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 fascia. 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)

 

rHoRAx I

trmvefur arch of azygos

Main

for aortc arch

Lobar bronchi

ffoove fursupedor vena

tulmonary

Cardlrc impresslon Groove fu esophagus

Groove lor

honacic aorh

Bight Lung

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

vessels, bronchi and nerves.

The parietal pleura is highly sensitive to pain while the visceral pleura is not, due

to its lack of sensory innervation,

Pleural recesses:

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

second the visceral layer.

The pericardium contains approximately ten to fifteen cc's of serous fluid.

the pleural space. lt

wall. While the inner

structures, i.e. blood

I THORAX

Ascending aorta:

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.

BnRrucnes:

The two coronaru arterieswhich supply the heart.

Arch of the aorta:

BECINS & ENDS atthe tever le of Lewis).

Bnarucnes

1- Brachiocephalic trunk (lnnominate artery)

. The 1"t branch of arch of aorta.

o Divides into right common carotid & right subclavian behind the right

sterno-clavicu lar joint.

. lt is crossed by the left brachiocephalic vein.

2- Left common carotid ariery.

3- Left subclavian aftery.

4- Thyroida ima artery (3%).

rHoRAx I

Descendin thoracic aorta:

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.

,

Bnarucnes

. Bronchial arteries.

. Esophageal arteries.

. Posterior intercostal arteries.

. Sub costal artery.

. Mediastinal artery.

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Supgrior Vena Cava:

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

anteriorly.

END

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.

Brachioce halic veins

Becrus:

By the union of the internaljugular and the subclavian veins posterior to the medial

ends of the clavicle ,lt receives the internal thoracic vein

Counse:

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

of the sternum

Ettos: by the union of Rt & Lt ) form the sVC

Tntg urnnlgs : Rt) Rt tymph duct, Lr) Thoracic duct + as branches of 1"t

part of subclavian artery

They are valveless yeins

THORAX I

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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

thorax.

f THORAx

The Azygos Vein

Ontcltt:

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,

. The azygos vein connects the superior and inferior venae cavae, o The azygps vein drains blood from the posterior walls of the thorax and abdomen.

CoURSE:

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

the right lung.

o lt then arches over the superior aspect of this root to join the SVC.

TnrsurRnles:

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.

The Hemiazygos Vein:

OnlCttt: lt usuaily begins in the teft ascendinq lumbar vein or 1g4grygft

Counse:

o This vein arises on the left side of the junction of the left subcostal and

ascending lumbar veins.

o lt ascends on the left side of the vertebral column, posterior to the thoracic

aorta, as far as T9 vertebra.

. Here it crosses to the right, posterior to the aorta, thoracic duct, and

oesophagus, and joins the azvoos vein.

Tnreutlnles:

The hemiazygos vein receives the inferior three intercostal veins, the inferior

oesophageal veins, and several small mediastinal branches.

The Accesso Hemiazygos Vein

It receives tributaries from veins in the 4th to 8th intercostal spaces and sometimes

from the left bronchialveins.

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

it in the azygos.

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.

rHoRAx I

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THORAX

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The Abdomen ffmt lies

between the thorax and the

pelvis. The abdominal

cavity is divided from the

thoracic cavity by the

diaphrqgm but it is

continuous with the pelvic

cavity. Viscera contained

within the abdominal cwity

are not bilaterally

syrnrnetrical. Therefore, it is

worth noting that use of the

words *righf'and "lef in

names and irutructions

refers to the right and left

sides of the cadwer in the

anatomical position.

Lavers of Anterior Abdominal Wallt

(From superficial to deep)

Lateral:

1.Skin.

2. Fascia:

a. Camper's fascia - fatty superficial layer.

b. Scarpa's fascia - deep fibrous layer.

3. Muscles:

a. External oblique muscle.

b. lnternal oblique muscle.

c. Transversus Abdominis muscle.

4. Fascia transversalis.

5. Peritoneum.

F MeCial:

1. Skin.

2. Superficial fascia.

3. Anterior wall of rectus sheath.

4. Rectus Abdominis muscle.

5. Posterior wall of rectus sheath.

6. Peritoneum.

G. urduomlssc0oa

TABDoMEN

Superficial fascia in the lower part of anterior abdominal wall is differentiated into 2

layers:

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.

3) Extent:

. 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

the scrotum.

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

and symphysis pubis.

2) Attachments:

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

fascia.

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.

Extends over:

- The penis and scrotum; giving a fascial covering.

- The muscles in the superficial part of the perineum.

o

a

ABDOMEN I

1-

2-

3-

4-

5-