Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Surface Anatomy of Thorax, Lungs and Breast Fady Anis Objectives Anterior Thoracic Wall Planes Surface markings Breast Lungs and Pleura Anterior Planes 3 Anterior Planes • Median Plane • 2x Midclavicular Plane 3 Anterolateral Planes • Anterior Axillary Plane • Midaxillary Plane • Posterior Axillary Plane Other Surface Lines Sternal Angle – T4/T5 – Rib 2 Suprasternal – above sternum Xiphisternal – T9 – Rib 7 Subcostal – L3 Surface Markings The Breast The breast overlies the 2nd-6th Ribs Overlying pectoralis major and serratus anterior It contains ~20 lactiferous ducts opening into nipple Nipple is located at the 4th ICS – In males and varies in females Areola = Pigmented area around nipple The Breast Lymphatic Drainage 7 Lymph drainage sites : 1. Apical Axillary LN 2. Central Axillary LN 3. Lateral Axillary LN 4. Pectoral Axillary LN 5. Supra/infra Clavicular LN 6. Parasternal Nodes LN 7. Abdominal LN Vasculature of the breast Medial mammary branches of anterior intercostal branches of the internal thoracic artery Lateral thoracic Thoraco-acromial arteries Posterior intercostal arteries, from the thoracic aorta Lungs - Pleura The pleura of the lungs are divided into 2 different parts: • Parietal Pleura = Adheres to the Internal thoracic wall • Visceral Pleura = Attached to the lungs In between the two layers you have the pleural space which is filled with serous fluid reducing friction and provides surface tension to push parietal pleura against thoracic wall Pleural Parts 4 Pleural Parts 1. Costal part- covers the internal surface of thoracic wall and is separated from wall by endothoracic fascia 2. Mediastinal part- lateral aspects of mediastinum 3. Diaphragmatic part- superior surface of diaphragm 4. Cervical pleura- extends superior to thoracic inlet into the root of the neck 3 Pleural Reflections Pleural Reflections = Pleural folds / change in direction of pleura – 1 Anterior, 1 Posterior and 1 Inferior 1. Sternal line – Costal Pleura continuous with mediastinal pleura Anteriorly 1. Costal line – Costal pleura continuous with diaphragmatic Inferiorly 1. Vertebral line – Costal pleura becomes continuous with mediastinal pleura Posteriorly Parietal Vs. Visceral Pleura • Visceral pleura: • 2, 4, 6, 8, 10 • Together cc2-4, cardiac notch to cc6, midaxillary cc8, rib 10 posteriorly • Parietal pleura: • 2, 4, 6, 8, 10, 12 • Together cc2-4, cardiac notch to cc6, midclav cc8, midaxillary cc10, 12 rib posteriorly Thoracic Dermatomes Nipple - T4 Xiphoid - T7 Umbilical – T10 Suprapubic – L1 Pleural Effusion QUIZ! (T or F) 1. The rib overlies Rib 2-6? • True 2. There are 4 pleural reflections – Diaphragmatic, Mediastinal, Cervical and costal ? • False – there are 3 reflections – Sternal, vertebral and costal 3. One of the lymph drainage sites is the medial axillary LN? • False – Apical, pectoral central and lateral 4. The four branches supplying the breast are Lateral Thoracic, medial mammary, thoraco-acromial and posterior intercostal arteries ? • True Thank you for listening ! If you have any questions email the Fadz – [email protected]