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Thorax
Thorax
Thorax
A. Thorax
The thorax is an irregularly shaped cylinder
with a narrow opening (superior thoracic aperture)
superiorly and a relatively large opening (inferior
thoracic aperture) inferiorly.
The superior thoracic aperture is open,
allowing continuity with the neck; the inferior
thoracic aperture is closed by the diaphragm.
General Description
B. Thoracic Cavity
The thoracic cavity enclosed by the thoracic wall
and the diaphragm is subdivided into three major
compartments:
a. Left Pleural Cavity
b. Right Pleural Cavity
c. Mediastinum
FUNCTIONS
A. Breathing
Up and down movements of the diaphragm and
changes in the lateral and anterior dimensions of
the thoracic wall, caused by movements of the ribs,
alter the volume of the thoracic cavity and are key
elements in breathing
B. Protection of Vital Organs
The thorax houses and protects the heart,
lungs, and great vessels.
FUNCTIONS
C. Conduit
The esophagus, vagus nerves, and thoracic
duct pass through the mediastinum as they
course between the abdomen and neck.
The phrenic nerves, which originate in the neck,
also pass through the mediastinum to penetrate
and supply the diaphragm.
COMPONENT PARTS
I. Thoracic Wall
A. Posteriorly, it is made up of twelve thoracic
vertebrae and their intervening intervertebral discs;
B. Laterally, the wall is formed by ribs (twelve on
each side) and three layers of flat muscles;
C. Anteriorly, the wall is made up of the sternum,
which consists of the manubrium of sternum,
body of sternum, and xiphoid process.
COMPONENT PARTS
IV. Diaphragm
The right dome is higher than the left, reaching
as far as rib V.
As the diaphragm contracts, the height of
the domes decreases and the volume of the thorax
increases.
The esophagus and inferior vena cava penetrate
the diaphragm; the aorta passes posterior to the
diaphragm.
COMPONENT PARTS
V. Mediastinum
The mediastinum is a thick midline partition that
extends from the sternum anteriorly to the
thoracic vertebrae posteriorly, and from the
superior thoracic aperture to the inferior thoracic
aperture.
VI. Pleural Cavities
The mediastinum is a thick midline partition that
extends from the sternum anteriorly to the
thoracic vertebrae posteriorly, and from the
superior thoracic aperture to the inferior thoracic
aperture.
PECTORAL REGION
I. Breast
The breasts consist of mammary glands and
associated skin and connective tissues.
The mammary glands are modified sweat
glands in the superficial fascia anterior to the
pectoral muscles and the anterior thoracic wall.
PECTORAL REGION
In non-lactating women, the predominant
component of the breasts is fat, while glandular
tissue is more abundant in lactating women.
Typical Rib:
o consists of a curved shaft with anterior and
posterior ends
o The anterior end is continuous with its
costal cartilage.
o The posterior end articulates with the
vertebral column and is characterized by a
head, neck, and tubercle.
THORACIC WALL
D. Sternum
1. Manubrium of Sternum
- The superior surface of the manubrium is
expanded laterally and bears a distinct and
palpable notch, the jugular notch (suprasternal
notch), in the midline.
THORACIC WALL
2. Body of Sternum
- The anterior surface of the body of the sternum
is often marked by transverse ridges that
represent lines of fusion between the segmental
elements called sternebrae, from
which this part of the sternum arises
embryologically.
THORACIC WALL
3. Xiphoid Process
It begins as a cartilaginous structure, which
becomes ossified in the adult.
On each side of its upper lateral margin is a
demifacet for articulation with the inferior end
of the seventh costal cartilage.
THORACIC WALL
II. Joints
A. Costovertebral Joints
B. Costotransverse Joints
C. Sternocostal Joints
D. Interchondral Joints
E. Manubriosternal and Xiphisternal Joints
III. Intercostal Spaces
In each space, the vein is the most superior
structure and is therefore highest in the costal
groove.
THORACIC WALL
II. Joints
A. Costovertebral Joints
B. Costotransverse Joints
C. Sternocostal Joints
D. Interchondral Joints
E. Manubriosternal and Xiphisternal Joints
III. Intercostal Spaces
In each space, the vein is the most superior
structure and is therefore highest in the costal
groove.
MUSCLES
THORACIC WALL
V. Arterial Supply
- Anterior and Posterior Intercostal Arteries
VI. Venous Drainage
- Intercostal Veins > Azygos Vein or Internal
Thoracic > Brachiocephalic Vein
VII. Lymphatic Drainage
A. Thoracic Wall Parasternal Nodes >
Bronchomediastinal Trunks
B. Heads and necks of ribs Intercostal Nodes >
Bronchomediastinal Trunk or Thoracic Duct
C. Diaphragm - Diaphragmatic nodes
VIII. Innervation
- Intercostal Nerves
DIAPHRAGM
- The diaphragm is a thin musculotendinous structure that
fills the
inferior thoracic aperture and separates the thoracic
cavity from
the abdominal cavity
I. Arterial Supply
A. Pericardiacophrenic and Musculophrenic arteries
B. Superior Phrenic Arteries
C. Inferior Phrenic Arteries
DIAPHRAGM
II. Venous Drainage
A. Brachiocephalic veins in the neck,
B. Azygos system of veins
C. Abdominal veins (left suprarenal vein and inferior vena
cava).
III. Innervation
- Phrenic Nerves
DIAPHRAGM
MOVEMENTS OF THE THORACIC WALL AND DIAPHRAGM
DURING BREATHING
I. Middle Mediastinum
The middle mediastinum is centrally located in the
thoracic cavity.
It contains the pericardium, heart, origins of the great
vessels, various nerves, and smaller vessels.
PLEURAL CAVITIES
A. Pericardium
- The pericardium is a fibro serous sac
surrounding the heart and the roots of the great
vessels.
1. Fibrous Pericardium
2. Serous Pericardium
a. Parietal Layer - lines the inner surface of
the fibrous pericardium
b. Visceral Layer - adheres to the heart and
forms its outer covering
PLEURAL CAVITIES
B. Heart
a. Orientation
- The general shape and orientation of the heart are that of
a pyramid that has fallen over and is resting on one of its
sides.
b. Surface
1. Anterior
2. Diaphragmatic
3. Left Pulmonary
4. Right Pulmonary
c. Cardiac Chambers
1. Right Atrium
2. Left Atrium
3. Right Ventricle
4. Left Ventricle
PLEURAL CAVITIES
II. Superior Mediastinum
The superior mediastinum is posterior to the
manubrium of the sternum and anterior to the
bodies of the first four thoracic vertebrae
The major structures found in the superior
mediastinum include the:
1. thymus,
2. right and left brachiocephalic veins,
3. left superior intercostal vein,
4. superior vena cava,
5. arch of the aorta with its three large branches,
PLEURAL CAVITIES
6. trachea,
7. esophagus,
8. phrenic nerves,
9. vagus nerves,
10. left recurrent laryngeal branch of the left
vagus nerve,
11. thoracic duct, and
12. other small nerves, blood vessels, and
lymphatic
PLEURAL CAVITIES
III. Posterior Mediastinum
- The posterior mediastinum is posterior to the
pericardial sac and diaphragm and anterior to
the bodies of the mid and lower thoracic
vertebrae
IV. Anterior Mediastinum
- The anterior mediastinum is posterior to the
body of the sternum and anterior to the
pericardial sac