Properties of Myocardial Cells
    70. Heart - A Mechanical Pump
    71. Cardiac Cycle
    72. Electrocardiogram (ECG)
    73. Cardiac Output (CO)
    74. Haemodynamics of Circulation
    75. Heart Sounds
    76. Arterial Pulse
    77. Blood pressure
    78. Regional circulation
    79. Cardiovascular chanes during exercise
    80. Edema Dropsy of fluid retention
    81. Shock
    82. Hematology
  4. Pathology
    5. 83. Anaemia
    84. Hypertension
    85. Hypertensive Heart Disease
    86. Ischemic Heart Disease
    87. Angina pectoris
    88. Myocardial infarction
    89. Rheumatic Fever and Rheumatic Heart Disease (RHD)
    90. Acute Pericarditis
    91. Myocarditis
    92. Infective Endocarditis (IE)
    93. Congenital Heart Disease
    94. Cardiomyopathies
    95. Arteriosclerosis
    96. Atherosclerosis
    97. Inflammatory Disease of Blood Vessels
    98. Aneurysms and Dissection
    99. Congestive Heart Failure
    100. Iron Deficiency Anaemia
    101. Megaloblastic anaemia
    102. Pancytopenia
    103. Leucocytosis and Leucopenia
    104. Aplastic anaemia
    105. Haemolytic anaemia
    106. Hereditary Spherocytosis
    107. Haemoglobinipathies
    108. Thalassemia syndrome
    109. Sickle Cell Disease
    110. Leukaemia
    111. Leukemoid reaction
    112. Lymphadenitits
    113. Hodgkin lymphoma
    114. Non-hodgkin lymphoma
    115. Myeloproliferative disorders
    116. Myelofibrosis
    117. Multiple myeloma
    118. Bleeding disorders
    119. Coagulation disorders
    120. any
    121. Blood grouping
  5. Microbiology
    6. 122. Introduction of Blood borne infections
    123. Infective Endocarditis
    124. Brucella
    125. Rickettsiae
    126. Leishmania donovani
    127. Plasmodium
    128. Wuchereria bancrofti
  6. Biochemistry
    7. 129. Metabolism in Blood Cells
    130. Iron metabolism
    131. Haemoglobin
    132. Lipoprotein metabolism
    133. Biochemical aspect of MI
Anatomy
1. Mediastinum
INTRODUCTION
▢ Definition: Mediastinum (plural-mediastina)(Latin intermediate) is the middle space left in the thoracic cavity in between the lungs.
▢ Boundaries of Mediastinum:
❖ Anteriorly: Sternum
❖ Posteriorly: Vertebral column
❖ Superiorly: Thoracic inlet
❖ Inferiorly: Diaphragm
❖ On each side: Mediastinal pleura of each lungs
DIVISIONS
Superior Mediastinum
▢ Boundaries:
❖ Anteriorly: Manubrium sterni
❖ Posteriorly: Upper four thoracic vertebrae (T1-T4)
❖ Superiorly: Thoracic inlet
❖ Inferiorly: An imaginary plane passing through the sternal angle in front, and the lower border of the body of the fourth thoracic vertebra behind is known as Transverse thoracic plane.
❖ On each side: Mediastinal pleura
▢ Contents:
❖ Retrosternal:
  1. Muscles
    2. ◈ Origins of:
    1. Sternohyoid
    2. Sternothyroid
  2. Veins
    1. Upper half of the superior vena cava
    2. Right and Left brachiocephalic veins
    3. Left superior intercostal vein
  3. Thymus
❖ Intermediate:
  1. Arteries
    1. Arch of aorta
    2. Brachiocephalic artery
    3. Left common carotid artery
    4. Left subclavian artery
  2. Nerves
    1. Vagus
    2. Phrenic
    3. Cardiac nerves of both sides
❖ Prevertebral:
  1. Trachea and Oesophagus
  2. Thoracic duct
  3. Lymph nodes
    1. Paratracheal
    2. Brachiocephalic, and
    3. Tracheobronchial
