Organization of posterior mediastinum


Position and Extent:

It’s the portion of the mediastinum posterior to the heart and pericardium.


  • Superior: the plane joining the sternal angle to T4/5
  • Inferiorly: the thoracic diaphragm
  • Anteriorly: the heart and pericardium
  • Posteriorly: the inferior 8 thoracic vertebrae (T5-T12)


  • The thoracic aorta
  • Part of the thoracic esophagus and the related vagus nerve
  • The azygous venous system
  • The thoracic duct

The thoracic aorta


T4/5, to T12,

Course and Relations

  • At first it lies on the left of the bodies of T5-6, then inclines medially over the front of T7, displacing the esophagus to the right .

  • Further down the aorta passes behind the espophagus

  • It descends posterior to the root of the left lung and the pericardium in contact with the medial surface of the left lung

  • The thoracic duct and azygous vein ascend on the right of the aorta

  • The hemiazygous and accessory hemiazygous are related to it on the right.


  • The bronchial
  • The posterior intercostals
  • Esophageal
  • Pericardial
  • Subcostal arteries
  • Esophageal arteries
  • Pericardial branches
  • Mediastinal branches
  • Superior phrenic arteries


Posterior Mediastinum and posterior chest wall