Posterior mediastinum

The posterior mediastinum (or paravertebral compartment) is a potential space along the paravertebral sulci. It is conceptually considered a portion of the inferior mediastinum, and separated from the middle mediastinal compartment and the remainder of the extrapleural intrathoracic cavity by arbitrary lines.

Gross anatomy

Relations

• superiorly: superior mediastinum
• anteriorly: anterior and middle mediastinum (which form the other compartments of the inferior mediastinum).

It is continuous with the retropharyngeal space via the posterior part of the superior mediastinum.

Contents

• thoracic spine ⁵
• paraspinal nervous system ⁶
  • thoracic spinal ganglion
  • sympathetic trunk and major branches
  • rami communicantes of intercostal nerves
• paravertebral soft tissues ⁵
  • proximal intercostal vessels
• distal azygos-hemiazygos venous system ⁶

Boundaries

• superiorly: thoracic inlet
• inferiorly: diaphragm
• anteriorly: posterior boundaries of middle mediastinum (1 cm posterior to anterior margin of thoracic vertebral bodies) ⁵
• posteriorly: posterior margin of chest wall, along the transverse processes of thoracic vertebrae
• laterally: mediastinal parietal pleura

Related pathology

• wide variety of malignancies, e.g. mesothelioma, lung, neurogenic (e.g. schwannoma), teratoma, lymphoma, sarcoma
• lymphadenopathy
• aortic aneurysm
• extramedullary hematopoiesis

See also

• main article: differential for a posterior mediastinal mass