SternumSternum

Difference between male and female?Difference between male and female?

shorter and thinner in femaleshorter and thinner in female

ManubriumManubrium

Has a superior margin called what?Has a superior margin called what?

Jugular notchJugular notch

ManubriumManubrium

Has another notch called what?Has another notch called what?

clavivular notchclavivular notch

for articulation with the claviclefor articulation with the clavicle

ManubriumManubrium

Articulates with what bones?Articulates with what bones?

- clavicle - clavicle

- 1st rib- 1st rib

- 2nd rib (upper half)- 2nd rib (upper half)

- body of sternum- body of sternum

SternumSternum

Body articulates with what costal Body articulates with what costal cartilages?cartilages?

2nd – 7th2nd – 7th

Sternal angle (of Sternal angle (of Louis)Louis)

It is the level where what happens?It is the level where what happens?

- - transverseplane through intervertebral transverseplane through intervertebral disk disk T4/T5T4/T5

- - 2nd rib2nd rib articulate with sternum articulate with sternum

-- aortic archaortic arch begins and ends begins and ends

-- tracheatrachea bifurcates at carina bifurcates at carina

- - inferior border of the superior inferior border of the superior mediastinum is demarcatedmediastinum is demarcated

Xiphoid processXiphoid process

Difference between birth and adult?Difference between birth and adult?

Is a flat, cartilaginous process at birth Is a flat, cartilaginous process at birth that ossifies slowly from the central that ossifies slowly from the central core and unites with the body of the core and unites with the body of the

sternum after sternum after middle agemiddle age..

Xiphisternal jointXiphisternal joint

What level?What level?

9th thoracic vertebra9th thoracic vertebra

RibsRibs

Structure of typical rib?Structure of typical rib?

- head- head

- neck- neck

- tubercle- tubercle

- body (shaft)- body (shaft)

RibsRibs

Head articulates with what?Head articulates with what?

- vertebral bodies- vertebral bodies

- intervertebral disks- intervertebral disks

- suprajacent vertebral bodies- suprajacent vertebral bodies

RibsRibs

Tubercle articulates with what?Tubercle articulates with what?

transverse processtransverse process

With the exception With the exception of ribsof ribs

1111 and and 1212

RibsRibs

Which are true, false and floating ribs?Which are true, false and floating ribs?

TrueTrue1-71-7

FalseFalse8-128-12

FloatingFloating11-1211-12

RibsRibs

First rib has what?First rib has what?

scalene tuberclescalene tubercle for for

insertions of anterior scalene m.insertions of anterior scalene m.

two groovestwo grooves for for

subclavian artery and veinsubclavian artery and vein

ArticulationsArticulations

Sternoclavicular joint – what type of Sternoclavicular joint – what type of joint?joint?

saddle-typesaddle-type of synovial joint of synovial joint

(with movements of a ball-and-socket (with movements of a ball-and-socket joint)joint)

ArticulationsArticulations

Sternocostal joint – what type of joint?Sternocostal joint – what type of joint?

SynchondrosesSynchondroses in which the sternum in which the sternum articulates with the first seven costal articulates with the first seven costal

cartilages.cartilages.

ArticulationsArticulations

Costochondral joint – what type of Costochondral joint – what type of joint?joint?

SynchondrosesSynchondroses in which the ribs in which the ribs articulate with their respective costal articulate with their respective costal

cartilage.cartilage.

Muscles of the Muscles of the thoracic wallthoracic wall

External intercostal, internal intercostal, External intercostal, internal intercostal, innermost intercostal, transversus thoracis innermost intercostal, transversus thoracis

and subcostalis – what nerve?and subcostalis – what nerve?

intercostal nerveintercostal nerve

Muscles of the Muscles of the thoracic wallthoracic wall

Levator costarum. What nerve?Levator costarum. What nerve?

Dorsal primary rami of C8-T11Dorsal primary rami of C8-T11

Lymph nodesLymph nodes

Where can you find sternal or Where can you find sternal or parasternal nodes?parasternal nodes?

Along internal thoracic arteryAlong internal thoracic artery

Lymph nodesLymph nodes

Where can you find phrenic nodes?Where can you find phrenic nodes?

