Lectures of Anatomy for Physical Therapy PDF

‫‪Lectures of Anatomy for‬‬ ‫‪Physical Therapy.‬‬ ‫ا‪.‬د ‪/‬مرسي عبد الفتاح مرسي‪.‬‬ ‫أستاذ التشريح واآلجنة‪ /‬كلية الطب‪ /‬جامعة طنطا‪.‬‬ ❑ Objectives: By the end of this lecture the student will be able to: ❖Identify the pleura. ❖Describe the lungs (surfaces, borders, fissures, lo...

‫‪Lectures of Anatomy for‬‬ ‫‪Physical Therapy.‬‬ ‫ا‪.‬د ‪/‬مرسي عبد الفتاح مرسي‪.‬‬ ‫أستاذ التشريح واآلجنة‪ /‬كلية الطب‪ /‬جامعة طنطا‪.‬‬ ❑ Objectives: By the end of this lecture the student will be able to: ❖Identify the pleura. ❖Describe the lungs (surfaces, borders, fissures, lobes). ❖Identify mediastinum. ❖Describes heart (surfaces, borders, sulci, chambers and valves). ❖Identify pericardium. Thoracic contents ❑The cavity of thorax is filled by the lungs laterally. ❑Each lung lying in the pleural cavity. ❑The space between the pleural cavities occupying the centre of the thoracic cavity is the mediastinum. ❑Thoracic cavity: 1-Mediastinum. 2-Right lung and pleura. 3-Left lung and pleura. mediastinum Rt.lung and pleura Lt.lung and pleura  Thoracic wall. Lungs. Pleura. Mediastinum. ❑PLEURA: The pleura is a closed serous sac. It clothes each lung and lines the thoracic cavity. Superiorly, they extend above 1st rib into the root of the neck. Inferiorly, they extend to a level just above the costal margin. The medial wall of each pleural cavity is the mediastinum. It formed of two layers: 1-Parietal layer: lines the thoracic wall 2-Visceral layer: which invests the lung and lines the lung fissures. ❑Pleura and pleural cavity: ❑Lungs: The two lungs are organs of respiration and lie on either side Pleura of the mediastinum surrounded by the right and left pleural cavities. Air enters and leaves the lungs via Lung main bronchi, which are branches of the trachea. The pulmonary arteries deliver deoxygenated blood to the lungs Mediastinum from the right ventricle of the heart. Oxygenated blood returns to the left atrium via the four pulmonary veins. The right lung is normally a little larger than the left lung because the middle mediastinum, containing the heart, bulges more to the left than to the right.  Each lung has a half-cone shape, with a base, apex, two surfaces and three borders. The base sits on the diaphragm. The apex projects above 1st rib and into the root of the neck. The two surfaces are 1- costal surface which lies immediately adjacent to the ribs and intercostal spaces of the thoracic wall 2-The mediastinal surface lies against the mediastinum anteriorly and the vertebral column posteriorly and contains the comma-shaped hilum of the lung through which structures enter and leave the lungs.  The three borders which are the inferior border of the lung is sharp and separates the base from the costal surface. The anterior and posterior borders separate the costal surface from the medial surface. The anterior and inferior borders, are sharp, while the posterior border is smooth and rounded. The heart and major vessels form bulges in the mediastinum that indent the medial surfaces of the lung; the ribs indent the costal surfaces. Pathology, such as tumors, or abnormalities in one structure can affect the related structure. ❑THE LUNG: Apex. Base. Anterior border. Inferior border. Posterior border. Hilum. Pulmonary ligament. Mediastinal surface. ❑Left lung: ❖ Half cone. ❖ It has apex and base. ❖ It has anterior , posterior and inferior borders. ❖ It has sternocostal and mediastinal surfaces. ❖ It has one fissure(oblique fissure). ❖ It has cardiac notch and lingula. ❑Right lung: ❖Half cone. ❖It has apex and base. ❖It has anterior ,posterior and inferior borders. ❖It has sternocostal and mediastinal surfaces. ❖It has two fissures (horizontal and oblique fissures). ❑Differences between both lungs: Right lung Left lung Short, wide no cardiac notch Long , narrow with cardiac notch Has 3 lobes separated by 2 Has 2 lobes separated by fissures one fissure Contains 10 Contains 8 bronchopulmonary bronchopulmonary segments segments ❑Mediastinum: The mediastinum is a broad central partition that separates the two laterally placed pleural cavities. It extends from the sternum to the bodies of the vertebrae; and from the superior thoracic aperture to the diaphragm. The mediastinum contains the thymus gland, the pericardial sac, the heart, the trachea, and the major arteries and veins. The mediastinum is subdivided into superior mediastinum; and inferior mediastinum, which is further divided into the anterior, middle, and posterior mediastinum by the pericardial sac. ❑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. ❑Pericardium: It is a fibro serous sac that enclose the heart and roots of the great vessels. ❖Functions: 1.It provides lubricating container. 