The Middle Mediastinum:

Pericardium & Heart

 Mediastinum

• The space between 2 lungs

Sup.: thoracic inlet

Inf.: diaphragm

Ant.: sternum & 2-6 CC

Post.: thoracic vertebrae

By Imaginary line  superior & inferior mediastina

 Divisions
2 divisions by imaginary line: sternal angle  T4-T5

Superior:
Ant.: manubrium
Post.: T1-T4
Sup.: ?? Inf.: ??

Inferior:
Ant.: sternal body
Post.: T5-T12
Sup.: ?? Inf.: ??
 Inferior Mediastinum
3 parts:

Ant.: from sternum  heart covering

(pericardium)

Middle: heart & pericardium

Post.: post. to heart

Pericardium
 Pericardium

• Covering fibroserous sac of 2 layers of tissues that

encloses the heart

• Outer: fibrous (fibrous pericardium)

• Inner: serous (serous pericardium)

• Fxn.: 1. Protection 2. Lubrication (friction)

 Fibrous Pericardium

• Strong single layer

• Attached:
Ant.: sternum (sternopericardial lig.)
Inf.: diaphragm (central tendon)
Sup.: fuse to great vessels (t. adventitia)

• Sensory innervations by phrenic nerve

(very sensitive)

What are the cervical spinal segments of

the phrenic nerve origin?
 Serous Pericardium

• 2 layers of mesothelial cells that are continuous with each

other

• Outer (Parietal):
lines over fibrous pericardium
reflects around the roots of large vessels
to become continuous with

• Inner (Visceral):
closely attached to the heart

Epicardium (outer heart layer)
 Review

• Sup & Inf mediastinum

• Inf  middle:
pericardium & heart

Fibrous: Protection

Serous: Lubrication

visceral  epicardium
 Heart
Read Your Textbook For Details

• 3 layers

• 4 chambers

• 3 borders
(examining X-ray)

• 3 surfaces

• Apex & Root

 Heart Surfaces

1. Anterior (sternocostal):
Rt. Atrium, Rt. V., Lf. V., ant. intervent. groove
2. Inferior (diaphragmatic):
Rt. & Lf. V’s, & post. interventricular groove
3. Posterior:
Lf. Atrium
Base of the heart
4. Apex:
part of Lf. V. (lf. 5th intercostal space, 9 cm from ??)
5. Root:
origin of great vessels
(aorta, pulmonary trunk, SVC)
Posterior Surface

Inferior Surface Anterior Surface

Site for posterior surface
of the heart (Base)

Site for inferior surface of

the heart (Diaphragmatic)
 Right Atrium
Read Your Textbook For More Details

- Receives deO2 bld. From the body

- Forms Rt. Border of the heart
- Composed of:
smooth walled chamber &
rough out pouch (auricle)
Rough = pectinate muscle

- Border between:
crista terminalis
Outside:
sulcus terminalis

- Atrial septum (fetal remnants):

Fossa ovalis
Anulus ovalis
 Openings of Rt. Atrium
1. SVC:
bld. from upper body

2. IVC:
bld. From lower body / larger

3. A-V orifice:
Ant. to IVC
Guarded by tricuspid valve

4. Coronary Sinus:
Between IVC & A-V orifice
Bld form heart wall

5. ant. cardiac veins

 Rt. Ventricle
Read Your Textbook For More Details

Crescent shaped from inside (cross-section)

3 muscular projections:
1. Papillary muscles:
Finger-like projections
Attach the cusps of A-V valve via Chordae tendineae

2. Moderator band:
inf. septal wall  base of ant. Papillary muscle
contains nervous bundle to Rt. Ventricular wall

3. Trabeculae carneae:
prominent muscular ridges
 Openings

• A-V orifice:
guarded by tricuspid valve

• Pulmonary opening:
smooth funnel-shaped wall (infundibulum)

infundibulum = conus arteriosus

guarded by pulmonary valve

 Lf. Atrium
• Most of the posterior wall

• Small lf. Auricle (muscular ridges)

• Usually 4 openings for P. V.& 1 for mitral valve

 Left Ventricle

• Wall  3x thicker than Rt. V.

• Circular in cross-section

• 2 large papillary m. (groups)

• Aortic vestibule:
smooth surface inf. to
aortic valve

No moderator band
 Heart Position
• Behind the sternum &
slightly to the left
 strong sounds = left to
the sternum

• Dextrocardia:
The heart is on the right
side of the chest
 heart sounds = right to
the sternum
- 1 in 12,000