复旦大学：《局部解剖学 Regional Anatomy》教学课件（英文）Part 11 – Thorax（Part 1）Thoracic wall

Copy Right- hongqi zhang张红旗 of Department of Anatomy-Fudan University Regional Anatomy Part 11- Thorax(Part 1) Thoracic wa∥ INTERNATIONAL EDITION Hongqi zhang(张红旗) Dissector Dept of Anatomy, Histoembryology 上ma: Zhanghe58@126m 1 qi zhang张红旗 of Department of Anatomy-Fudan University

Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University 1 Regional Anatomy Part 11 – Thorax (Part 1) Thoracic wall Hongqi Zhang (张红旗) Dept. of Anatomy,Histoembryology Email: zhanghq58@126.com

Boundary and divisions o Location: is the upper part of the trunk superiorly, continuous jugular notch clavicle with the neck. below it is separated from the abdomen manubrium sterni sternal angle by the diaphragm 3rd costal cartilage Sup. border(the inlet of the body of sternum thorax) formed by a line 9th rib th sternocostal j drawing from he jugular notch, along the sup. margins of the xiphoid process clavicles to the acromion and then to the spinous process of infrasternal angl the 7th cervical vertebra

 Location：is the upper part of the trunk. superiorly, continuous with the neck, below it is separated from the abdomen by the diaphragm.  Sup. border (the inlet of the thorax) formed by a line drawing from he jugular notch, along the sup. margins of the clavicles to the acromions, and then to the spinous process of the 7th cervical vertebra. Boundary and divisions

Boundary and divisions Inf border: (outlet of the thorax) is formed by the xiphoid process in front. the costal margin and the free border of 11st and 12nd ribs on both sides and the spinous process of the 12ng thoracic vertebra posteriorly jugular notch sternoclavicular j manubrium stemi gular notch sternal angle 3rd costal cartilage body of sternum -7th sternocostal j

 Inf.border: (outlet of the thorax) is formed by the xiphoid process in front. the costal margin and the free border of 11st and 12nd ribs on both sides and the spinous process of the 12nd thoracic vertebra posteriorly. Boundary and divisions

boundary and divisions Thoracic cage: consist of sternum, ribs, thoracic vertebrae and their articulations The thoracic wall: consist of the thoracic cage, skin, fasciae, muscles, blood vessels and nerves The thoracic cavity: it is divided into two parts by the mediastinum. The cavities on each side are occupied by the lungs and pleural sac Mediastinum: is generally defined as the intervals between the right and left pleural sacs. jugular notch sternoclavicular manubrium stemi jugular notch sternal angle Brd costal cartilage body of stern 9th rb -7th sternocostal j angle of Louis costal margin

 Thoracic cage: consist of sternum, ribs, thoracic vertebrae and their articulations.  The thoracic wall: consist of the thoracic cage, skin, fasciae, muscles, blood vessels and nerves.  The thoracic cavity: it is divided into two parts by the mediastinum. The cavities on each side are occupied by the lungs and pleural sac.  Mediastinum：is generally defined as the intervals between the right and left pleural sacs. boundary and divisions

Copy R Reference lines of thorax Universily 1-Anterior median line 2-Sternal line 3-Midclavicular line 4-Parasternal line 5-Anterior axillary line 6-Midaxillary line 7-Posteior axillary line 8-Scapular line 9-Posterior median line 5 Copy R3t4;2.zng张红旗 of deparment of anatom8.an9. /versit

Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Reference lines of thorax 1-Anterior median line 2-Sternal line 3-Midclavicular line 4-Parasternal line 5-Anterior axillary line 6-Midaxillary line 7-Posteior axillary line 8-Scapular line 9-Posterior median line 3 4 2 1 5 6 7 8 9

Layers of thoracic wall 1. skin 2. Sup. fascia: mammary, fat tissue, sup. blood vessels, cutaneous nn and lymphatic vessels 3. Deep fascia 4. Muscles: 4 layers 5. Intercostal space: intercostal muscles, intercostal blood vessels and nerves, int thoracic blood vessels and lymph nodes 6. Int. thoracic fascia: dense connective tissue. lined on the inner surface of ribs and intercostal spaces

Layers of thoracic wall 1. skin 2. Sup.fascia: mammary, fat tissue, sup. blood vessels, cutaneous nn. and lymphatic vessels. 3. Deep fascia. 4. Muscles: 4 layers: 5. Intercostal space: intercostal muscles, intercostal blood vessels and nerves, int. thoracic blood vessels and lymph nodes. 6. Int, thoracic fascia : dense connective tissue, lined on the inner surface of ribs and intercostal spaces

Thoracic wall-Superficial structures Skin Superficial fascia ◆ Mammary Q Artery -internal thoracic a. its branches Vein-thoracoepigastric veins, Lateral thoracic v ◆ Cutaneous nn ◆ Supraclavicular n Ant cutaneous branch of intercostal nn Lat cutaneous branch of intercostal nn

Thoracic wall-Superficial structures Skin Superficial fascia  Mammary  Artery - internal thoracic a. & its branches  Vein - thoracoepigastric veins, Lateral thoracic v.  Cutaneous nn.  Supraclavicular n.  Ant.cutaneous branch of intercostal nn. Lat.cutaneous branch of intercostal nn

Sup. structures of thoracic walls Deltopectoral groove supraclavicular n. anterior cutaneous branches of intercostal n perforating branches of internal thoracic a cephalic v lateral cutaneous branches of intercostal n thoracoepigastric v 8

Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Sup.structures of thoracic walls Deltopectoral groove 8

Copy Right- hongqi Zhang张红旗 of Department of Anatomy-Fudan University Cutaneous nerves of thoracic wall Lat. cutaneous branch of intercostal nerve Attention the distribution of Ant cutaneous branch of intercostal nerve lower six pairs of thoracic nn Copy Right- hongqi zhang张红旗 of Department of Anatomy- Fudan University

Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Copy Right- hongqi zhang 张红旗 of Department of Anatomy-Fudan University Ant.cutaneous branch of intercostal nerve Lat.cutaneous branch of intercostal nerve Cutaneous nerves of thoracic wall Attention: the distribution of lower six pairs of thoracic nn

Thoracic wall -deep structures Deep structures Deep fascia Superficial layer Deep layer-clavipectoral fascia Muscles of thorax Pectoralis major Rectus abdominis First layer 二头肌 Ext obliquus m Subclavius emus abdominis Pectoralis minor F Second layer mus abdominis Serratus anterior Intersects Lines alba 疲壁下动 Ext Intercostal m 园sien Int intercostal m -Third layer 投沟神 innermost intercostal m 谁状机 Transverse thoracic m. Fourth layer creaser Endothoracic fascia

Thoracic wall - deep structures Deep structures Deep fascia Superficial layer Deep layer—clavipectoral fascia Muscles of thorax Pectoralis major Rectus abdominis Ext.obliquus m. Subclavius Pectoralis minor Serratus anterior Ext. Intercostal m. Int.intercostal m. innermost Intercostal m. Transverse thoracic m. Endothoracic fascia First layer Second layer Third layer Fourth layer