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    Anatomy, Lecture 4, Thoracic Wall (2) (Slides)

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    Ali Al-Qudsi
    The document describes the anatomy of the thoracic wall, including the muscles like the intercostal muscles and diaphragm, as well as the neurovascular structures. It discusses the layers of the thoracic wall from skin to bone, and the functions of protection for thoracic viscera and breathing. Accessory muscles that assist with respiration are also mentioned.

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    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd

    Anatomy, Lecture 4, Thoracic Wall (2) (Slides)

    Uploaded by

    Ali Al-Qudsi
    822 views23 pages
    The document describes the anatomy of the thoracic wall, including the muscles like the intercostal muscles and diaphragm, as well as the neurovascular structures. It discusses the layers of the thoracic wall from skin to bone, and the functions of protection for thoracic viscera and breathing. Accessory muscles that assist with respiration are also mentioned.

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    Anatomy, Lecture 4, Thoracic Wall (2) [Slides]

    Original Title

    Anatomy, Lecture 4, Thoracic Wall (2) [Slides]

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    The document describes the anatomy of the thoracic wall, including the muscles like the intercostal muscles and diaphragm, as well as the neurovascular structures. It discusses the layers of the thoracic wall from skin to bone, and the functions of protection for thoracic viscera and breathing. Accessory muscles that assist with respiration are also mentioned.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    822 views23 pages

    Anatomy, Lecture 4, Thoracic Wall (2) (Slides)

    Uploaded by

    Ali Al-Qudsi
    The document describes the anatomy of the thoracic wall, including the muscles like the intercostal muscles and diaphragm, as well as the neurovascular structures. It discusses the layers of the thoracic wall from skin to bone, and the functions of protection for thoracic viscera and breathing. Accessory muscles that assist with respiration are also mentioned.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 23

    The Thoracic Wall (2):

    Muscles, nerves, vasculature & surface


    anatomy
    Thoracic Wall

    • Structure:
    skin  fascia  muscle  bone
    blood vessels & nerves

    • Functions:
    1. protection of thoracic
    viscera

    2. provides the mechanical


    function of breathing
    Muscles of Thoracic Wall:

    IM’s, Diaphragm, Accessory muscles of


    respiration
    Intercostal Muscles
    3 layers of m. that cover intercostal spaces

    From outside to inside:

    1. External intercostal m.:

    runs toward sternum (your ant. pockets)

    replaced anteriorly by membrane

    2. Internal intercostal m.:

    runs toward VC (your post. pockets)

    replaced posteriorly by membrane


    3. Innermost intercostal & Transversus Thoracic
    IIm:
    on lateral sides only

    TTm:
    4-5 slips of muscles
    From post. surface of sternum
    To 2nd-6th costal cartilages

    Bld. Vessels & nerves run between:


    Internal & innermost IMs
    Intercostal Muscles
    Intercostal Muscles
    Lower broder of the rib above

    Upper border of the rib below
    Ex.
    External

    Internal In.

    Innermost

    Intercostal neurovascular bundle


    runs between Internal & Innermost
    Intercostal NeuroVascular Bundle
    Costal Groove:

    Vein

    Artery

    Nerve

    Collateral neurovascular bundle: over upper borders


    of the ribs
    Intercostal Arteries
    Each intercostal space:
    1 Large post. inter. artery
    2 small ant. inter. Arteries

    Post.:
    Descending aorta
    & Costocervical trunk
    (sup. Inter. A.)

    Ant.:
    Internal Thoracic a.
    & musculophrenic a.
    Intercostal Veins
    Each intercostal space:
    Large post. inter. vein
    2 small ant. inter. veins

    Post.:
    Azygos Vein
    & hemiazygos

    Ant.:
    Internal Thoracic V.
    & musculophrenic V.
    Intercostal Nerves
    Diaphragm
    A thin muscular & tendinous sheet that separates the
    thoracic cavity from the abdomen
    (primary muscle of respiration)
    Diaphragm
    • Origin:
    Xiphoid process (sternal)
    lower 6 ribs & CC (7th-12th, costal)
    1st-3rd bodies of lumbar V & IV discs (as crura & ?, vertebral)
    (see next slide)

    • Insertion
    Central Tendon

    • Innervation
    Motor: Phrenic nerve (C3, 4 & 5)

    Sensory: Central: phrenic


    Lateral: intercostal nerves (7-12)

    • Action: ??
    Vertebral Origin of Diaphragm

    Crura:
    vertical columns of muscle bundles
    Rt: L1-L3 & IV discs
    Forms a sling around esophagus
    Lf: L1-L2 & IV disc

    Arcuate Ligaments:
    Medial: L2 body  L1 Trans. P.
    Lateral: L1 TP  12th rib
    Median: medial borders of crura
    Shape of Diaphragm
    2 domes:
    Rt: upper border of 5th rib (why?)
    Supports Rt. lung

    Lf: lower border of 5th rib


    Supports Lf. lung

    Central Tendon:
    3 leaves
    At xiphisternal joint
    Supports the heart
    Merges with fibrous pericardium
    Openings in The Diaphragm
    3 main openings:

    1. Aortic opening:
    At T12, between crura
    Aorta, azygos vein & thoracic duct

    2. Esophageal opening:
    At T10, in sling of right crus
    Esophagus & vagus nerves

    3. Caval opening:
    At T8, in central tendon
    IVC, & Rt phrenic n
    Any other openings?
    Diaphragmatic Hernia
    - Rupture in the diaphragm leading to herniation of
    lumbar viscera into the thorax
    - most common in left side with stomach fundus
    (Sliding or paraesophageal)

    Hiccup

    - Involuntary contractions of the diaphragm


    - After eating or drinking  irritation of vagus n.
    Accessory Muscles

    Levator Costarum: Please see Grants atlas for images

    Triangular
    Inspiratory
    Posterior rami
    Serratus Posterior Superior:
    Flat
    Inspiratory
    Serratus Posterior Inferior:
    Expiratory
    Surface Anatomy:

    Surface markings & lines

    Self Reading
    Surface markings of Ant. Chest

    Clavicle
    Sternum:

    Jugular notch

    Sternal angle

    Body of sternum

    Xiphoid process

    Costal margins
    Surface Anatomical Lines

    Anterior:
    1. Median sagittal line:
    intersection of median plane
    with ant. chest wall

    2. Midclavicular lines:
    Midpoints of clavicles
    to inguinal region
    Lateral:
    1. Ant. axillary line:
    Along ant. axillary fold
    (formed by border of Pec. Major m.)

    2. Post. axillary line:


    Along post. axillary fold
    (formed by latissimus dorsi & teres
    major M.)

    3. Mid axillary line:


    Runs from the apex of axilla
    Parallel to ant. & post. lines

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