CHAPTER 3
Thorax
ffi ANTERToR BoNYTHoRAx
The thoracic sketeton is composed of the sternum, 12 pairs of ribs and their costatcartitages, and
the intervertebrat (lV) disk between them.
; CO¿OR e ach of the following using a different color for each structure:
Sternum
The sternum is a flat, etongated bone in the midline of the
anterior thoracic wa[[ and consists of three pads: manubrium,
body, and xiphoid process.
@ 1. Manubrium: Super¡or poftion, primari§ trapezoid
in shape, and is the widest and thickest part of the
sternurR
@ 2. Body: Longer, narrower, and thinnerthan the manubrium
and is tocated at T5-T9 vertebral levets
The manubrium and body of the sternum tie in stightty
different planes as they meet forming a projection referred to
as the manubriosternal ioint (§ternal anole).
Q 9. Xiphoidprocess: Smallest and most variable part of the
sternum. The inferíor end lies at the T'10 vertebraltevel.
Junction of the body and xiphoid process creates the
xiphisternaljoint, which indicates the inferior limit of the
central part of the thoracic cavity.
1 2 th a racic verÍeárae and
Ribs
Ribs are curved, flat bones that form the majority of the thoracic
cage. Ribs are numbered sequentiatty from superior to inferior
{,7st-l2th). There are three ctassifications of ribs:
j 4. True ribs: lst to 7th ribs, which directty attach to
the sternum through costal cartilages
{p 5. False ribs:9lh and 9th ribs and, usual§, the 10th rib
@ 5. Ftoating ribs: 11th and 'l2th ribs and, sometimes,
the 1Oth rib with anterior caps of costatcartilage
C 7. Costalcartilage; Articutates with the anterior aspects
of each rib, providing a flexible attachment
(p 8. Cosfalmargin: Formed by the costatcartitages of the
false ribs (Bth-10th) connecting to the costa[ cartitages
superior to them
lntercostal spaces separate the ribs and their costal caftilages
from each other. Each intercostal space is numbered for the
rib forming its superior border. For example, the &th íntercastal
space is between the 8th and 9th ribs. There are onty 11 in-
tercostal spaces; the space below the izth rib is the subcostal
space.
 i,.'i i:i :r :r-
i r,¿t: tt : i r,.i: tr r:-

ANTERIOR BONY THORAX

,. i{anuLrn
ls{ thoracic vertebra

q. (orlilhs- verffiÉrt'E

Manubriosternal jo¡nl
(sternal angle)

z.eáersg-del--
esterrwñ

Xiphíst8mal ioint

s. Ponmn Xi$nidr.

z. Cü{to¿s f{'*}ol

8th interüoshl space

Body of 1Zth
froracic vertebra

Martrn Cslol o Re]nr.rg

-
Costol lnferor
 Thorax FEATURES OF TYPICAL RIB§
TEATURT§ OF TYPICAL RIBS
,$ COTOR ea ch of the following using a different color for each structure:
Each typical rib (3rd-9th) has the foltowing features:
| 1. Head: Wedge shaped and marked by a crgstof head.
The head is demarcated by two facets that articutate
with the vertebraI bodies;
(l ?. Superiarfacet
$ 3. lnferiarfacet
The head of each typicat rib articulates with the vertebral
body of the same number and the vertebral body superior to
it, formi ng th e iai nA of tha head afthe rib. The head of the 7t&
rib, for exampte, witl articutate with the superior costal facet
of the 7-l vertebra[ body and to the inferior costal facet of 15.
The heads of the 1st, 1 1th, and 12th ribs only articulate with
the vertebral body of the same number.
Q 4. Superiorcostal,facet.ofT6: Articulates with the inferior
facet of the head of the €$t.ríb
l 5. lnferiorcastalfacetofTT: Articulates with the superior
facet of the head of the 8táriá
§ 6. Neck Connects the head to the body {shaft) of the ríb
Q 7. Tubercle: Located atthejunction ofthe neckand body
(shaft)
The tubercle of each rib wittarticulate with the transverse
process of the vertebra of the same number, forming the co:-
totransverse ioint The tubercte of the 7th rib, for example,
articutates with the transverse costalfacet of T7.
§ 8. IransversecostalfacetofTí: Articulates with the tubercle
of the 6th rib
{§ 9. eody (shaft):Thin, ftat, and curved component of the rib. The
costatanale occurs where the body turns anterolateralty.
eI 0. Costal groove: Stight concave indentation paralteting
the inferior border of the body of the rib that protects
the intercostal neurovasculature
fhe anterior blunt end of the rib mark the site ofqrfigulaüion
with th-e costal cartitaae.
 FEATURES OF TYPICAL RIBS THORAX