Thoracic surface of the diaphragmThoracic surface of the diaphragm

Superior mediastinumSuperior mediastinum

Boundries?Boundries?

superiorlysuperiorlyoblique plane of first riboblique plane of first rib

inferiorly inferiorly sternal anglesternal angle

laterallylaterallypleural cavitiespleural cavities

anteriorlyanteriorlymanubrium of sternummanubrium of sternum

posteriorlyposteriorlyvertebral columnvertebral column

Superior mediastinumSuperior mediastinum

Contains?Contains?

SVCSVCbrachiocephalic veinsbrachiocephalic veinsarch of aortaarch of aortathoracic ductthoracic ducttracheatracheaesophagusesophagusvagus nerve (CN X)vagus nerve (CN X)left recurrent laryngeal nerveleft recurrent laryngeal nervephrenic nervephrenic nervethymusthymus

Anterior mediastinumAnterior mediastinum

Boundries?Boundries?

anterior anterior sternum (body and xiphoid process)sternum (body and xiphoid process)transverse thoracic musclestransverse thoracic muscles

posterior posterior pericardiumpericardium

laterally laterally pleural cavitiespleural cavities

superiorsuperiorinferior border of superior mediastiuminferior border of superior mediastium

inferior inferior diaphragmdiaphragm

Anterior mediastinumAnterior mediastinum

Contains?Contains?

- remnants of thymus- remnants of thymus

- lymph nodes- lymph nodes

- connective tissue- connective tissue

Middle mediastinumMiddle mediastinum

Borders?Borders?

anterior anterior posterior border of anterior mediastinumposterior border of anterior mediastinum

posterior posterior anterior border of posterior mediastinumanterior border of posterior mediastinum

laterally laterally pleural cavitiespleural cavities

superiorsuperiorinferior border of superior mediastiuminferior border of superior mediastium

inferior inferior diaphragmdiaphragm

Middle mediastinumMiddle mediastinum

Contains?Contains?

- heart- heart- pericardium- pericardium- phrenic nerve- phrenic nerve- roots of the great vessels- roots of the great vessels- arch of azygos vein- arch of azygos vein- main bronchi- main bronchi

Posterior mediastinumPosterior mediastinum

Where?Where?

anterior anterior posterior border of middle mediastinumposterior border of middle mediastinum

posterior posterior vertebral columnvertebral column

laterally laterally pleural cavitiespleural cavities

superiorsuperiorinferior border of superior mediastiuminferior border of superior mediastium

inferior inferior diaphragmdiaphragm

Posterior mediastinumPosterior mediastinum

Contains?Contains?

- esophagus- esophagus- thoracic aorta- thoracic aorta- azygos and hemiazygos veins- azygos and hemiazygos veins- thoracic duct - thoracic duct - vagus nerve (CN X)- vagus nerve (CN X)- sympaphtetic trunk- sympaphtetic trunk- splanchnic nerves- splanchnic nerves

HeartHeart

Name the pericardia!Name the pericardia!

- fibrous pericardium- fibrous pericardium

- serous pericardium- serous pericardium• • parietal layerparietal layer

• • visceral layervisceral layer

HeartHeart

Between what layer is the pericardial Between what layer is the pericardial cavity located?cavity located?

betweenbetween

parietal & visceralparietal & visceral layerlayer

of serous pericadiumof serous pericadium

HeartHeart

Another name for epicardium?Another name for epicardium?

visceralvisceral layerlayer of of serous pericadiumserous pericadium

HeartHeart

Borders of Borders of transversetransverse pericardial pericardial sinus?sinus?

anteriorly:anteriorly:

- aorta- aorta

- pulmonary trunk- pulmonary trunk

posteriorlyposteriorly

- SVC- SVC

HeartHeart

Borders of Borders of obliqueoblique pericardial sinus? pericardial sinus?

anteriorly:anteriorly:

left atriumleft atrium

superiorly: superiorly:

left atriumleft atrium

laterally:laterally:

pulmonary veinspulmonary veins

HeartHeart

Heart skeleton consists of what?Heart skeleton consists of what?

