The Thoracic

Cavity
Mediastinum, Lungs
and Heart
Bien Eli Nillos, MD
 The Thoracic Cavity
► Divided into
 Mediastinum –
median partition
 Pleurae and
Lungs – lateral
portions
 Mediastinum
► Movable
► Extends superiorly to the thoracic inlet and
the root of the neck and inferiorly to the
diaphragm
► Extends anteriorly to the sternum and
posteriorly to the twelve thoracic vertebrae
► Contains the remains of the thymus, heart,
large blood vessels, trachae, esophagus,
thoracic duct, lymph nodes, vagus and
phrenic nerves.
► Superiorand inferior
mediastina – divided by
an imaginary plane
passing from the
sternal angle anteriorly
to the lower border of
the body of the fourth
thoracic vertebra
posteriorly.
► Inferior
mediastinum is divided into
anterior, middle and posterior
mediastinum.
Contents of the Mediastinum
► Superior: thymus, large veins, large
arteries, trachea, esophagus, thoracic
duct, sympathetic trunks

Bounded infront – manubrium sterni

Bounded behind – first four thoracic
vertebrae
► Inferior Mediastinum:
 Anterior – thymus
 Middle – heart, phrenic nerves
 Posterior – esophagus, thoracic duct,
descending aorta

Bounded infront – body of sternum

Bounded behind – lower eight thoracic
vertebrae
 Pleura
► Parietal layer – lines the thoracic wall,
covers the thoracic surface of the
diaphragm and lateral aspect of the
mediastinum
► Visceral layer – completely covers the
outer surfaces of the lungs

► Become continuous with one another

by means of a cuff of pleura that
surrounds the structures at the lung
root.
► Pleural cavity/space – slitlike space
between the parietal and visceral
pleurae.
► Pleural fluid – contained within the
pleural space, permits the two layers
to move on each other with the
 Parietal Pleura
► Cervical Pleura – extends up into the
neck, lining the undersurface of the
suprapleural membrane, reaching
about 1 to 1 ½ inches above the
medial third of the clavicle.

► Costalpleura – lines the inner surface

of the ribs, costal cartilages,
intercostal spaces, sides of the
vertebral bodies and back of sternum
► Diaphragmatic pleura – covers the
thoracic surface of the diaphragm

► Costodiaphragmatic recess – lower

area of the pleural cavity, 5 cms deep
in the scapular line posteriorly, 8-9
cms in the midaxillary line, 2.5-4 cms
in the midclavicular line.
► Mediastinal pleura – covers and forms
the lateral boundary of the
mediastinum

► Costomediastinal recesses – situated

along the anterior margins of the
pleura.
 Nerve supply
► Costalpleura – intercostal nerves
► Mediastinal pleura – phrenic nerve
► Diaphragmatic pleura – phrenic nerve
(domes) and lower five intercostal
nerves (periphery)

Visceral pleura – insensitive to pain and

touch
 Trachea
►5 inches long, 1 inch in diameter
► Fibroelastic wall, embedded by U-
shaped bars of HYALINE cartilage
► Begins at the neck (below the cricoid
cartilage of the larynx) at the level of
the body of the sixth cervical vertebra.
► Ends below in the thorax at the level
of the sternal angle.
 Boundaries
► Anterior – sternum, thymus, left
brachiocephalic vein, arch of the aorta
► Posterior – esophagus, left recurrent
laryngeal nerve
► Right Side – azygos vein, right vagus
nerve, pleura
► Left Side – arch of the aorta, left
common carotid and left subclavian
arteries, left vagus and left phrenic
nerves, pleura
 Principal Bronchi
► Right Main Bronchus – wider,
shorter, more vertical than the left, 1
inch long, gives off the superior lobar
bronchus before it enters the right
lung. On entering the hilum of the lung
it divides into a middle and inferior
lobe bronchus.
► LeftMain Bronchus – narrower,
longer, more horizontal, 2 inches long.
Passes to the left below the arch of the
aorta and in front of the esophagus.
Upon entering the hilum, it divides into
a superior and inferior lobar bronchi
 LUNGS
► Soft and spongy
► Very elastic
► Should the thoracic cavity be opened,
they immediately shrink to 1/3 or less
in volume.
► Each lung is conical in shape
► Suspended free in its own pleural
cavity, being attached to the
mediastinum only by its root.
► Apex – projects upward into the neck
for about 1 inch above the clavicle
► Costal surface – convex, corresponds
to the chest wall
► Mediastinal surface – concave, molded
to the pericardium and other
mediastinal structures
► Hilum – a depression, in which the
bronchi, vessels, nerves enter the lung
to form the root.
► Anterior border – thin and overlaps
the heart; it is here on the left lung
that the cardiac notch is located.
► Posterior border – thick, lies beside the
vertebral column
Lobes and
Fissures

Right Lung –
divided by oblique
and horizontal
fissures into three
lobes: upper,
middle and lower
lobes.

Left Lung – divided

by oblique fissure
into two lobes:
upper and lower
lobes.
► Each lobar bronchus gives off
branches called segmental bronchi.
► Each segmental bronchus passes to a
bronchopulmonary segment =
pyramidal in shape, apex toward the
root of the lung
 Blood Supply of the Lungs
► Bronchial Arteries – branches of the
descending aorta; supply the bronchi,
connective tissue of the lungs and
visceral pleura
► Bronchial Veins – drain into the azygos
and hemiazygos veins into the
Superior Vena Cava.
► Pulmonary artery – deoxygenated
blood
► Pulmonary Vein – oxygenated blood, 2
pulmonary veins leave each lung root
“It opens the lungs, washes the
countenance, exercises the
eyes, and softens down the
temper; so cry away.”

Charles Dickens
Intro to the Heart