复旦大学：《局部解剖学 Regional Anatomy》教学课件（英文）Part 12 – Thorax（Part 2）Mediastinum

s Regional Anatomy Part 12-Thorax(Part 2) Mediastinum INTERNATIONAL EDITION Hongqi zhang(张红旗) Dissector Dept of Anatomy, Histoembryology CEmail:zhanghg58@126.com

1 Regional Anatomy Part 12 – Thorax (Part 2) Mediastinum Hongqi Zhang (张红旗 ) Dept. of Anatomy,Histoembryology Email: zhanghq58@126.com

1. Pay attention to the divisions of parietal pleura 2. Int thoracic a divided into sup. epigastric a. and musculophrenic a 3. Adhesion between lungs neighbouring tissues are seen 4. Identify the structure arrangement of pulmonary hilum 5. Observe the shape lobes and fissures of th lungs 6. Check the cupula of pleura, costomediastinal recess and costodiaphragmatic recess 7. Understand the significance of negative pressure of pleural cavity 8. Identify int and ext intercostal membranes and transversus thoracis 9. Master the routine arrangement location of intercostal blood vessels and nerves 10. Understand the concepts of pleural effusion, hemothorax empyema, chylothorax, and the position of thoracic puncture

1. Pay attention to the divisions of parietal pleura. 2. Int.thoracic a.divided into sup.epigastric a. and musculophrenic a. 3. Adhesion between lungs & neighbouring tissues are seen. 4. Identify the structure arrangement of pulmonary hilum. 5. Observe the shape, lobes and fissures of th lungs. 6. Check the cupula of pleura, costomediastinal recess and costodiaphragmatic recess. 7. Understand the significance of negative pressure of pleural cavity. 8. Identify int.and ext intercostal membranes and transversus thoracis. 9. Master the routine, arrangement & location of intercostal blood vessels and nerves. 。 10.Understand the concepts of pleural effusion, hemothorax: empyema, chylothorax, and the position of thoracic puncture

Each lung have two lobes by the oblique fissure

Each lung have two lobes by the oblique fissure

Internal thoracic blood vessels Complete parietal pleura and int thoracic blood vessels

Internal thoracic blood vessels. Complete parietal pleura and int.thoracic blood vessels

General introduction to mediastinum Concept: all the tissues and organs between both mediastinal pleura Location: situated between both mediastinal pleura, sagittal, to the left and separate the pleural sac and lungs. ◆ boundaries: Anteriorly: sternum and costal cartilages; Posteriorly: thoracic column Both sides: mediastinal pleura; Superiorly: inlet of thorax. Inferiorly diaphragm Contents: organs(heart trachea esophagus large blood vessels and nerve and connective tissue etc 甲状腺 前纵隔 boundary of ples interor burder of lun

 Concept: all the tissues and organs between both mediastinal pleura  Location: situated between both mediastinal pleura, sagittal,to the left and separate the pleural sac and lungs.  boundaries： Anteriorly: sternum and costal cartilages ;Posteriorly: thoracic column. Both sides: mediastinal pleura;Superiorly: inlet of thorax. Inferiorly: diaphragm.  Contents: organs (heart, trachea, esophagus, large blood vessels and nerve and connective tissue etc. General introduction to mediastinum

Anterior aspect jof mediastinum brachial plexus costal pleura right phrenic n superior vena cava right lobe of thymus left phrenic n middle lobe of right lung left lobe of thymus anterior boundary ot pleura pericardium mediastinal mediastinal pleura inferior border of lung inferior costodiaphragmatic recess undary of pleura costal arch

Anterior aspect jof mediastinum

Mediastinum specimen in adult (left view) left vertebral anterior branch of 7th cervical n left internal jugular left subclavian a Ith rib costal pleura sternal angle aortic arch mediastinal pleura left pulmonary a left superior pulmonary v left superior lobar bronchus left inferior left inferior lobar bronchus pericardium thoracic aorta costomediastinal recess f2phrenicomediastinal recess 6th costal cartilage -lOth rib diaphragmatic pleura costodiaphragmatic

Mediastinum specimen in adult (left view)

Mediastinum specimen in adult (right view) anterior branch of 7th cervical n right vagus n right subclavian a. right common carotid a Ist rib mediastinal pleura costal pleura ternal angle right superior lobar bronchus right superior lobar v. right superior pulmonary v ht middle lobar bronchus costomediastinal recess right inferior lobar bronchus right middle lobar v right inferior pulmonary v. costodiaphragmatic recess costodiaphragmatic recess diaphragmatic pleura

Mediastinum specimen in adult (right view)

Observe the mediastinum观察纵隔 观察纵隔的分区:分上、下两部, 下纵膈又分为前、中、后纵隔三部分。 观察纵隔的侧面: 前纵隔- 后 中部为肺根 前方有膈神经、心包膈血管: ◆前下方为心包: ◆后方有食管和迷走神经。 ◆左肺根:上方主动脉弓、左锁骨下动脉和胸导管,后是胸主 动脉。 ◆右肺根:上方是下腔静脉、奇静脉和气管,后为奇静脉。 ◆后外侧:有胸交感干、内脏大神经、肋间后血管和肋间神经

观察纵隔的分区：分上、下两部， 下纵膈又分为前、中、后纵隔三部分。 观察纵隔的侧面：  中部为肺根 前方有膈神经、心包膈血管：  前下方为心包：  后方有食管和迷走神经。  左肺根：上方主动脉弓、左锁骨下动脉和胸导管，后是胸主 动脉。  右肺根：上方是下腔静脉、奇静脉和气管，后为奇静脉。  后外侧：有胸交感干、内脏大神经、肋间后血管和肋间神经。 Observe the mediastinum 观察纵隔

Observe the mediastinum Superior Divisions: sup and inf. part mediastinum Anterior Inf part is divided into three parts, mediastinum Ant. mid and post mediastinum 上纵隔 Observe both sides of mediastinum ◆ The middle part is pulmonary root曹 后 纵 anteriorly: phrenic n and pericardia phrenic blood vessels Anteroinferior part: pericardium: Posteriorly: esophagus and vagus Midddle mediastinum nerve Inferior mediastinum

Divisions: sup.and inf.part Inf.part is divided into three parts， Ant.mid and post.mediastinum. Observe both sides of mediastinum：  The middle part is pulmonary root anteriorly: phrenic n.and pericardio phrenic blood vessels.  Anteroinferior part: pericardium：  Posteriorly: esophagus and vagus nerve Observe the mediastinum Superior. mediastinum Inferior mediastinum Midddle mediastinum Anterior mediastinum