Mnemonic

Tracheal Relations in the Thorax

A memory aid for the structures around the trachea in the superior mediastinum.

Expansion

Aortic arch and great vessels in front and to the left, oesophagus behind

Expansion

Within the superior mediastinum:

  • Anteriorly - the left brachiocephalic vein, the brachiocephalic trunk and left common carotid artery, the aortic arch, and the remnants of the thymus
  • Posteriorly - the oesophagus, and behind it the vertebral column
  • To the left - the aortic arch, the left common carotid and subclavian arteries, and the left recurrent laryngeal nerve in the tracheo-oesophageal groove
  • To the right - the azygos vein arching forwards, the right vagus nerve, and the right pleura

The tracheo-oesophageal groove is the key surgical landmark: it carries the recurrent laryngeal nerve on each side, and it is the plane dissected in thyroid and oesophageal surgery.