→ → fibrous rings of orifices:fibrous rings of orifices:- pulmonary- pulmonary- aortic- aortic- left and right atrioventricular- left and right atrioventricular

→ → fibrous trigones (left and right)fibrous trigones (left and right)→ → interventricular septuminterventricular septum

HeartHeart

Name linings of the heart-wall!Name linings of the heart-wall!

endocardiumendocardium → inner lining→ inner lining

myocardiummyocardium → intermediate layer→ intermediate layer

epicardiumepicardium → outer lining→ outer lining

HeartHeart

Name the septi of the heart!Name the septi of the heart!

- interatrial- interatrial

- interventricular- interventricular

→ → membranous partmembranous part

→ → muscular partmuscular part

- atrioventricular- atrioventricular

→ → membranous partmembranous part

interatrialinteratrial

interventricularinterventricular

atrioventricularatrioventricular

HeartHeart

Name the conducting system of the Name the conducting system of the heart!heart!

- sinuatrial node (AV node)- sinuatrial node (AV node)

- atrioventricular node (SA node)- atrioventricular node (SA node)

- atrioventriuclar bundle (of His)- atrioventriuclar bundle (of His)

- right bundle- right bundle

- left bundle- left bundle

- subendocardial branches (purkinje fibers)- subendocardial branches (purkinje fibers)

HeartHeart

Embryologic division of right atrium?Embryologic division of right atrium?

- atrium proper- atrium proper

- venous sinus- venous sinus

HeartHeart

Relation to crista terminalis?Relation to crista terminalis?

- atrium proper- atrium proper→ → anteriorlyanteriorly

- venous sinus- venous sinus→ → posteriorlyposteriorly

HeartHeart

What kind of muscles in the walls of What kind of muscles in the walls of atrium proper and venous sinus?atrium proper and venous sinus?

- atrium proper- atrium proper

→ → rough rough (pectinate m.)(pectinate m.)

- venous sinus- venous sinus→ → smoothsmooth

HeartHeart

Blood supply of coronary arteries?Blood supply of coronary arteries?

(types in %)(types in %)

70% balanced type70% balanced type

15% left coronary dominance15% left coronary dominance

15% right coronary dominance15% right coronary dominance

HeartHeart

First and second heart sounds formed First and second heart sounds formed by closures of what structures?by closures of what structures?

- First sound (- First sound (”lub”)”lub”)→ → tricuspid valvestricuspid valves→ → mitral valvesmitral valves

- Second sound (- Second sound (”dub”)”dub”)→ → aortic valvesaortic valves→ → pulmonary valvespulmonary valves

HeartHeart

Name cusps of mitral valve!Name cusps of mitral valve!

- anterior cusp- anterior cusp- posterior cusp- posterior cusp

HeartHeart

Name cusps of tricuspid valve!Name cusps of tricuspid valve!

- anterior cusp - anterior cusp - posterior cusp- posterior cusp- septal cusp- septal cusp

HeartHeart

Name cusps of pulmonary valve!Name cusps of pulmonary valve!

- anterior semilunar cusp- anterior semilunar cusp- right semilunar cusp- right semilunar cusp- left semilunar cusp- left semilunar cusp

HeartHeart

Name cusps of aortic valve!Name cusps of aortic valve!

- right semilunar cusp- right semilunar cusp- left semilunar cusp- left semilunar cusp- posterior semilunar cuspposterior semilunar cusp

HeartHeart

What vessels can you find in anterior What vessels can you find in anterior interventricular sulcus?interventricular sulcus?

- - anterior interventricular branch of anterior interventricular branch of left coronary a.left coronary a.

-- great cardiac v.great cardiac v.

HeartHeart

What vessels can you find in posterior What vessels can you find in posterior interventricular sulcus?interventricular sulcus?

- - posterior interventricular branch of posterior interventricular branch of right coronary a.right coronary a.

-- middle cardiac v.middle cardiac v.

HeartHeart

Which artery accompanies posterior vein Which artery accompanies posterior vein of left ventricle?of left ventricle?

posterior left ventricular branch ofposterior left ventricular branch of

→ → circumflex branch of left circumflex branch of left coronary a.coronary a.

HeartHeart

What arteries accompanies oblique vein What arteries accompanies oblique vein of the left atrium (Marshallof the left atrium (Marshall’s vein)?’s vein)?

