Mediastinal Anatomy

This chapter provides in-depth knowledge of mediastinal anatomy and understanding of the critical structures and their relevance in Endobronchial Ultrasound (EBUS). It also explores the mediastinum’s divisions, including the anterior, middle, and posterior compartments, and highlights key anatomical landmarks. It also details the spatial relationships and positioning of various critical structures. This fundamental understanding is essential for clinicians performing EBUS procedures, as it enhances their ability to accurately assess and diagnose mediastinal diseases, particularly lung cancer staging and other intrathoracic pathologies.It is essential to have knowledge and understanding about the airway anatomy and of the mediastinum before proceeding for endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA). This allows the bronchoscopist to correlate well the radiological findings obtained by computed tomography of thorax with the luminal anatomy before performing bronchioalveolar lavage and biopsy. It is also essential to have an orientation about the ultrasound images of various anatomical structures in the mediastinum and the artifacts that will be encountered during the procedure [1].