  4. Nerves
    1. Left recurrent layngeal nerve
  5. Muscles
    6. ◈ Origins of:
    1. Lower ends of Longus colli
Inferior Mediastinum
Anterior Mediastinum
▢ Boundaries:
❖ Anteriorly: Sternum
❖ Posteriorly: Pericardium
❖ Superiorly: Transverse thoracic plane
❖ Inferiorly: Diaphragm
❖ On each side: Mediastinal pleura
▢ Contents:
  1. Sternopericardial ligament
  2. Lymph nodes and Lymphatics
  3. Small mediastinal branch of the internal thoracic artery
  4. Lowest part of Thymus
  5. Areolar tissue
Middle Mediastinum
▢ Boundaries:
❖ Anteriorly: Anterior mediastinum
❖ Posteriorly: Posterior mediastinum
❖ Superiorly: Transverse thoracic plane
❖ Inferiorly: Diaphragm
❖ On each side: Mediastinal pleura
▢ Contents:
  1. Pericardium and Heart
  2. Lower part of Inferior venacava
  3. Ascending aorta
  4. Pulmonary trunk and its divisions
  5. Pulmonary vein
  6. Arch of Azygous vein
  7. Bifurcation of Trachea
  8. Phrenic nerve
  9. Inferior Tracheobronchial Lymph nodes
Posterior Mediastinum
▢ Boundaries:
❖ Anteriorly: Pericardium
❖ Posteriorly: Vertebral column (T5-T12)
❖ Superiorly: Transverse thoracic plane
❖ Inferiorly: Diaphragm
❖ On each side: Mediastinal pleura
▢ Contents:
  1. Oesophagus
  2. Descending Thoracic aorta
  3. Thoracic duct
  4. Azygous system of Vein
    1. Azygous vein
    2. Hemiazygous vein
    3. Accessory hemiazygous vein
  5. Nerves
    1. Vagi
    2. Splanchnic nerves
  6. Posterior mediastinal lymph nodes
CLINICAL ANATOMY
Mediastinitis
▢ Definition: Inflammation of soft tissues of mediastinum usually caused by passing down of infection from neck to either superior or posterior mediastinum is known as Mediastinitis.
Mediastinal syndrome
▢ Definition: Compression of any mediastinal structures by tumors give rise to group of symptoms known as Mediastinal syndrome.
▢ Symptoms:
❖ Dyspnea: Pressure over trachea causes difficulty in breathing known as Dyspnea.
❖ Dysphagia: Pressure over Oesophagus causes difficulty in eating known as Dysphagia.
❖ Dysphonia: Pressure over Left recurrent laryngeal nerve causes hoarseness of voice known as Dysphonia.
❖ Intercostal neuralgia: Pressure over intercostal nerves give rise to pain in the area supplied by them known as Intercostal neuralgia.
❖ Paralysis of Diaphragm: Pressure on the phrenic nerve causes paralysis of the diaphragm of that side.
❖ Engorgement of veins: Obstruction of superior vena cava gives rise to engorgement of veins in the upper half of the body.
❖ Erosion of the vertebral bodies: Pressure on the vertebral column may cause erosion of the vertebral bodies.
▢ Causes:
  1. Bronchogenic carcinoma
  2. Hodgkin's disease causing enlargment of mediastinal lymph nodes
  3. Aneurysm or dilatation of aorta
Mediastinal shift
▢ Definition: Shifting of the mediastinum (usually trachea from the midline) either right or left side due to tumors, lessions or diseases of lungs is known as Mediastinal shift.
Mediastinoscopy
Mediastinoscopy is the diagnositic procedure down to take specimen sample of tracheobronchial lymph nodes with the help of mediastinoscope usually in case of tumors of trachea and bronchus is known as Mediastinoscopy.

Question Answers

Q.

Mention the boundaries and contents of Mediastinum.

(2 + 3= 5)

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