2.It protects and anchors the heart to the surrounding. ❖Location: It lies within the middle mediastinum and posterior to the body of the sternum. ❖Structure : It has a two layers fibrous and serous. 1-Fibrous pericardium: It is a conical sac, attached firmly below to the central tendon of the diaphragm, and anteriorly to the sternum. 2-Serous pericardium: It is a closed serous sac invaginated by the heart from above and behind. It has two layers, with slit like space in- between ( pericardial cavity) which contains a small amount of fluid ( pericardial fluid) which acts as lubricants. It consists of two layers: 1. Parietal layer: 2. Visceral layer : (epicardium) closely applied to the heart. ❑Heart: The heart is pyramidal in shape placed in the thoracic cavity between the right and left lungs, the apex of this pyramid Left projects forward, downward, and to the Right lung left, whereas the base is opposite the lung Heart apex and faces in a posterior direction. The sides of the pyramid consist of a right pulmonary surface and a left pulmonary surface, diaphragmatic (inferior) surface on which the pyramid rests; an anterior (sternocostal) surface oriented anteriorly;. ❖ Base of the heart: It is quadrilateral and directed posteriorly. It consists of: ✓the left atrium. ✓a small portion of the right atrium. ❖ Apex of the heart: It is formed by the inferolateral part of the left ventricle. ❖Surfaces of the heart: The heart has four surfaces: 1. Anterior surface 2. Right pulmonary surface 3. Left pulmonary surface 4. Diaphragmatic surface ❖Borders and surfaces of the Superior border heart: The heart has four borders: ✓ Superior (both atria) ✓ Right (Rt atrium) ✓ Inferior (mainly Rt ventricle) Right border ✓ Left (mainly Lt ventricle) Left Right atrium atrium Left border Left ventricle Right ventricle Inferior border ❖The heart consisted of four chambers: 1-Right atrium. 2-Right ventricle. 3-Left atrium. 4-Left ventricle. ❑Sulci of the heart: 1-Coronary sulcus (atrio- Coronary sulcus ventricular): It separated between the two atria from the two ventricles and lodges the two coronary arteries and coronary sinus. 2-Anterior and posterior interventricular sulci: Anterior interventricular It separated the two sulcus ventricles anterior and Coronary sulcus posteriorly and lodges the corresponding interventricular arteries. posterior interventricular sulcus ❖Valves of the heart: The heart has four valves 1-Pulmonary valve between the right ventricle and pulmonary trunk and has three cusps. 2-Aortic valve between the left ventricle and ascending aorta and has three cusps. 3-Tricusped valve between the right atrium and right ventricle and has three cusps. 4-Mitral valve between the left atrium and left ventricle and has two cusps. ❖ Blood supply of the Ascending aorta Left coronary heart: artery Arterial supply by right and left coronary arteries from ascending aorta Right coronary artery Pulmonary trunk Venous return by coronary sinus into the right atrium Coronary sinus  MCQ Q1: The lungs surrounded with which of the following's serous sac? a. Pericardium b. Peritoneum c. Pleura d. Tunica vaginalis Q2:Regarding the left lung which one of the followings is true? a. It consists of three lobes b. It has two fissures c. It contains cardiac notch d. It short and wide Q3:Which one of the followings is false regarding the lungs? a. The half cone b. They have apex and base c. They have three surfaces d. The have three borders Q4:Regarding the heart which one of the following statements is true? a. It has base and apex b. It has three borders c. It has three surfaces d. It has three valves Q5:The mitral valves separates between which of the following structures? a. Right atrium and right ventricle b. Left atrium and left ventricle c. Right ventricle and pulmonary trunck d. Left ventricle and ascending aorta Thanks, with the best wishes. Pr.Dr/Morsy Abdelfattah.