Dissection of mediastinum and paravertebral structures

Upper thoracic part of left sympathetic trunk; intercostal vessels; ligamentous band between vertebrae and mediastinal structures

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Image #128-1

Dissection of mediastinum and paravertebral structures

Upper thoracic part of left sympathetic trunk; intercostal vessels; ligamentous band between vertebrae and mediastinal structures

The aortic arch and thoracic aorta have been pulled forward. The tracheobronchial tree has been retracted to the right. A ligamentous band (9), firmly attached to the anterior longitudinal ligament over the fourth and fifth thoracic vertebrae, can be seen extending downward and anteriorly to blend with the fascia which covers the esophagus, trachea and aorta. A similar ligament is also shown in another specimen (132-3).

1. Trachea
2. Ansa subclavia
3. Upper pointer: Brachiocephalic trunk Lower pointer: Left common carotid artery
4. Vertebral artery
5. Left subclavian artery
6. Posterior intercostal artery III
7. Left vagus nerve
8. Superior tracheobronchial lymph node
9. Ligamentous band extending from vertebrae to mediastinal structures
10. Recurrent laryngeal nerve
11. Left main bronchus (retracted to the right)
12. Bronchial branch of thoracic aorta
13. Stellate ganglion
14. Inferior trunk brachial plexus
15. Costocervical trunk
16. Aberrant ramus communicans
17. Thoracic ganglion
18. Esophagus
19. Sympathetic trunk
20. Intercostal nerve V
21. Rami communicantes
22. Anterior longitudinal ligament (pointer on vertebra Th. V)
23. Accessory hemiazygos vein
24. Thoracic aorta
25. Costal pleura