No arteries.No arteries.

HeartHeart

What structure can you find in coronary What structure can you find in coronary sulcus?sulcus?

coronary sinuscoronary sinus

HeartHeart

Which vein is the largest vein draining Which vein is the largest vein draining the heart?the heart?

coronary sinuscoronary sinus

HeartHeart

What veins drain into the right atrium?What veins drain into the right atrium?

- coronary sinus- coronary sinus

- anterior cardiac vein- anterior cardiac vein

- smallest cardiac veins- smallest cardiac veins

It might sound strange It might sound strange but but NOTNOT

IVC & SVCIVC & SVC

HeartHeart

What veins drain into the coronary What veins drain into the coronary sinus?sinus?

- great cardiac vein- great cardiac vein

- middle cardiac vein- middle cardiac vein

- small cardiac veins- small cardiac veins

- oblique vein of the left atrium- oblique vein of the left atrium

- posterior vein of the left ventricle - posterior vein of the left ventricle

TracheaTrachea

Consists of?Consists of?

- - 16 to 20 incomplete hyaline 16 to 20 incomplete hyaline cartilaginous ringscartilaginous rings

- - annular ligamentsannular ligaments

- - posterior posterior membranous wallmembranous wall

TracheaTrachea

Begins where?Begins where?

Cricoid cartilage (C6)Cricoid cartilage (C6)

TracheaTrachea

Has a structure in the last tracheal cartilage Has a structure in the last tracheal cartilage which forms a keel-like ridge separating the which forms a keel-like ridge separating the openings of the right and left main bronchi. openings of the right and left main bronchi.

What is it called?What is it called?

carinacarina

BronchiBronchi

Difference between right and left main Difference between right and left main bronchus?bronchus?

Right is:Right is:

- shorter- shorter

- wider- wider

- more vertical- more vertical

BronchiBronchi

Difference between right and left main Difference between right and left main bronchus concerning lobar bronchi?bronchus concerning lobar bronchi?

right divides into:right divides into:

- superior- superior

- middle- middle

- inferior- inferior

left divides into:left divides into:

- upper- upper

- lower- lower

PleuraPleura

Divided into what?Divided into what?

- parietal - parietal

- visceral- visceral

Divided into:Divided into:

- costal- costal- diaphragmatic- diaphragmatic- mediastinal- mediastinal- cervical- cervical

PleuraPleura

Parietal pleura is reinforced by what Parietal pleura is reinforced by what structure?structure?

SibsonSibson’s fascia’s fascia

Innervation of pleuraInnervation of pleura

Innervation of visceral and parietal Innervation of visceral and parietal pleura?pleura?

visceralvisceralpulmonary plexuspulmonary plexus

parietalparietalcostalcostal

intercostal n.intercostal n.mediastinalmediastinal

phrenic n.phrenic n.diaphragmatic diaphragmatic

phrenic phrenic lower intercostal n.lower intercostal n.

PleuraPleura

Parietal pleura forms what ligament?Parietal pleura forms what ligament?

pulmonary ligamentpulmonary ligament

which extends along the which extends along the mediastinal surface of each lung mediastinal surface of each lung

from the hilum to the base.from the hilum to the base.

Pleural cavityPleural cavity

Name the pleural cavities!Name the pleural cavities!

- costodiaphragmatic recess- costodiaphragmatic recess

- costomediastinal recess- costomediastinal recess

BreastBreast

Location?Location?

- between - between 2nd2nd and and 6th6th rib rib

- superficial to - superficial to

pectoralis majorpectoralis major

serratus anteriorserratus anterior

BreastBreast

Lymph drainage from what quadrants Lymph drainage from what quadrants and what nodes?and what nodes?

75% AXILLARY NODES*DIRECT ROUTE

from lateral quadrantspectoral nodes ( • )

*INDIRECT ROUTEfrom upper quadrantsinterpectoral nodes ( • )from lower quadrantsparamammary nodes ( • )

25% OTHER NODESfrom medial quadrantsparasternal nodesinferior phrenic nodes

pectoral (direct)

interpectoral (indirect)

paramammary (indirect)

parasternalinferior phrenic

BreastBreast

Lymph drainage in % from what Lymph drainage in % from what quadrants?quadrants?

