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 l

ung and pleura cavity.

The thoracic wall

superficial structures

1)skin2)superficial fascia3)cutaneous nerve ： The supraclavicular nerve Anterior cutaneous branches of intercostal ne

rve Lateral cutaneous branches of intercostal ner

ve

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 thora

cic V.

Deep structures

Intercostal spaces Position Contents:1) The intercostal externus2) The intercostal internus3) The intercostal intimus 4) The intercostal nerves:

Intercostal spaces

5) Veins and Arteries

6)The relationship of the intercostal nerve a

nd 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

2 Division four parts of the

mediastinum

Mediastinum

superior mediastinumglandular plane venous plane arterial-nervous plane visceral plane

lymphatic plane 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.

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

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.

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 Posterior Mediastinum

The thoracic part of esophagus

Relation

• Anteriorly:

• Posteiorly:

• Left side:

• Right side:.

The thoracic part of esophagus

2) Blood supplyArteries:• Superior part• Inferior partVeins:

→ azygos vein, hemiazygos vein,accessory he

miazygos 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 passage2 ） branchesParietal branches and visceral branches3 ） 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