Shoulder Region and Thorax3

8/8/2019 Shoulder Region and Thorax3

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Heart, Lungs & ThoraxPart 3

Gross Anatomy II

Pages 23-31

Lec # 5

01-24-07

2007


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ANNOUNCEMENTS

Be sure to get well oriented before removing ribs.

On page 25 where directed to remove ribs. Rather than as instructed leave only ribs7,8, 16, 17 and 18. See p r26 for removal of 1st rib (Leave Scalenus with Phrenic N.Branches) (A change from Book) Be careful on medial side of 1st rib to preserve thevessels and nerves medial to the 1st rib

Be very careful not to enter the peritoneal cavity at this time.

When you remove the lungs, be very careful and try to preserve the vagus and phrenic

nerves. Do not remove the heart and other structures of the mediastinum as directed on page

28. Leave the heart in situ.

Minimum structures on heart to identify: Chambers of the heart, left and right auricle,the coronary and interventricular grooves, the left and right coronary arteries, theligamentum arteriosum, open the left and right atria to identify the coronary sinus,fossa ovale and left and right AV valves. This may require using paper towels toremove blood/latex from the atria.

Remember to share sides and to see the horse from both the right and left

Corrections on veins in figures 2-9, 2-10, page 27 of lab guide.

Autonomics: see all possible without transecting the arteries

3 enlarged images for slides, 9, 12 & 14


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Surface Anatomy of the Lungs

Apex and base (diaphragmatic surface) Costal and medial surface

Dorsal, ventral & basal borders

Cardiac notches

Lobes: left 2 / right 3

Hilus

Root: Pulmonary A. & Vs, Bronchus, Bronchial A.,

Pulmonary Nerves, Pulmonary Lymphatics

Pulmonary Ligaments

Area of Adhesion (Normal)

Impressions


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PII140 & 141

Left

Right

PII 140 & 141

Apex (Cranial End)

15 Base (Diaphragmatic Surface)

Costal Surface (Not Pictured)

Medial Surface (Visible)3/4 Dorsal Border

6/7 Cardiac Notches

1/2 Two Lobes on Left

1/2/3 Three Lobes on Right

Hilus & Root (BAV)

13/19Pulmonary Ligaments

7/11 Tracheal

8 Aortic

9 Esophageal

10 Azygous

15/12 Costocervical

13 Cranial VC

14 Cardiac

20 Caudal VC

See S520 for Correct Labeling. Ventral

and Basal Borders on these figuresmislabeled in Popesko

1520

Ventral Border

Basal Border

Area of Adhesion

Impressions


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Review Question The pulmonary arteries as they enter the

lung should be located dorsal/ventral to

the pulmonary veins and both vessels will

in general be located dorsal/ventral to the

principal bronchus although on the left

the left pulmonary artery will approachthe lung in a position cranial to the left

principal bronchus.


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Lymph Nodes and Divisions of the Lungs

1: Left Tracheobronchial L.ns.

2: Right Tracheobronchial L.ns.

3: Middle Tracheobronchial Lns.

4: Pulmonary Lns.

Left and Right Principal (Primary Bronchi)Lobar Branches (Secondary)

Segmental Bronchus (Tertiary) plus associated

Lung Tissue = Bronchopulmonary Segment


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S522

Left

S522 Dorsal View of Horse Lungs

Right

A Cranial Lobe (apical)

C Caudal Lobe (Diaphragmatic)

D Accessory Lobe (Intermediate)

LOBES

LYMPH NODES

1 Left Tracheobronchial

2 Right Tracheobronchial

3 Middle Tracheobronchial

4 Pulmonary

Left Tracheobronchial into

Cranial Mediastinal. Right

Tracheobronchial into Middle

& Cranial Mediastinal. Middle

TB into Right TB and Cr., Mid.

& Caudal Mediastinal

A

A

C

C

D

12

3

4


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Lymphatics of the Thorax

Left, Right & Middle Tracheobronchial

Tend to be ventral to esophagus

Cranial, Middle & Caudal Mediastinal

Tend to be dorsal to the esophagus except possibly for cranial

mediastinal lns

Cranial & Caudal Sternal

Intercostals

Thoracic Aortic

Caudally located intercostal and thoracic aortic lns may drain

through aortic hiatus into celiac lns of the abdomen

Lymphatic vessels from the diaphragm and liver may

drain to the caudal and cranial sternal and caudal

mediastinal lymph nodes i.e. into the thorax


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S622

Lymphatics of the Thorax S622

1,1 Cranial & Caudal Sternal

1

1

2 Cranial Mediastinal

3 Nuchal

4 Intercostal

5 Thoracic Aortic

6 Middle and CaudalMediastinal

7 Middle Tracheobronchial

8 Left Tracheobronchial

g Thoracic Duct

Esophagus


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Clarification Question A Kupffer cell sarcoma of the liver might

reasonably metastasize and produce an

opacity in the cranial mediastinum in

both the horse and dog. True/False


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Right View of Thorax Vagus Nerve and branches including Recurrent Laryngeal Nerve

Phrenic Nerve Sympathetics

Brachiocephalic Trunk

(Left Subclavian Artery)

Costocervical Trunk (right) Deep Cervical (1st space)

Dorsal Scapular (2nd space)

Supreme Intercostal

Vertebral Artery (right) (cranial to 1st rib)

Internal Thoracic (right) (may arise after Bicarotid Trunk)

Bicarotid Trunk

Right Subclavian

Superficial Cervical (right)

Vena azygous (right azygous)

Chambers of the heart


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12Thorax from Right

PII129

PII129

Vagus, Recurrent Laryngeal, D&V Vagal Trunks

18 Esophagus, 12 Aorta & 13 Azygous

Phrenic Nerve & Sympathetic Trunk

27,28,29 Chambers of Heart, 25 Pulmonary Veins

Brachiocephalic Trunk:

Origin of Costocervical

Trunk & Vertebral A. on the

Right

Costocervical Trunk withDorsal Scapular & Deep

Cervical

Vertebral Artery

Bicarotid Trunk

Internal Thoracic

Superficial Cervical

Right Subclavian A.