r. Cohe¿E
-
u. üualltt

Crest of head

6tt rib

s.l

z.
-tri¡lmusrl+
"-

Site of artieulation with coshl cartilage

,0. S*..o Cn*¡¡l

+.Fsqrh Co*leñ q,*F

sFdflfl+q ffidrt -
Trsrfigssü
Joints of head of r¡b

Costotransverse joint

s Ffiñ+r¡ frxr,l{rl lnF

\ rlii{iii,
 ' Thorax FEMALE PECTORAL REGION WITH THE BREA§T

FEM*[r,pE{T, I R:E§.ffit U¡lfn:tHg BfEAsT

-E
Breasts consist of gtandutar tissue sunounded by ft¡[ and are typicatty more devetoped in women.

ffi COf OR ea ch of the followi ng using a diffe rent colar for each structu re:

@ 1. Pectaralismascle (and pqctqralfascía): Underlies the O 5. Lactíferousducú; Drains each of the 15 to 20 tobules
major§ of the breast. Between the breast and the of the mammary gland. The lactiferous ducts ditate
pectoralfascia is a loose connect¡ve tissue plane (po- peripheral§ as the la€tiferous sinuses as they converge
tentiat space), the ret{ofamma¡y.space. This space toward the nippte sunounded by the areala.
atlows a minor amount of movement of the breast on
the pectoraI fascia.
o 2. Sarrafrrs a nterio r m uxle: U nd e rli es a m i no r com ponent
of the lateral breast
@ 3. Atcillary process ftai$i Portion of the mammary gtand
extending along the inferolateralmargin of the pectoralis
major and into the axitla
@ 4. §uqpensoryligaments: Attach the mammarygtand to
the dermis of the overtying skin

¡', f'. :"1 ;¡ ,ii :

 THORAX ilffi r.:ll,l

, -I'tds¿ula-Fe+*o'a!

Deltoid Pectoral fascia

Retromammary space

Cephalic vein

Fat (left breast)

