Thoracic Anatomy Lecture 1 - PDF

Thoracic anatomy Lecture 1 Introduction & thoracic wall l By Buraq muataz QMC  Objective 1-superior thoracic aperture 2-inferior thoracic aperture 3-Thoracic wall -Sternum 4-Sternal angle 5-MCQs braq_m We will use anatomy apps : like this… We will take some MCQ We will ta...

Thoracic anatomy Lecture 1 Introduction & thoracic wall l By Buraq muataz QMC  Objective 1-superior thoracic aperture 2-inferior thoracic aperture 3-Thoracic wall -Sternum 4-Sternal angle 5-MCQs braq_m We will use anatomy apps : like this… We will take some MCQ We will take some cases ‫اكاديمية العطاء الطبية‬ ‫ براق معتز‬.‫د‬ ✔ The thorax is an irregularly shaped cylinder " with a narrow opening (superior thoracic aperture) superiorly # 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.  1-Superior thoracic aperture consists of body of vertebra TI posteriorly, communicates with the root of the neck the medial margin of rib I on each side, Also called thoracic outlet the manubrium anteriorly. because important vessels and nerves emerge from the thorax here to enter the neck and Superior thoracic aperture upper limbs conveys the esophagus, trachea, and The outlet is obliquely directed, several vessels and nerves. facing upward and forward the apices of the lungs and pleurae project upward into the ‫براق معتز‬.‫د‬ neck.  suprapleural membrane ♦ A dense fascial layer called the suprapleural membrane closes the thoracic outlet on either side of these structures ♦ This tent-shaped fibrous sheet " attaches laterally to the medial border of the first rib and costal cartilage; # medially to the fascia investing the structures passing from the thorax into the neck; & at its apex, to the tip of the transverse process of the seventh cervical vertebra. ' function\ It protects the underlying cervical pleura and resists the changes in intrathoracic pressure occurring during respiratory movements. ‫بعدين نعرفهن من‬ ‫نمشي با‪.‬ادة‬  2-inferior thoracic aperture The diaphragm closes the inferior Make thoracic cavity aperture communicates with the abdomen Structures that pass between the thoracic and inferior thoracic aperture abdominal cavities (e.g., Consist of the body of vertebra TXII posteriorly, esophagus, aorta) must either pierce the diaphragm or go rib XII and the distal end of rib XI posterolaterally, around the diaphragm. ‫براق معتز‬.‫د‬ the distal cartilaginous ends of ribs VII to X, which unite to form the costal margin anterolaterally, the xiphoid process anteriorly. Notes ' The joint between the costal margin and sternum lies roughly in the same horizontal plane as the intervertebral disc between vertebrae TIX and TX. ' , the posterior margin of the inferior thoracic aperture is inferior to the anterior margin. ' When viewed anteriorly, the inferior thoracic aperture is tilted superiorly.  Thoracic wall skeletal elements Part 1 The skeletal elements of the thoracic wall consist of : ♦the thoracic vertebrae, intervertebral discs, ♦ribs, ♦sternum. ✔ The thoracic wall is composed of skeletal elements and muscles. ( It extends between: the superior thoracic aperture the inferior thoracic aperture 1. Sternum  " Manubrium of the sternum ⛄ The manubrium of the sternum forms part of the bony framework of the neck and the thorax. ⛄ The superior surface of the manubrium is expanded laterally and bears a distinct and palpable notch, the jugular notch (suprasternal notch), in the midline. On either side of this notch is a large oval fossa for articulation with the clavicle. ⛄ Immediately inferior to this fossa, on each lateral surface of the manubrium, is a facet for the attachment of the first costal cartilage. ⛄ At the lower end of the lateral border is a demifacet for articulation with the upper half of the anterior end of the second costal cartilage.  # Body of the sternum ⛄ The body of the sternum is flat. ⛄ 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. ⛄ The lateral margins of the body of the sternum have articular facets for costal cartilages. ⛄ Superiorly, each lateral margin has a demifacet for articulation with the inferior aspect of the second costal cartilage. ⛄ Inferior to this demi-facet are four facets for articulation with the costal cartilages of ribs III to VI. ⛄ At the inferior end of the body of the sternum is a demifacet for articulation with the upper demifacet on the seventh costal cartilage. ⛄ The inferior end of the body of the sternum is attached to the xiphoid process.  & Xiphoid process ⛄ The xiphoid process is the smallest part of the sternum. ⛄ Its shape is variable: it may be wide, thin, pointed, bifid, curved, or perforated. ⛄ 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. ✔ The superior margin of the manubrium is in approximately the same horizontal plane as the intervertebral disc between vertebrae TII and TIII.  sternal angle (angle of Louis) Note * Formed by articulation of manubrium with body of sternum. * It lies at level of 2nd costal cartilage, point from which all costal cartilages and ribs are counted. * It lies opposite the intervertebral disc between T4 & T5.  sternal angle (angle of Louis) Note * Aorta-ascending aorta ending, arch of aorta beginning and ending, descending aorta beginning * Trachea - bifurcation * Pulmonary trunk - bifurcation * Left recurrent laryngeal nerve, * ligamentum arteriosum * Azygos vein drains into SVC * Nerves-cardiac plexus * Thoracic duct - crosses from right to left  Clinic. Cervical rib ‫اسئلة نظري‬ ‫اسئلة عملي‬  ‫‪Thank you‬‬ ‫إن مررتم من هنا إدعوا لي بقول ‪ :‬اللهم‬ ‫إبكيه فرحا ً فيما تمناه لعل احدكم اقرب‬ ‫مني الى ا‪ S‬منزل ًة وله دعوةً ‪ P‬تُرد‬ ‫د براق معتز‬ ‫للتواصل‬ ‫ل&شتراك @‪Medburaq‬‬