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Left View of Thorax

Vagus Nerve and branches including Recurrent Laryngeal Nerve Phrenic Nerve

Sympathetics

Left Subclavian

Costocervical Trunk Dorsal Scapular (2nd space)

Supreme Intercostal

Deep Cervical (1st space)

Vertebral Artery

Internal Thoracic


Thoracic duct

Chambers of the heart


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PII130

Thorax from Left


Esophagus, Aorta & Left Pulmonary Artery


39, 40, 41, 43 Chambers of Heart, 42 Pulmonary Vs

Thoracic Duct

19 Brachiocephalic Trunk

22 Left Subclavian

Costocervical Trunk,

Dorsal Scapular &Supreme Intercostal As

Deep Cervical A.

Vertebral A.

Internal Thoracic A.

Superficial Cervical A.

Axillary Artery


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Review Question The thoracic duct originates from the

________________ in the craniodorsal

________________ cavity, and passesthrough the _________________ to runon the left/right dorsolateral side of theaorta to about T7 levels (+/-) and then

passes to the left/right to run over theleft/right side of the esophagus beforeempting into the _____________ .


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Anatomical Correlates, JAVMAmay01001441 Heart murmurs were detected in 686 of 846 (81.1%) thoroughbred racehorses

48.7% 1 murmur; 24.8% 2 murmurs; 3 murmurs 6.7%; 4 murmurs 0.8%

Tricuspid Systolic 28.5%; Tricuspid Diastolic 13.7%

Pulmonary Systolic 43.1%; Pulmonary Diastolic 8.2%

Mitral Systolic 3.8%; Mitral Diastolic 1.7%

Aortic Systolic 27.4%; Aortic Diastolic 11.7%

Functional Systolic Murmurs: 57.7% of the 846 horses (81.1-57.7 = 23.4)

Was not made clear the exact criteria used for distinguishing functional murmurs

ECGs were done on a few horses with arrhythmias and Echocardiography done on 30 horses tofurther evaluate murmurs

Analysis of Race Records did not reveal a significant association between murmurs andperformance

Examination of the medical records of those against which the horses in this study were

competing found that many had such conditions as: exercise induced pulmonary hemorrhage,laryngeal hemiplegia, lameness, and COPD that were also probably performance limitingproblems

Conclusion of Study: Heart Murmurs are a common finding in racehorses and most donot appear to be clinically significant


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ND225 (2nd ed.) &

NND225 (3rd ed.)

SA NODE: VENTRAL TO CRANIAL VENA CAVA OPENING

AV NODE IN INTERATRIAL SEPTUM CRANIAL TO

OPENING OF CORONARY SINUS

3 Trabecula

Septomarginalis

RIGHTLEFT

Cardiac Conduction System

Components of SubAV

Node Conduction

System

1 Atrioventricular Bundle2 Right & Left Bundles

1

2

3


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CIRCULATION OF BLOOD

HEPATICVEINS

UNPAIRED ABDOMINAL BRANCHES

ABDOMINAL

VISCERA

PORTAL V.

LIVER

HEPATIC A.

Systemic Capillaries

Systemic Veins

Cr. & Cd. Vena Cava

Right Atrium

Rt.. Ventricle

Pulmonary Trunk

Lungs

Pulmonary Capillaries

Pulmonary Veins

Left Atrium

Left Ventricle

Aorta


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Review Question The liver receives a nutritional blood

supply from the ____________ (Vessel)

and a functional blood supply from the

______________ (vessel), and is most

likely to become congested and

edematous if there is left/right sided heartfailure.


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21Thorax from Right

PII129

PII129


18 Esophagus, 12 Aorta & 13 Azygous


27,28,29 Chambers of Heart, 25 Pulmonary Veins

Brachiocephalic Trunk:

Origin of Costocervical

Trunk & Vertebral A. on the

Right

Costocervical Trunk withDorsal Scapular & Deep

Cervical

Vertebral Artery

Bicarotid Trunk

Internal Thoracic


Right Subclavian A.

Corresponds to slide 12


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PII130

Thorax from Left


Esophagus, Aorta & Left Pulmonary Artery


39, 40, 41, 43 Chambers of Heart, 42 Pulmonary Vs

Thoracic Duct

19 Brachiocephalic Trunk

22 Left Subclavian

Costocervical Trunk,

Dorsal Scapular &Supreme Intercostal As

Deep Cervical A.

Vertebral A.

Internal Thoracic A.

Superficial Cervical A.

Axillary Artery

Corresponds to slide 14

Shoulder Region and Thorax3

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