3. $Yr.i.** .fr$íLm
dq, i-* Fr.¡.ErrruT

Areola

CnruLr"*a
lsctíhm

t.irtut!
"\i'rl'::.-:'-ri'
,: i ti=L:i *1-i r: i.:i :1 i Í
: r:l I'.:l a"r I i,: : : :ii.:
82 Thorax EXTERhIAL ASPECT OF ANTERIOR THORACIC WALL
EXTERNAL ASPECT OF ANTERIOR THORACIC WALL
cu [a r m uscle s {p§cto ra lk pectoralis
-m a ig. a n d
Axi oa ppe nd i wa[L include the externaI
ry! nof) (exte rn a I s b tiq qe.
an d a nterolatera I abd om ina t m usc[es
and rectus abdgminis) attach to the anterior thoracic watt, but
are involved in functions of other regions and have been mostly
removed in this figure. The true muscles of the anterior thoracic
CALOR each of the foltowing using a different color for
Q 1. Extern al intercasta{muscIes.' Fitt the intercostai spaces
from the tubercles of the ribs posteriorly to the junction
of the ribs and the costaI cartitages anteriorly. The fibers
rr.rn infersanterior§ from the superior rib to the inferior
rib (direction is like "hands in a pocket").
{) 2. Externalintercostal membranes; Replace the fibers of the
external intercostaI muscte between the costaI ca rtilages
antericrty to the sternum. The fibe¡'s continue to run in
an inferoanterior direction, but the membrane is often
thin enough to see the undertying internal intercostaI
muscle through it.
o 3. lnternal intercostat rnusc{es.. Atso fitt the inter-costal
spaces, birt are located deep to the externa[ intercostaI
musctes and membranes. The internal intercostaI musctes
attach to the costal cartitages and bodies of the ribs
from the sternum to the angles of the ribs posteriorly.
The fibers run at right angles tc the externaI intercostaI
muscles and membranes in an inferoposterior direction.
Posteriorly, fronr the angtes of the ribs to the vertebral
column, ihe muscle Íibers are replaced by the internat
intercostaI membrane.
C 4. Transversusthoracis nrilseJes: Cornposed of four to five
s[ips of muscle that extend from the internal aspect of
the sternum to the internal aspects of Znd to 6th costaI
cartitages
and internaI intercostaI muscles atong
with the transversus thoracis muscte.
A sma[[window has been cut into the externaI intercostaI
membrane and internal intercostal muscle near the sternum
on ihe right side to reveal the underlying structures.
each structure:
Q 5. trnüernalthoracicartery: Paired arteries that descend on
the ¡nternal surface of the thoracic wall on either side
of the sternurn between the internaI intercostaI and
transversus thoracis musctes
Q 6. Internalthoracicvein: Travels with the internalthoracic
artery on each side of the sternurn
Q 7. Anteriorintercostalarteries and yeins; Arise from or
drain into the internalthoracic artery and vein, respec-
tively, supplying the anterior aspects of the superior
nine intercostal spaces. Each anterior intercostal artery
and vein wit[ anastomose with a posterior intercostal
artery and vein of the same intereosta[ space in the
lateraI thoracic wa[[.
Q 8. lntercostal nerve: Formed by the anterior ramus of
spinal nerves T1-T11 and inner'¡ates the extent of a
single intercostal space.
Because only one source (the spinaI cord) gives rise to
the intercostal nerves, anteriorlposterior is not utilized in the
naming of intercostaI nerves. ln contrast, anterior/posterior
is used in naming the intercostal arteries and veins because
there are two sources that give rise to the vascutar supp§ of
the intercostal spaces (posterior intercostals from the aorta/
to the azygos system of veins and anterior intercostats from/
to the interna[ thoracic artery and vein).
 I

THORAX

¡ I,i** q i*, i ulit:¡''.*¡u?'c* l

u {ena Torrício
tnlerno Brachial plexus

Pectoralis minor

Pecbralis major (trt)

, irr&*,*:rr**&mi * s irrttráirws
r. j'hfxsi?"1ü "á "; {,:t';^3
iu;i*;.s"r,¡*iin- it g tnr ¡'i* ¡".

Psctoralis major (cut)

Recius abdominis

l frsí,i,r efrIo 'inrxf,{rl,ü**

Tfffitl:;¿s"6¡3
Mernbvqna \nlevos{ol Extervrq

tntIllit>
i i-1"!"it ]{.1 F Ir'I',¡t,,t'
84 Thorax TNTERNAL AspEcr oF THE ANTERIoR THoRActc wALL

i.if,,.,;.1¡, INTERNAL ASPECT OF THE ANTERIOR THORACIC WALL

The anterior thoracic wall has been removed and the internal been cut and also removed on the right side of the specimen.
aspect disptayed. The endothoracic fascia and costa[ layer of
The arteries from the arch of the aorta and the brachiocephatic
the parietal pleura have been removed. The diaphragm has
veins have also been cut.

COÁOR eac h of the fotlawing using a different color for each structure:

@ 1. I nte rn al i nte rcostal

m usc{es: Campletety f i it the i nter-
costal spaces atong the internal view of the anterior
thoracic wa[[. The innermost intercostal muscles are
not present on the anterior thoracic watl
ffi 2. Diaphragm: Originates from the internal surface of
S 6. Musculaphrenicartery: Terminal branch of internal
thoracic artery that courses atong the costa[ margin
supptying portions of the diaphragm and muscles of
the anterior abdomina[ wa[[
@ 7. §uperio r e pig astri c arÉery; Term na I bra nch of nterna I
i i