60% 15%60% 15%

10%10%

10% 5%10% 5%

LungsLungs

Name impression of right lung!Name impression of right lung!

- right atrium- right atrium

- SVC- SVC

- IVC- IVC

- azygos vein- azygos vein

- esophagus- esophagus

LungsLungs

Name impression of left lung!Name impression of left lung!

- left atrium & left ventricle- left atrium & left ventricle

- aortic arch- aortic arch

- thoracic aorta- thoracic aorta

- left subclavian a.- left subclavian a.

LungsLungs

Ends where – what lines and ribs?Ends where – what lines and ribs?

scapular linescapular line

10 th rib10 th rib

??? line??? line

8 th rib8 th rib

Can also be:Can also be:

left lungleft lung7th rib7th rib

right lungright lung9th rib9th rib

midclavicular linemidclavicular line

6 th rib6 th rib

parasternal lineparasternal line

right lungright lung6 th rib6 th rib

left lungleft lung4th rib4th rib

Pulmonary hilumPulmonary hilum

Anterior – posterior?Anterior – posterior?

- superior pulmonary v.- superior pulmonary v.

- pulmonary a.- pulmonary a.

- principal bronchus- principal bronchus

Pulmonary hilumPulmonary hilum

Superior – inferior?Superior – inferior?

LeftLeft- superior lobar bronchus- superior lobar bronchus- pulmonary a.- pulmonary a.- principal bronchus- principal bronchus- inferior pulmonary v.- inferior pulmonary v.

RightRight- pulmonary a.- pulmonary a.- principal bronchus- principal bronchus- inferior pulmonary v.- inferior pulmonary v.

Horizontal fissureHorizontal fissure

Follows approximately and ends with Follows approximately and ends with what rib?what rib?

Right 4th ribRight 4th rib

Oblique fissureOblique fissure

Begins and end with what ribs?Begins and end with what ribs?

left oblique fissurebegins withleft oblique fissurebegins withleft left 3rd rib3rd rib

right oblique fissure begins withright oblique fissure begins withright right 4th rib4th rib

they both end withthey both end withleft and rightleft and right 6th rib 6th rib

Segments of the lungSegments of the lung

Horizontal fissure – what segments?Horizontal fissure – what segments?

Right lung:Right lung:

2 - 62 - 6

Segments of the lungSegments of the lung

Oblique fissure right and left lung – Oblique fissure right and left lung – what segments?what segments?

right right

2–8 but 2–8 but NOT NOT 3 3

leftleft

1-8 but 1-8 but NOTNOT 3 3

Segments of the lungSegments of the lung

Cardiac impression – what segments?Cardiac impression – what segments?

right lung 5right lung 5

left lung 3-8 but not 6left lung 3-8 but not 6

Segments of the lungSegments of the lung

Groove for aorta – what segments?Groove for aorta – what segments?

left lung 1, 2, 6, 10left lung 1, 2, 6, 10

Segments of the lungSegments of the lung

Groove for azygos vein – what Groove for azygos vein – what segments?segments?

right lung 1, 2, right lung 1, 2, 33, 6,10, 6,10

Segments of the lungSegments of the lung

Groove for brachiocephalic vein – Groove for brachiocephalic vein – what segments?what segments?

right lung 1, 3right lung 1, 3

Segments of the lungSegments of the lung

Groove for SVC – what segments?Groove for SVC – what segments?

right lung 1, 5right lung 1, 5

Vessels of the lungVessels of the lung

Name Name ”public vessels”!”public vessels”!

Pulmonary Pulmonary a.a. + + v.v.

Vessels of the lungVessels of the lung

Name Name ”private vessels”!”private vessels”!

Bronchial Bronchial a.a. + + v.v.

Bronchial vesselsBronchial vessels

Origin of right and left bronchial Origin of right and left bronchial arteries?arteries?

left left

direct from thoracic aortadirect from thoracic aorta

rightright

3rd right posterior 3rd right posterior intercostal arteryintercostal artery

EsophagusEsophagus

Name the three constrictions!Name the three constrictions!

