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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.