Cardlrc impresslon Groove fu esophagus
o The lung is surrounded by pleura, a serous membrane which folds back upon
itself to form a two-layered, membranous structure.
The thin space between the two pleural layers is known as
normally contains a small amount of pleural fluid.
The outer pleura (parietal pleura) is attached to the chest
pleura (visceral pleura) covers the lungs and adjoining
The parietal pleura is highly sensitive to pain while the visceral pleura is not, due
to its lack of sensory innervation,
Costomed iastinal & costodiaphragmatic
Surface anatomy: (it differs from that of the lung in):
The pericardium is a tough, fibrous, outer coating with discrete attachments to the
sternum, great vessels, and diaphragm and an inner membranous coat.
It is divided into two layers, the first of which is called the parietal layer and the
The pericardium contains approximately ten to fifteen cc's of serous fluid.
OnlCltt: at the upper part of the base of the left ventricte, on a levet with the
lower border of the third costal cartilage.
GOUnSe: it passes obliquely upward, forward, and to the right, in the direction
of the heart's axis, as high as the upper border of the second right costal cartilage.
The two coronaru arterieswhich supply the heart.
BECINS & ENDS atthe tever le of Lewis).
1- Brachiocephalic trunk (lnnominate artery)
. The 1"t branch of arch of aorta.
o Divides into right common carotid & right subclavian behind the right
. lt is crossed by the left brachiocephalic vein.
2- Left common carotid ariery.
The thoracic aorta is one of the contents of the posterior mediastinum
BeClruS & eruOS It begins at ttre tower border of the 4th thoracic vertebra
and ends in front of the lower border of the 1Oth thoracic vertebra, at the aortic hiatus
in the diaphragm where it becomes the abdominal aorta.
. Posterior intercostal arteries.
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The superior vena cava is formed proximally by the union of the right and left
brachiocephalic veins within the superior mediastinum. This occurs at the level
of the risht first costal cartilaqe.
From this point, the SVC runs for about 5-7cm inferiorly, slightly medially and
It ends at the superior vena caval orifice in continuity with the right atrium deep to
the third risht costal cartilaEe in the middle mediastinum, lt becomes
ensheathed by pericardium superior to this point. Posteriorly, at the level of the
second costal cartilage, the azvsous vein arches anteriorly over the root of the
right lung to merge with the posterior surface of the SVC.
By the union of the internaljugular and the subclavian veins posterior to the medial
ends of the clavicle ,lt receives the internal thoracic vein
The right vein passes almost vertically downward in front of the brachiocephalic
artery, and the left vein passes from left to right behind the upper part
Ettos: by the union of Rt & Lt ) form the sVC
Tntg urnnlgs : Rt) Rt tymph duct, Lr) Thoracic duct + as branches of 1"t
The azygos system consists of veins on each side of the vertebral column.
These veins drain the back, thoracic and abdominalwalls.
The azvoos vein and its main tributary, the hemiazvoos vein, usually arise from
the posterior aspect of the IVC and the renal vein respectively.
These veins provide another means of venous drainage from the abdomen and
o lt is formed by the union of the ascending lumbar veins with the right
subcostal veins at the level of the 12th thoracic vertebra,
o lt ascends in the posterior mediastinum, passing close to the right sides of the
bodies of the inferior eight thoracic vertebrae (T4-T12).
o [t is covered anteriorly by the oesophagus as it passes posterior to the root of
o lt then arches over the superior aspect of this root to join the SVC.
1. Hemiazygos v. is the main tributary.
2. ln addition to the posterior intercostalveins, the azygos vein communicates
with the vertebral venous plexuses.
3. This vein also receives the mediastinal, oesophageal, and bronchialveins.
OnlCttt: lt usuaily begins in the teft ascendinq lumbar vein or 1g4grygft
o This vein arises on the left side of the junction of the left subcostal and
o lt ascends on the left side of the vertebral column, posterior to the thoracic
. Here it crosses to the right, posterior to the aorta, thoracic duct, and
oesophagus, and joins the azvoos vein.
The hemiazygos vein receives the inferior three intercostal veins, the inferior
oesophageal veins, and several small mediastinal branches.
It receives tributaries from veins in the 4th to 8th intercostal spaces and sometimes
It crosses over T7 or TB vertebrae, posterior to the thoracic aorta and thoracic
duct, where it joins the azygos vein.
Sometimes the accessory hemiazygos vein joins the hemiazvoos vein and opens with
The accessory azygos vein is frequently connected to the superior intercostal vein.
This vein begins at the medial end of the 4th or sth intercostal space and descends
on the left side of the vertebral column from T5 to T8.
syrnrnetrical. Therefore, it is
Lavers of Anterior Abdominal Wallt
a. Camper's fascia - fatty superficial layer.
b. Scarpa's fascia - deep fibrous layer.
c. Transversus Abdominis muscle.
3. Anterior wall of rectus sheath.
5. Posterior wall of rectus sheath.
Superficial fascia in the lower part of anterior abdominal wall is differentiated into 2
A-Superficial Fattv Laver (Camper's Fasciar:
1) It corresponds to and is continuous with the subcutaneous fat of the body.
2) Loses its fat in the penis and perineum.
. Descends to the thigh with its corresponding layer (SC fat).
. Reflects backwards as the superficial layer of perineum.
4) In the male, it is continuous over the penis and becomes dartos fascia in
5) ln the female, it is continuous from the abdomen to the labia majora.
B1) lt is condensation of the superficial fascia; midway between the umbilicus
a- Superior.' it fades away midway between the pubis & umbilicus above
& in the lumbar region at the srdes.
b- Inferior: just below the external ring, the name changes to Colle's
c- Lateral; it is attached to the fascia lata just below (2 fingers' breadth)
the inguinal ligament at the groin crease.
Superficial Perinea! Fascia (Colle's Fascia)
It is the continuation of Scarpa's fascia below superficial inguinal ring.
- The penis and scrotum; giving a fascial covering.
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