Download 胸 部

precentral gyrus
postcentral gyrus
Main Contents
The thoracic wall
Breast
Intercostal spaces
Mediastinum
Concept, boundaries, division
Superior mediastinum
Posterior mediastinum
Introduction
1 formation
2 division：
 Thoracic wall—
Anterior region of thorax, anterolateral region
of thorax and posterior region of thorax.
 Thoracic cavity—mediastinum, left and right
lung and pleura cavity.
The thoracic wall
superficial structures
1)skin
2)superficial fascia
3)cutaneous nerve ：
 The supraclavicular nerve
 Anterior cutaneous branches of intercostal
nerve
 Lateral cutaneous branches of intercostal
nerve
superficial structures
4) superficial vessels
 artery:
• perforating branches of internal thoracic artery
• the branches of posterior intercostal A.
 Vein：
• → internal thoracic V. and posterior intercostal V.
• The V. of thoracic and abdominal wall→lateral
thoracic V.
Deep structures
Intercostal spaces
 Position
 Contents:
1) The intercostal externus
2) The intercostal internus
3) The intercostal intimus
4) The intercostal nerves:
Intercostal spaces
5) Veins and Arteries
6)The relationship of the intercostal nerve
and vessels in the costal groove:
— V. A. N..
Mediastinum
Boundaries
 Anterior: the sternum and costal cartilages.
 Posterior: the thoracic vertebrae
 Two sides: the mediastinal pleurae.
 Superior: the thoracic inlet.
 Inferior: the diaphragm
Mediastinum
2 Division
 four parts of the
mediastinum
superior mediastinum
glandular plane
venous plane
arterial-nervous plane
visceral plane
lymphatic plane
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
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
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

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anterior layer
thymus or its rudiment;
right and left brachiocephalic V.;
superior vena cava;
middle layer(arterial layer)
aorta and its three branches;
right and left phrenic and vagus nerves;
posterior layer
trachea;
esophagus;
Left recurrent laryngeal nerve
thoracic duct.
superior mediastinum
1) Thymus
 Relationship
―two side:
―upper boundary:
―lower boundary:
 External feature
―two unequal lateral lobes and a pyramidal lob.
2) Superior vena cava
3) The aortic arch and its branches
superior mediastinum
4)The thoracic part of trachea
in front of the the thoracic part of trachea :
① the sternal manubrium;
② origins of sternohyoid and sternothyroid muscles;
③ thymus;
④ left brachiocephalic V.,
⑤ aortic arch;
⑥ brachiocephalic trunk;
⑦ left common carotid A.
⑧ cardiac plexus and lymph nodes.
The Posterior Mediastinum
Main organs:
① principal bronchi;
② thoracic part of esophagus;
③ thoracic aorta;
④ thoracic duct;
⑤ azygos and hemiazygos V.;
⑥ vagus nerves;
⑦ sympathetic trunk and lymph nodes.
The Posterior Mediastinum
The thoracic part of esophagus
Relation
• Anteriorly:
• Posteiorly:
• Left side:
• Right side:.
The thoracic part of esophagus
2) Blood supply
Arteries:
• Superior part
• Inferior part
Veins:
→ azygos vein, hemiazygos vein,accessory
hemiazygos vein → Superior vena cava
The thoracic part of esophagus
3) Lymphatic drainage
• Superior part
• Middle part
• Inferior part
• Part of it
4) Nerves
The Sympathetic Trunk
• 10-20 ganglia and interganglionic fibers.
• upper 4th-5th ganglions→esophageal, cardic,
pulmonary plexuses.
• 5th-9th ganglions→greater splanchnic N.
→celial ganglion
• 10th-12th ganglions→lesser splanchnic N.
→aorticorenal ganglion
Thoracic aorta
1）position and passage
2）branches
Parietal branches and visceral branches
3）relation
anteriorly：
posteriorly：
right：
left：
Question ?
What are they in the posterior mediastinum?
Summary
The thoracic wall
Breast
Intercostal spaces
Mediastinum
Superior mediastinum
Posterior mediastinum