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Anatomy for Dental Students$
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Martin E. Atkinson

Print publication date: 2013

Print ISBN-13: 9780199234462

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199234462.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2022. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use.date: 27 May 2022

The heart, pericardium, and mediastinum

The heart, pericardium, and mediastinum

(p.86) 12 The heart, pericardium, and mediastinum
Anatomy for Dental Students

Martin E. Atkinson

Oxford University Press

The heart, the arteries and veins leaving and entering the heart which are usually referred to as the great vessels, the trachea and bronchi, the oesophagus, and the vagus and phrenic nerves and sympathetic chains occupy the mediastinum , the area in the middle of the thoracic cavity between the two pleural sacs. The anteroposterior dimension of the thorax is narrowest in the mediastinum because of the presence of the thoracic vertebrae posteriorly. Laterally, the pleural sacs enclosing the lungs extend much further back alongside the vertebrae in the areas known as the paravertebral gutters. The great vessels enter and leave the superior aspect of the heart. The large veins draining the head, neck, and arms lie most superficially; they unite to form the superior vena cava that enters the right atrium of the heart. These veins overlie the two large arteries exiting the heart, the aorta, and pulmonary trunk. The aorta has a short ascending part, then forms the aortic arch passing backwards and to the left before continuing down the posterior wall of the thorax as the descending thoracic aorta. The subclavian and common carotid arteries, supplying blood to the arms and head and neck, respectively, arise from the aortic arch. The oesophagus is the deepest structure lying on the vertebrae and the trachea and main bronchi lie superficial to it. The sympathetic chains lie lateral to the vertebral bodies and the vagus and phrenic nerves are in intermediate positions. All these structures will be described in more detail in the rest of this chapter. The mediastinum is divided, for descriptive convenience, into the superior and inferior mediastinum. Figure 12.1 shows the imaginary line of division joining the sternal angle and the intervertebral disc below T4 that demarcates the boundaries of the superior and inferior of the mediastinum. The superior mediastinum occupies the space between the thoracic inlet above and the imaginary horizontal plane. The inferior mediastinum lies below that line and extends as far as the diaphragm. The lateral borders of both subdivisions of the mediastinum are the parietal pleura covering the medial aspect of the lungs, the mediastinal pleura.

Keywords:   aneurysms, bacterial endocarditis, cardiac plexuses, diastole, epicardium, fibrous pericardium, great vessels, heart block, intercostal nerves

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