the inferior six costal cartilages, the sternum, and the
superior [urnbar vertebrae
@ 3" lnternaltharacicarteryr: Paired arteries that arise
from the first part of the subclavian artery, descend
lateralto the sternum, and then trave[ anterior to the
transversus thoracis muscte
@ 4. Subclavian artery: On the right side typicatly arises from
the brachiocephatic trunk, whereas on the left typicatty
arises direct§ from the arch of the aorta
@ 5. Transversusthoracismuscle; Composed of four to five
slips of muscle that extend from the internal aspect of
the sternum to the internaI aspects of Znd to 6th costal
cartilages. The internaI thoracic artery travels anterior
to the transversus thoracis muscte and terminates in
the 6th intercostatspace into the musculophrenic and
superior epigastric arteries.
thoracic artery that continues inferior§ posterior to
rectus abdominis rnuscle
Q 8" lnternalthoracicvein; Fotiows the same course as the
internatthoracic artery, but typicatiy drains to the bra-
chíocephatic veins
@ 9. Bractriocephalicvein; Fonned by the union of the internal
jugular vein and the subctavian on each side
fll0. Anterior intercostal artery: Arises from the internal
thoracic artery to supply the lst to 6th intercostal
spaces and from the muscutophrenic artery to suppty
the 7th to 9th intercostal spaces. Each intercostal space
is typicatly supptied by a sma[[ pair of anterior intercostal
arteries. The 1Oth to i 1th intercostal spaces are only
supplied by posterior intercostaI arteries.
@11. Anferiorintercostalvein; Follows the same course as
the anterior intercostal artery
 THORAX

s. lrleriq Trydcirn lr,lq.rre

e.Ualo TorcdeÁ h+¿Érts

,,.tüeru hlrcrm*rl
h,*erloü
,0 fr*kria ttwm**t*l
á*hrlur
2nd intercGtal nerve

Borly of st€rnum

,.,\,...r:r.'\

;-a--

5.

, t¡t¡trmr&ryn üc
 Thorax FEATURES OF THE RIGHT AND LUNG§

Fil3FEffiEI FEATURES oF THE RIGHT AND LEFT tUNGs

The lungs have been removed from the thoracic cavity. A lateral and posterior view is displayed from the right tung (A) and
the left tung (B).

CALOR each of the fatlowlng using a dlfferent colar for each structure:

Each lung has a superiorty positioned apex and a concave, in- and diaphragmatic surfaces atong with qnteríor, inferior, and
feriorly positioned base. Each [ung also has costal, mediastinat, pgsterior borders.

Rigtrt Lung (A)

Divided into three lobes: The superíor tobe of the teft tung is demarcated by two features:
ü 1. §uperior )6. Cardiacnotch: Deep indentation alongthe antero-
| 2. Míddle inferior border
{) 3. lnferior l) 7. tingulal Tongue-like process that extends inferior
I 4. Obligue fissure: Separates the inferior lobe from the to the cardiac notch
superior and middte lobes
) 5. l{arlrutalfisurc: Separates the middte and superior lobes

Left Lung {B)

Divided into two lobes:
,O 1. Superior
§ 3. lnferior
) +. OOtiquefisure: Separates the superiorand inferior lobes

i!Iir!.: .-ll r.i-ia1 iliri"ii..l

 THORAX

o F¡su rts fl}h&ue,qr

Posterior border

Ér,e*rs sr fS^lo.nr*

FJscsm Flnr i I
'*r*Ssr

lÁhrrln Mp.lin

, t'dh ¿,tm \vrÉ:erur-.*

, SuF rior tci&rutn

o Éstus ei {}k t¿.c,lq

Anterior border

Poser¡or border

6 t$e*¿h {dhrffi

¡ ti
 MEDIASTINAL SURFACE OF THE RIGHT LUNG

itriffi.*..F MEDIA§TINAL §URFACE OF THE RIGHT LUñC

The right lung has been cut at the hílum, removed from the the secondary (lobar) bronchi" The branching of the putmonary
thoracic cavity, and the mediastinatsurface disptayed. ln this artery and veins is also visibte. lmpressions of surrounding
image, the cut was performed stightty lateral (eloser to the structures are atso present, as is common with embalmed
lung) and disptays the right main bronchus as it branches into cadavers.

