Lecture 2 gross anatomy

What is considered the thorax?

Region between the neck and abdomen

What makes up the thorax

thoracic wall, thoracic cavity, and the organs contained within it.

Boundaries of the thorax

Superior thoracic aperture, inferior thoracic aperture

Superior Thoracic aperture

passageway for structure between thorax and neck

inferior thoracic aperture

Passageway for structures between thorax and abdomen

enclosed by diaphragm

Bony elements of the thoracic wall

Ribs, vertebrae bodies (T1-12) sternum, costal cartilages

Rib types

True ribs (1-7) false ribs (8-10) Floating (11-12)

Costal cartilages localtion

Costal margin Rib 7-10

sternum components

manubrium, body, xiphoid process

Joints of the thoracic wall

costovertebral, intervertebral, costotransverse, costochondral, sternocostal

Intervertebral

2 Thoracic vertebrae plus intervertebral disc

Costovertebral

costo transverse

costochondral junction

end of rib to costal cartilage

sternocostal

sternum to costal cartilage

Rib motion during respiration

sternum moves forward and upward during inhalation

A-P dimension of the upper thorax increases ( pump handle)

M-L dimension of the lower thorax increases (bucket handle )

Spine and Rib interaction

Muscles of inhalation

Diaphragm

central tendon of the diaphragm

Motion of the diaphragm

Apertures of the diaphragm

opening s that allow passage of structures between thorax and abdomen

Aortic hiatus, esophageal hiatus, caval opening

Aortic hiatus

Aorta, thoracic duct, azygos vein

esophageal hiatus

esophagus, anterior and posterior vagal trunks

caval opening

inferior vena cava and right phrenic nerve

innervation and blood supply of the diaphragm

Phrenic nerves (C3-5) pierce the diaphragm and inervate it from its abdominal surface

inferior phrenic arteries first paired arteries that arise from the abdominal aorta

muscles of inhalation

muscle of exhalation

internal intercostals

innermost intercostals

transversus thoracic

deep seen when flip ribcage over

muscles of pectoral region

pectoralis major, pectoralis minor, subclavius

pectoralis major

1 clavicular head and 2 sternocostal head

pectoralis minor

coracoid process and ribs 3-5

subclavius

rib 1 to anterior clavicle

nerves of the thoracic wall

pectoral nerves

lateral and medial pectoral nerves

lateral pectoral nerve (C5-C7)

derived from lateral cord of the brachial plexus

emerges at upper medial border of pectoralis major along with pectoral artery

innervated pectoralis major

median pectoral n (C8-T1)

derived from medial cord of the brachial plexus

usually pierces through pec minor

Supplies pectoralis minor and major

intercostal nerves

all other spinal nerves correlrte to their vertebrae

key dermatomes

arteries of the thoracic wall

arteries of the pectoral region

pectoral artery runs with lateral pectoral nerve

internal thoracic arteries

What is interanl thoracic arteries used for

intercostal arteries

intercostal veins

Azygos system of veins

acessory =upper

The breast

Retromamillary spcae

space separates breast tissue from underlying muscle

Mamillary lobes and lactiferous ducts

breast blood supply and innervation

lymphatics in breast

The Thoracic cavity

Pleura

pleural recesses

pleural effusion

The lungs

Hilar region of the lungs

features of the right lung

costal, cardiac, esophageal, and venous impressions(IVC and arch of azygos vein)

features of the left lung

costal impressions, aortic arch, thoracic aorta, cardiac impressions,

pulmonary artery is superior to bronchus in the left lung Remeber RALS

RALS:

bronchial tree

pulmonary embolism

mediastinum

superior mediastinum

thymus gland

RL brachiocephalic veins

branches of arch of the aorta

trachea and esophagus

phrenic nerves

Vagus nerves (cranial nerve X)

Right vagus nerve

left vagus nerve

another name for the left and right vagus nerve

recurrent laryngeal nerves

divisions of the the inferior mediastinum

anterior middle and posterior

inferior medistinum- anterior division

inferior mediastinum-middle divison

pericardial sac

pericardial cavity

phrenic nerves

phrenic nerves

heart

surfaces of the heart

external sulcus of the heart

coronary circulation

Right coronary artery

left coronary artery (realy tiny before branching)

cardiac Veins

coronary sinus

areas of myocardial infraction

coronary artery bypass grafts

walls of the heart

epicardium, myocardium, endocardium

epicardium

thin layer formed by visceral later of pericardium

myocardium

thick middle layer

Acts as the motor for pumping action

endocardium

thin inner layer,lines chambers of the heart

chambers of the heart

Right atrium

right atrium pt 2

Right ventricle

right ventricle pt 2