The mediastinum lies within the thorax and is enclosed on the right and left by pleurae.

It is surrounded by the chest

wall in front, the lungs to the sides and the spine at the back. It extends from the sternum in front to thevertebral
column behind, and contains all the organs of the thorax except the lungs. It is continuous with the loose connective
tissue of the neck.
The mediastinum can be divided into an upper (or superior) and lower (or inferior) part:

The superior mediastinum starts at the superior thoracic aperture and ends at the thoracic plane.
The thoracic plane separates the superior and inferior mediastinum. It is a plane at the level of the sternal
angle, and the intervertebral disc of T4-T5.[2][3][4]
The inferior mediastinum from this level to the diaphragm. This lower part is subdivided into three regions, all
relative to the pericardium - the anterior mediasteinum being in front of the pericardium, the middle
mediastinum contains the pericardium and its contents, and the posterior mediastinum being behind the
pericardium.

Anatomists, surgeons, and clinical radiologists compartmentalize the mediastinum differently. For instance, in the
radiological scheme of Felson, there are only three compartments (anterior, middle, and posterior), and the heart is
part of the anterior mediastinum

Superior mediastinum
The superior mediastinum is bounded by:

superiorly by the thoracic inlet, the upper opening of the thorax

inferiorly by the transverse thoracic plane
laterally by the pleurae
anteriorly by the manubrium of the sternum
posteriorly by the first four thoracic vertebral bodies

Thoracic plane

The thoracic plane separates the superior and inferior mediastinum. It is a plane at the level of the sternal
angle, and the intervertebral disc of T4-T5.[6][7][8]

A number of structures occur at the level of the thoracic plane, which divides the superior and inferior mediastinum:

Inferior mediastinum
Anterior mediastinum
Bounded:
Laterally by the pleurae
Posteriorly by the pericardium
Anteriorly by the sternum, the left transversus thoracis and the fifth, sixth, and seventh left costal
cartilages
Middle mediastinum
Bounded: pericardial sac
Posterior mediastinum
It is bounded:
anteriorly by the pericardium (in front of)
inferiorly by the thoracic surface of the diaphragm (below).
superiorly by the transverse thoracic plane
posteriorally by the bodies of the vertebral column from the lower border of the fifth to the
twelfth thoracic vertebra (behind).
laterally by the mediastinal pleura (on either side)
CLINICAL SIGNIFICANCE

The mediastinum is frequently the site of involvement of various tumors:

Anterior mediastinum: substernal thyroid goiters, lymphoma, thymoma and teratoma.

Middle mediastinum: lymphadenopathy, metastatic disease such as from small cell carcinoma from the lung.
Posterior mediastinum: Neurogenic tumors, either from the nerve sheath (mostly benign) or elsewhence (mostly
malignant).

Mediastinitis is inflammation of the tissues in the mediastinum, usually bacterial and due to rupture of organs in the
mediastinum. As the infection can progress very quickly, this is a serious condition.

Pneumomediastinum is the presence of air in the mediastinum, which in some cases can lead
to pneumothorax, pneumoperitoneum, and pneumopericardiumif left untreated. However, that does not always
occur and sometimes those conditions are actually the cause, not the result, of pneumomediastinum. These
conditions frequently accompany Boerhaave's syndrome, or spontaneous esophageal rupture.

There are many diseases that can present with a widened mediastinum (usually found via a chest x-ray). The most
common ones are aortic unfolding,traumatic aortic rupture, thoracic aortic aneurysm, and traumatic thoracic
vertebral fracture. A widened mediastinum is a classic but rare hallmark sign of anthrax infection