I COLOR ea ck af the fotlowing using a different calor for each structure:

The fissures continue to the rnediastinalsurface of the right Q 8. Crooveforarchof arygosvein: Passes overthe superior
lung dividing it into superror, rglddle, and ínferiortabes. aspect of the hilum of the lung
Q 9. Groove forsuperiarvena €ava: Lies anterior to the hitum
@) 1. Oáliq{re fissure of the lung
Q 2. Harizontalfíssure C10. Cardiacimpressron; Lies inferior to the groove for the
superior vena cava along the inferior aspect of the
The hilum of the lung is penetrated by the root of the superior lobe and the middle tobe
lung structures. The structures in the root of the right lung are
organized as fotlows:

&
(l
3. nigrrü main bronchus; Located posteriorly
4. BronchíaI vesse{s: Small vessets [ocated immedíate§
next to the bronchus
) S. eulmonaryartery: Situated anteriorly to the right main Apu'lmonary emboius (btood ctot) typicatty arises from a thrombus that
bronchus originates in lhe deep venous system of the tower limb. The thrombus
travels through the venous system to.the heart and then through one
Q 6. Pulmonaryveins: Located anteroinferiorly
cf lhe pulmonary arteries to either tung. The thrombus then beiome¡
lodged either'at the bifurcation of the pulmonary artery or at the further
The mediastinalsurface demonstrates impressions made by di.visions of the iobar arteries. Consequently, blood flor,r¿ to a lung or a
, pórtion of a iung is btocked. Clinicat presentation of pulmonary embotism
nearby structures that come into contact with the right [ung.
varies greatly. A large rhrorrrbus blocking a putmonary artery may cause
sudden,and catastrophic hemodynamic {blood flow dynamics) eollapse,
Q 7. Groove{oresophagrs: Lies posterior to the hilum of wheieas a smell tlirombus btocking a bronchopulmonary segment may
the [ung cause gradual§ progressive dyspnü (srrortnesi of breatñ).
 MEDIA§TINAL SURFACE OF THE RIGHT LUNG THORAX

a, ;.;'-iT i-l ,.},¡:,.i :lI+::L t{r;

'i '" ."'.r 'rr .+¡oi j :'-: .
¿ !h 1 =l

r Fisrrrq §hlicua

c,*$/0 §uPB?iS'r
, Brm,qng fuirqipol
Derc#'o

10. :t
--- ri'*',,ñ' if,
t '1^'"--'"tr¡'-
Si -a'- r'l
'. tf{I ,''¡ÚL"¡a'=-t
u Venas-pl{mqnars¡

{_il'¿ults
i-i j-l i- r ,i. a]]:.-i i't::: i..r1,,,..1ri i ,'i;;'_:, :',: "+
ii
: t¡'.-r i i1¡¡1¡ii
i,,1_
._, l"^r ,-:
^. I r,_.:' - r,. -:...i ,: ...
 Thorax MEDIASTINAL SURFACE OF THE LEFT LUNG

fffiffi MEDIASnNAL suRFAcE oF THE LEFT LUNG

The teft tung has been cut at the hitum, removed from the main bronchus, putmonary artery, and the left superior and
thoracic cavi§, and the mediastinat surface displayed. ln this inferior pulmonary veins. fmpressions of surrounding structures
image, the cut was performed medial to the branching of the are atso present, as iscomrnon with embalmed cadavers.

;$ COíOR ea ú of the following using a diffarent calar far each structure:

) I Ahtiquefssure: Continues to the mediastinalsurface, 0 6. the

Groove fortha descending aotta: Passes posterior§ to
dividing the teft tung into superior and inferior lobes hilum of the left tung
@ 7.'the
Cardiacimpression: Lies atong the inferior aspect of
The anangement of the root of the lung structures at the superior lobe and the anteroinferior aspect of the
hilum of the teft tung differs stightty from that of the right lung. inferior [obe

