3 hypothenar muscles (Abductor digiti minimi, flexor digiti minimi &
opponens digiti minimi) + 1 muscle superficial to them (Palmaris brevis).
Fleror dlglt rl{drl{ brfi,*t Flrror poll* bmrla
Fhxsr pslEc& beilb ard std.Ebr
poltcE fpeft lnta lateral rued
- Palmar ) adduction of IPJ (Pad)
Lumbricals + Interossei ) Writing Position (Flexion ln MP Joint + Extension Of lP
JtE The Ulnar nerye supplies all the intrinsic muscles of the hand except the 3
ry muscles of thenar eminence + lumbricals 1 & 2 (supplied by median nerve).
Eorsal hftrosssous muscle Ext€flssr lEod
The thoran is the house and protect
the heart and lungs. The protective
function of the thoracic wall is
accommodate volume changes during
respiration. These two dissimilar
functions, protection and flexibility,
are accomplished by the alternating
intercostal muscles. The superficial
fascia of the thorax contains the usual
superficial fascia in all body regions:
cutaneous nerves, and sweat glands.
In additioq the superficial fascia of
the anterior thoracic wall in the
female contains the mammary glands.
o Supra-pleural membrane is attached to the inner margin of the 1st rib.
-^_o lf a rib is fractured at two nearby places, the part of rib between two fractured sites
JtL will show Paradoxical movement itvtoves inward during inspiration). tr
. The opening at the superior end of the rib cage through which cervical
. lt marks the boundary between the neck & the superior mediastinum.
. Clinically, it is called thoracic outlet.
On bolb sides; the 1't ribs & their costal cartilages.
Superior thorecie sFifiJrG Ffl I
Structures that pass through the thoracic inlet:
SURGICAL IMPORTANCE: Thoracic outlet syndrome
o Vertebral column posteriorly.
o Right & left pleura & lungs on either side.
N.B: The upper border of the sternum is at level of lower border of T2)
. Below: line joining the sternal angle to the lower border of T4.
. Arteries: aortic arch, innominate artery, left common carotid & Ieft
. -@S: innominate veins & SVC,
o /Verves: the vagus, cardiac, phrenic, and left recurrent nerves.
W. trachea, esophagus and thoracic duct.
. Thymus gland (Prominent in children).
. Sterno-pericardial ligaments.
o The superior vena cava with the azygos vein opening into it.
o The pulmonary artery dividing into its two branches.
o The right & left pulmonary veins.
o The bifurcation of the trachea & the two bronchi.
Eil L > fne site chosen for pericardiocentesis: Left sth intercostals space.
F o Posterior inter-ventricular artery is a branch of right coronary, while
- anterior inter-ventricu.lar is a branch of left coronary.
. Origin of the left common carotid artery.
o The brachiocephalic trunk ascends at first in front of & then to
fi ilhl ttoiclrodr$dastld Umpltrtd
Arteries: thoracic part of the descending aorta.
Veins: azygos & hemi-azygos vein.
Nerves: vagus & thoracic splanchnic nerves,
Lvmph structures: thoracic duct & some LNs.
It is the upward continuation of the cisterna chyli.
It enters the thorax through the aortic opening of the diaphragm between the
azygos vein medially & aorta laterally.
. Ascends behind esophagus in the posterior mediastinum bnd crosses
. Lies superficial (anterior) to the posterior intercostal arteries, crossing
azygos system, the dome of pleura, Lt. vertebral & Lt. subclavian artery.
' At the level of C7, it crosses laterally behind the carotid sheath & anterior
It ends at: the confluence of Lt. subclavian vein & Lt. internaljugular vein.
Drains: the lymph from the entire body except Rt. upper limb, Rt. side of
chest & Rt. half of head & neck.
. 3 Surfaces (costal, mediastinal & diaphragmatic).
o 3 Borders (anterior, postreior & inferior).
Contents of the root of the lung:
A. Bronchi, CT of the lung & visceral pleura:
o Bronchial As + 2 Lt. from descending thoracic aorta &
1Rt. from 3d posterior intercostalA.
o Bronchial Vs - Azygous & hemiazygous
o Terminal branches of pulmonary As supply the alveoli with
. Trebutaries of pulmonary Vs carrying oxygwnated blood.
. Apex: 1 inch above the medial 3'd of the clavicle.
a. Rt. Lung -+ extend from the apex to the sternoclavicular
joint, sternal angle then vertically to the level of 6th costal
b. Lt. lung -+ extend from the apex to the sternoclavicular
joint, sternal angle then vertically to the level of 4th costal
cartilage, deviates to the Lt. & descend again 1 inch lateral
to sternal margin down to the 6th costal cartilage.
e 6th rib (in the midclavicular plane).
: ?o,r' : J'U::"Ti'.,il",i.ililil i co, u mn )
The riaht lunq is different from the left lunq in that:
. lt is larger in transverse diameter.
. lt usually has two fissures.
. lt has 2 bronchi in the hilum.
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