Topographical Anatomy of the Thorax
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Transcript of Topographical Anatomy of the Thorax
TOPOGRAPHICAL ANATOMY
THE THORAX
INTRODUCTION
The trunk of the body is divided by the diaphragm into an upper part, called the thorax, and a lower part called the abdomen.
Upper part
Lower part
THORACIC CAGE
Clinical correlate
THE LUNGS
Right and Left Pleural Cavities
• Parietal Pleura• Visceral (Pulmonary) Pleura• Parietal– Costal– Mediastinal– Diaphragmatic– Cupola
• Connecting Pleura
Pleural Cavities
Pleural Cavities
Lungs
• Pair of Cone-shaped organs • Lie in pleural cavity• Weigh approx 800g– 90% air– 10% tissue
• Left lung is narrower• Right lung is shorter
Right Lung
Right Lung
Left Lung
Left Lung
Left Lung
Lungs
• Apices-extend 1-2 cm past clavicles• At end-expiration
– 6th rib – midclavicular– 8th rib – laterally
• Posteriorly– Tops is at 1st vertebra
• Inferior border– Rises & falls betwee 9th & 12th rib
MEDIASTINUM
The median septum of the thorax between the two lungs.
DIVISIONS OF THE MEDIASTINUM
Split into two for descriptive purposes:Superior and Inferior Mediastina
Lower border of T4
Sternal angle
CONTENTS OF THE MEDIASTINUM
Superior mediastinum:EsophagusTracheaArch of AortaBig branches of Aortic archBrachiocephalic (innominate) veinsUpper half of superior vena cavaPhrenic nervesVagi nerves
Middle mediastinum:PericardiumHeartPulmonary trunkAscending AortaLower half of SVCUpper part of IVCBifurcation of tracheaPosterior mediastinum:Esophagus.Descending thoracic Aorta.Azygos and hemiazygos veins.Vagi, greater, lesser and least splanchnic nerves.
THE CARDIOVASCULAR SYSTEM
“Cardio” = Heart“Vascular” = Vessels
SIZE, LOCATION, AND SURFACES
COVERINGS OF THE HEARTPericardiumMyocardiumEndocardium
MAJOR VESSELS OF THE HEART
Anterior view
Posterior view
GROSS ANATOMY
MYOCARDIAL THICKNESS AND FUNCTION
R.A
R.V
L.A
L.V
HEART VALVES
ATRIOVENTRICULAR VALVES
SEMILUNAR VALVES
BLOOD SUPPLY TO THE HEART
VENOUS DRAINAGE THE HEART
INNERVATION OF THE HEART
INNERVATION OF THE HEART
1- Sympathetic innervation: Stimulates heart rate (tachycardia) coronary vasodilatation
2- Paraympathetic innervation: Slows heart rate (bradycardia) Coronary vasoconstriction
3- Pain fibers: upper thoracic segments of the spinal cord
CLINICAL ANATOMY
CORONARY ARTERY DISEASEHeart muscle receiving insufficient blood supply
narrowing of vessels---atherosclerosis, artery spasm or clotatherosclerosis--smooth muscle & fatty deposits in walls of arteries
Treatmentdrugs, bypass graft, angioplasty, stent
BY-PASS GRAFT
MI = MYOCARDIAL INFARCTIONdeath of area of heart muscle from lack of O2 replaced with scar tissueresults depend on size & location of damage
BLOOD CLOTuse clot dissolving drugs streptokinase or t-PA & heparinballoon angioplasty
ANGINA PECTORISheart pain from ischemia (lack of blood flow and oxygen)
of cardiac muscle
PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY
CONGESTIVE HEART FAILURE (CHF)
Congestive heart failure (CHF) is caused by:Coronary atherosclerosisPersistent high blood pressureMultiple myocardial infarctsDilated cardiomyopathy (DCM) – main pumping
chambers of the heart are dilated and contract poorly.
CONGENITAL HEART DEFECTS
ATRIAL SEPTAL DEFECT
ARTIFICIAL HEART
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