Medial surface of lung

The medial surface of the lung is the flat, concave inner aspect of each lung.

It is subdivided into:

• Mediastinal surface: faces the mediastinum and contains the hilum the region where the bronchi, pulmonary vessels, lymphatics, and nerves enter and exit the lung.

• Cardiac impression: A large concavity on the medial surface produced by the heart. This impression is deeper and larger on the left lung than the right, owing to the leftward position of the heart.

• Vertebral surface of lung (Vertebral part): The most posterior portion of the medial surface lies adjacent to the thoracic vertebral bodies. It contacts the sympathetic trunk and posterior intercostal vessels.

Right lung medial surface landmarks:

• Grooves for the superior vena cava (SVC) and inferior vena cava (IVC)

• Groove for the azygos vein arching over the hilum

• Groove for the esophagus (posterior to the hilum)

• Contact with the right atrium

Left lung medial surface landmarks:

• Groove for the aortic arch and descending thoracic aorta (posterior to the hilum)

• Groove for the left subclavian artery and vein (superior)

• Groove for the esophagus (posterior and inferior)

• The cardiac notch on the anterior border, which is related to the prominent cardiac impression on this surface

Pleural covering: The entire medial surface is covered by visceral (pulmonary) pleura, except at the hilum where the pleura reflects to become the parietal pleura, forming the pulmonary ligament inferiorly.