- - C6C6 (where it begins) (where it begins)

- crossing - crossing left main bronchusleft main bronchus

- - T10T10 (piercing diaphragm) (piercing diaphragm)

EsophagusEsophagus

Receives blood from what arteries?Receives blood from what arteries?

- inferior thyroid- inferior thyroid

- bronchial- bronchial

- esophageal- esophageal

Lymph drainageLymph drainage

Pathway of left lung!Pathway of left lung!

All lobes:All lobes:

- pulmonary nodes- pulmonary nodes- bronchopulmonary nodes- bronchopulmonary nodes- inferior tracheobronchial nodes- inferior tracheobronchial nodes- right superior tracheobronchial nodes- right superior tracheobronchial nodes- right paratracheal nodes- right paratracheal nodes- right bronchomediastinal lymphatic trunk- right bronchomediastinal lymphatic trunk- right brachiocephalic veinright brachiocephalic vein- right lymphatic trunk- right lymphatic trunk

Lymph drainageLymph drainage

Pathway of right lung!Pathway of right lung!

Superior lobe:Superior lobe:

- pulmonary nodes- pulmonary nodes- bronchopulmonary nodes- bronchopulmonary nodes- inferior tracheobronchial nodes- inferior tracheobronchial nodes- left superior tracheobronchial nodes- left superior tracheobronchial nodes- left paratracheal nodes- left paratracheal nodes- left bronchomediastinal lymphatic trunk- left bronchomediastinal lymphatic trunk- left brachiocephalic vein- left brachiocephalic vein- thoracic duct- thoracic duct

Inferior lobe:Inferior lobe:

- pulmonary nodes- pulmonary nodes- bronchopulmonary nodes- bronchopulmonary nodes- inferior tracheobronchial nodes- inferior tracheobronchial nodes- - rightright superior tracheobronchial nodes superior tracheobronchial nodes- - rightright paratracheal nodes paratracheal nodes- - rightright bronchomediastinal lymphatic trunk bronchomediastinal lymphatic trunk- - rightright brachiocephalic vein brachiocephalic vein- - rightright lymphatic duct lymphatic duct

Azygos venous systemAzygos venous system

Consists of?Consists of?

- azygos vein- azygos vein

- hemiazygos vein- hemiazygos vein

- Accessory hemiazygos vein- Accessory hemiazygos vein

- posterior intercostal veins- posterior intercostal veins

Azygos venous systemAzygos venous system

Azygos vein is formed by union of Azygos vein is formed by union of what structures?what structures?

- right subcostal v.- right subcostal v.

- right ascending lumbar v.- right ascending lumbar v.

Azygos venous systemAzygos venous system

Hemiazygos vein is formed by union Hemiazygos vein is formed by union of what structures?of what structures?

- left subcostal v.- left subcostal v.

- left ascending lumbar v.- left ascending lumbar v.

Azygos venous systemAzygos venous system

Accessory hemiazygos vein is formed Accessory hemiazygos vein is formed by union of what structures?by union of what structures?

- 5th-8th posterior intercostal v.- 5th-8th posterior intercostal v.

Azygos venous systemAzygos venous system

First posterior intercostal vein (right First posterior intercostal vein (right and left) drain into what?and left) drain into what?

brachiocephalic veinsbrachiocephalic veins

Azygos venous systemAzygos venous system

Left 2th, 3rd and 4th posterior Left 2th, 3rd and 4th posterior intercostal veins drain into what?intercostal veins drain into what?

left superior intercostal veinleft superior intercostal vein

→ → brachiocephalic veinbrachiocephalic vein

Azygos venous systemAzygos venous system

Right 2th, 3rd and 4th posterior Right 2th, 3rd and 4th posterior intercostal veins drain into what?intercostal veins drain into what?

right superior intercostal vein right superior intercostal vein

→ → azygos veinazygos vein

Azygos venous systemAzygos venous system

Right 5th-11th posterior intercostal Right 5th-11th posterior intercostal veins drain into what?veins drain into what?

azygos veinazygos vein

Azygos venous systemAzygos venous system

left 5th-11th posterior intercostal veins left 5th-11th posterior intercostal veins drain into what?drain into what?