O 2. Leftmaínbronchus: Located posteriorty, similar in ar-

rangefnent to the right lung
(§ 3. Pulmonaryveins: Located in an anteroinferior location,
É'"'i':{btated iñ fher reglon sf
simitar in anangement to the right lung ..lsrg arrd&r vkcera{
) a. Pulmonaryartery: Shifts to a more superiorposition in
the left lung and vascutar) via the putmonary

r pq$gs tocated at the bifurcation of the

The teft lung atso demonstrates impressions left by nearby
il'trunk, apd then to the thoracic duct or
structures. rt qf tfrese nodes c¿n occur with a variety
rary manifestations of sarcoido§s, lung
@ 5. Grooveforarchofaorta..Passes superiorto the hitum
of the left lung
 MEDIA§TINAL SURTACE OF THE LEFT LUNG THORAX

s, ;{ii,srl* .'S*.1 i¡t :r:,

lh i;,:. r§¡$r't

r. risuro Dblicuo

u ilrlcrm
fulrorrar
z Srnnquio -
Ortutrpot' laquiu&

Anterior border

o§¡¡fm d* trn
f,§Y+ü

Cardiac notch

tliaphragirraiic surface

lnferior border

1. Fisl,rq 0hhorr

r. .t
-d l ¡É .*,
1.¡ "-l
L{t at,

' I:i l.' i: l:,,"' I í¡ 'r : a" ?"i 1' . ir i l'¡-'i l: : i".
, '::
 PERICARDIAL REI.ATIONSHIPS TO THE §TERNUM

1+t*,;,f 1=:r;: PERICARDIAL RELATIONSHIpS TO THE STSRNUM

The mediastinurn is the central cornponent of the thoracic cavity and T5. The inferior medíastinum
is further subdivided into the
between the two pteuraI cavíties snd contains alt of the thoracic anterior, rniddte, and posterior mediastinum.
The heart and the
viscera and structures except for the tungs" The mediastinum roots of the great vessels contained
within the pericardium
is subdivided into the superior and inferior mediastinum by a compose tne middte mediastinum.
line passing from the sternalangle to the iV disk between T4

The majority of the pericardium (and the heart within the

pericardial sac) iies to the left of the median piane.

Q 1. Badyof thesternnm; Lies anterior to a portion of the @ 5. Superiorvenarava; Forms at the tevel of the 1st right
pericardium (and the heart) to the level of the sternal costal cartilage by the union of the right and teft bra-
angte chiocepha[ic veins
Q Z. Diaphragm: The central portion lies inferior to the
Q 7. lnternalthoracicarteries: paired arteries that course
pericardium fi"om the subclavian artery posterior to the first six
@ 3. Rightand leftbrachiocephaticveins: Forms posterior to costal c,artilages on either side of the sternum
the sternoclavicular (SC)joints by union of two vessels
on each side of the body:
Q 8. Phrenicnerves: Paired nerves that suppty the diaphragm
and the fibrous pericardium;descend anterior fothrypAt
Q 4. Right and left internaljugu{arveins afboth lunqs and run along the fibrous perícardiqln to
Q 5. Rightand leftsubclavian veins pierce the diaphragm
 PERICARDIAL RE1ATION§FIIPS TO THE STERNUM THORAX

Right common caroüd artery Left common.c¡rolid a¡tery

o qfunms seqEiar ü&lerrg

tnq ? d&

1st cosbl canihg€

Manubrium

Stemalangle

znd costal cart¡lage

fiool of lung

Ir.
(:,, Bmt of lung
rtt¡

'.:i

¡.tu*r$&-
üs*r-,.ir,

\]
\- ..

Pericardium

Xiphoid process

*/
l. qLül H5
r'!..::: r i-j: ,'
94 Thorax srERNocosrAL {ANTERIüR} suRFAcE GF Tt{E HIART

" ' , §TERNOCOSTAL {ANTERIOR} SURFACE OÉTHE HEART AND CREAT VESS§LS
The sternun: and pericardiuln {fibrous and parietal layers) cavity. The majorit_y of the ieft brachiocephalic vein has been
have been removed to visuatize the anterior (sternocostal) removed from thís image to demonstráte the arch of the aorta
surface of the heart and great vessels intact in the thoracic and its branches.

