Download figure 98-1

ANATOMY AND PHYSIOLOGY
OF THE CHEST WALL
FIGURE 98-1 Anterior and posterior views of the bony thorax.
FIGURE 98-2 Rib characteristics and costovertebral articulations.
FIGURE 98-3 Internal view of the anterior thoracic wall.
FIGURE 98-4 Anatomy of the superior thoracic outlet.
FIGURE 98-5 Anterior thoracic wall.
FIGURE 98-6 Posterior thoracic wall.
FIGURE 98-7 Muscles of the anterior chest wall that may be used for muscle flaps.
FIGURE 98-8 Muscles of respiration
ANATOMY OF THE LUNG
FIGURE 35-1 The bronchopulmonary segment.
FIGURE 35-2 The lobes
and segments of the lung.
Right upper lobe
segments: 1, apical; 2,
anterior; 3, posterior.
Right middle lobe
segments: 4, lateral; 5,
medial. Right lower lobe
segments: 6, superior; 7,
medial basal; 8, anterior
basal; 9, lateral basal; 10,
posterior basal. Left upper
lobe segments: 1 and 3,
apical posterior; 2,
anterior; 4, superior
(lingular); 5, inferior
(lingular). Left lower lobe
segments: 6, superior; 7
and 8, anteromedial basal;
9, lateral basal; 10,
posterior basal.
FIGURE 35-3 The right intrapericardial anatomy.
FIGURE 35-4 The left intrapericardial anatomy.
FIGURE 35-5 The right hilar anatomy, anterior view.
FIGURE 35-6 The right hilar anatomy, posterior view.
FIGURE 35-7 The course and relationships of the thoracic duct.
FIGURE 35-8 The left hilar anatomy, anterior view.
FIGURE 35-9 The course and relationship of the left vagus and left recurrent
laryngeal nerves.
FIGURE 35-10 The left hilar anatomy, posterior view.
FIGURE 35-11 The posterior superior dissection of the right major fissure. A,
Dissection at the confluence of the fissures allows identification of the pars
intralobares of the pulmonary artery and its major branches. The dissection is
carried out between the posterior ascending segmental artery and the superior
segmental artery. B, The posterior hilar dissection is carried out between the
inferior margin of the right upper lobe bronchus and the bronchus intermedius. C,
The posterior superior portion of the right major fissure is completed by
FIGURE 35-12 The anterior inferior dissection of the right major fissure. A,
Dissection at the confluence of the fissures allows identification of the pars
intralobares and its branches in the fissure. The dissection is carried out between
the inferior middle lobe artery and the basal segmental artery. B, The anterior hilar
dissection is carried out between the superior and inferior pulmonary veins. C, The
anterior inferior portion of the right major fissure is completed by connecting the
dissections of the pulmonary artery (A) and the pulmonary veins (B).
FIGURE 35-13 The dissection of the minor (horizontal) fissure. A, Dissection at
the confluence of the fissures allows identification of the pars intralobares and the
branches to the middle lobe. B, The anterior hilar dissection is carried out
between the middle lobe vein and the inferior segmental vein of the upper lobe.
C, The minor fissure is completed by connecting the dissections of the pulmonary
artery (A) and the pulmonary veins (B).
FIGURE 35-14 The posterior superior dissection of the left major fissure. A,
Dissection in the midportion of the left major fissure allows the pulmonary artery
in its interlobar position and the branches of the pulmonary artery to be identified.
B, The posterior hilar dissection of the pulmonary artery allows identification of the
branches to the upper and lower lobes. C, The posterior superior portion of the
left major fissure is developed by connecting the pulmonary arterial dissection in
the fissure (A) to the posterior hilar arterial dissection (B).
FIGURE 35-15 The anterior inferior dissection of the left major fissure. A,
Dissection at the midportion of the major fissure allows identification of the
pulmonary artery and its branches. The dissection is carried out between the
lingular pulmonary artery and the basal segmental pulmonary artery. B, The
anterior hilar dissection is carried out between the superior and inferior pulmonary
veins. C, The anterior inferior portion of the left major fissure may be developed
by connecting the dissection around the pulmonary arteries (A) with the
FIGURE 35-16 Regional lymph nodes: 1, highest mediastinal; 2R and 2L, right
and left paratracheal; 3a, prevascular; 3p, retrotracheal; 4R and 4L, right and left
tracheobronchial; 5, aortopulmonary; 6, para-aortic; 7, subcarinal; 8,
paraesophageal; 9, pulmonary ligament; 10R and 10L, right and left hilar; 11R
and 11L, right and left interlobar; 12R and 12L, right and left lobar; 13R and 13L,
right and left segmental; 14R and 14L, right and left subsegmental. Ao, aorta;
FIGURE 35-17 The bronchial arterial anatomy is variable. The most frequent
bronchial arterial supply (top) is one right bronchial artery arising from an
intercostal artery and two left bronchial arteries with separate aortic origins. The
smaller images (bottom) demonstrate the next three most common bronchial
arterial arrangements.