5-8 →5-8 →accessory hemiazygos veinaccessory hemiazygos vein

9-11 →9-11 →hemiazygos veinhemiazygos vein

They both drain intoThey both drain into

azygos veinazygos vein..

RespirationRespiration

Divided into what?Divided into what?

inspiration and expirationinspiration and expiration

RespirationRespiration

Muscles of inspiration – name them!Muscles of inspiration – name them!

- diaphragm- diaphragm

- external, internal, innermost intercostal- external, internal, innermost intercostal

- sternocleidomastoid- sternocleidomastoid

- scalenus- scalenus

- pectoralis major + minor- pectoralis major + minor

- levator costarum + scapulae- levator costarum + scapulae

- serratus anterior + posterior superior- serratus anterior + posterior superior

RespirationRespiration

Forced inspiration involves what?Forced inspiration involves what?

- contraction of the intercostal muscles- contraction of the intercostal muscles

- elevation of the ribs- elevation of the ribs

RespirationRespiration

Forced inspiration results in what?Forced inspiration results in what?

Rsults in increased Rsults in increased transverse and transverse and anteroposterior diametersanteroposterior diameters of the thoracic of the thoracic cavity.cavity.

The abdominal volume is decreased with an The abdominal volume is decreased with an increased abdominal pressure.increased abdominal pressure.

ExspirationExspiration

Expiration involves what muscles?Expiration involves what muscles?

- muscles of the anterior abdominal wall- muscles of the anterior abdominal wall

- internal intercostal muscles- internal intercostal muscles

- serratus posterior inferior- serratus posterior inferior

Internal thoracic arteryInternal thoracic artery

Divides where into what?Divides where into what?

Divides into:Divides into:

- musculophrenic a.- musculophrenic a.

- superior epigastric a.- superior epigastric a.

At the At the 6th6th intercostal space intercostal space

Intercostal arteriesIntercostal arteries

What structures give rise to anterior What structures give rise to anterior intercostal areteries?intercostal areteries?

1st-6th intercostal space1st-6th intercostal space

- internal thoracic a.- internal thoracic a.

7th-9th intercostal space7th-9th intercostal space

- musculophranic a.- musculophranic a.

Intercostal arteriesIntercostal arteries

What structures give rise to posterior What structures give rise to posterior intercostal arteries?intercostal arteries?

1-21-2

- supreme intercostal a.- supreme intercostal a.

(branch from costocervical trunk)(branch from costocervical trunk)

3-113-11

- thoracic aorta- thoracic aorta

ClinicalClinical

What is pneumothorax?What is pneumothorax?

Presence of air in the pleural cavityPresence of air in the pleural cavity

ClinicalClinical

What is emphysema?What is emphysema?

accumulation of air in accumulation of air in

terminal bronchiolesterminal bronchioles and and alveolar sacsalveolar sacs

ClinicalClinical

What is pneumonia?What is pneumonia?

Is an Is an inflammation of the pleurainflammation of the pleura also also known as pneumonitisknown as pneumonitis

ClinicalClinical

What is thoracentesis or What is thoracentesis or pleurascentisis?pleurascentisis?

Pleural tapPleural tap is a surgical punture of the is a surgical punture of the thoracic wall into the pleural cavity for thoracic wall into the pleural cavity for

aspiration of fluid.aspiration of fluid.

ClinicalClinical

What are hydrothorax, hemothorax, What are hydrothorax, hemothorax, chylothorax and pyothorax?chylothorax and pyothorax?

Accumulations of fluidsAccumulations of fluids in the pleural in the pleural cavitycavity..

hydrothoraxhydrothorax

waterwater

hemothoraxhemothorax

bloodblood

chylothorachylothora

lymphlymph

pyothoraxpyothorax

pus pus

ClinicalClinical

Lesion of phrenic nerve may not produce Lesion of phrenic nerve may not produce complete paralysis of the corresponding half complete paralysis of the corresponding half

of the diaphragm. Why not?of the diaphragm. Why not?

Because of Because of accessory phrenic nerve accessory phrenic nerve (C5) (C5) that usually joins the phrenic nerve.that usually joins the phrenic nerve.