COLOR each of the fotlowing usíng a different color for each structure:

(} 1. RrgfÉ vantrícle: Comprises a majority of the anterior
{sternocostat) surface of the heart
Q Z. Leftventricte: Contributes to a minor component of the
anterior surface cf the heart at the apex of the heart.
The right ventricte is separated frcm the left ventricle
by the aRteriúr interventrieular groove {sutcus), which
is oceupieo by two vessets:
$ 3. Anterior intewentricular branch of leftcaronary
artery (teft anterior descending artery)
() 4" Greatcardiacvein
@ 5. Rigáf atriu¡n: Contributes to the right margin of the
heart and is separated from the right ventricle by the
at¡'ioventricu[ar groove (coronary sutcus) occupied by
the right coronary artery. Each atrium has an anteriorly
directed earlike projection called the Ag1slg"
aorta and travels within the atrioventricular groove
between the right atrium and right ventricle
Q 7. Marginal artery: Arises from the right coronary arterv
near the right margin of the heart
Q 8. Anüeruo r cardiacveins: Superficiall-y cross over the right
coronary artery to drain directly into the right atr¡um.
These veins are untike the r-ernainder of the venous
system of the heart, which drains into the cúronary
sinus before reaching the right atrium.
Q 9. §uperio rvefia cava: tornrs by the union of the b,raqáq:
cephalicveins and eniers the right atrium superioriy
S10. Ascending aorta: Lies to the left of the superior vena
cüva ás it extends from the lefi ventric[e. Two branches,
the left and right coronary arteries, arise from the as-
cending aorta.
@11. Are& of the aorta: Curved continuation of ihe aorta.
The areh typicaily gives rise to three branches:
()12. Brachiocephalictrurk: First anC largest bi'anch a*ses
posterior to the manubriunr, anterior to the trache¿,
and posterior to the left brachiocephalic vein
Q 1 3. LefÉ c o m mo fi €,a rati d a fi e ry : Seeond bra nch a rises
Bostei'ior to the manubriurn and stightty posterior
and to the left of the brachiocephalic trunk. Ascends
anterior to the trachea initiatty and then cours€s
along the leit side as it enters the neck posterior
to the teft SC ioint.
f)ia. lefrsubclavianartery: Third branch arises posterior
io the left common carotici artery. Ascencis iateral
to the trachea and left common carotid arterv and
exits the mediastinum posterior to the left SC joint.
@15. Pu{r?ronarytrunk: A.rises anterior to the or"igin of the
ascending aorta to then pass to the [eft. The pulmonary
trunk divides into tr,vo branchesl
'-
.,16. Right pulmonary arúery; Courses posterior ta the
ascending aorta and superior vena cava to the hilum
of the right lung
()'17, Left pulmonary artery: Shorter than the right because
of its praximity to the left [ung
()18. Ligarnentum aiteriosum: Passes from the origin of the
left putmonary ai"ter)/ to the ai-ch of the aorta and is
an embryotogic remnant ef the Cuctus arteriosus. The
left recurrent laryngeal nerve lccps under the arrh of
the aoria in proximity to the l¡gamentum a¡"teriosum.
S19. Superior pulmonaryveins: Two veins tright and teft)
along with two infei'ior pulmanary veins cirain into the
left atrium posteriorly
 STERNOCOSTAL {ANTERTOR} §URFACE OF THE HEART THORAX

t/

Hight brachiocephalic vein

ii Avr:fi rjg, hc',1&r'tm

Left vagus nerve

Left recurreni laryngeal nerve

g. \/c r\i -t ¿.. rl*.di.+

§¡¡,¿,,'r, 6 ri';í 18.-

Avtev io ftri r , ., ¡. ::

d erg ¡kls
rs TrOnc* txrlr¡nmnff
OScf r*€ re Veffii $t*hnnrw¡:r
icryrie*ak
c;h{¡ Left aür¡cle

Right auricle

g.li,:*s*",*u r rk, o,,qt*&* r'"li§\#

{.\tr,{, I u
,,..,{ ,
er .rh {1§ r:.É,r q q11,; t,i.É

¡'i rr :.' ir.,l5a.i{:* ;,: r"4r¡e t X +,&$

o \3*ros «¡*uffiir&
e"Yrá {IYC
daveeh¿\

¡.4*rea3
d¿ted.o

Diaphragm / --t-

Pericardium
(cut edge)