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THORAX

DANIK AGUSTIN P.
DEPARTEMENT OF ANATOMY-HISTOLOGY
MEDICAL FACULTY
BRAWIJAYA UNIVERSITY
THORAX

THORAX :
The part of the body between the neck and
abdomen

FUNCTION :
Breathing
Protection of vital organs
THORACIC CAVITY

Cavity of thorax contains


right & left pleural cavities
completely invaginated &
occupied by lungs
Right & left pleural cavities
separated by thick median
partition called mediastinum
Heart lies in mediastinum
Mediastinum
Central region between 2
pleural sacs
Contaisn all thoracic strcutures
except lungs and pleura
Separated into regions
Superior (1)
Inferior
Anterior (2)
Middle (3)
Posterior (4) Mediastinum (Norman 1999)
Thoracic Structures

Thoracic wall
Skeletal : ribs, vertebra,
sternum
Muscles
Diaphragm
Mediastinum includes heart,
midline
Pleural cavities either side of
mediastinum, includes lungs
Boundaries of the thorax
Superior Thoracic inlet ( Apertura Thoracic Superior)
Bounded by vert.TI , costae 1 and incissura jugularis
sterni

Inferior thoracic outlet (Apertura Thoracic Inferior)


Thorax continuous with abdomen but separated by
diaphragm
Bounded by vert. T12, costae 12, costal cartilage of
costae 7-10 & xiphisternal joint
THORACIC WALL

FASCIA :
Fascia pectoralis superficialis
Fascia thoracica externa
Fascia thoracica interna
Fascia endothoracica

SKELETON :
12 pairs of ribs
12 thoracic vertebrae
Sternum

MUSCLES :
THE MUSCLES OF THORACIC WALL

Function :
Alter the position of
the ribs and sternum
Change thoracic
volume during
breathing
THORAX MUSCLES
MUSCLE INNERVATION ACTION
Intercostalis Inspiration
Externus (Move Ribs
Superiorly)
Intercostalis Expiration
Internus (Move Ribs
Inferiorly)
Intercostalis Nn. Intercostales Act With
Intima Intercostalis
internus
Subcostalis Depress Ribs

Transversus Depress Costal


Thoracis Cartilages
VASCULARISATION & INNERVATION OF THORACIC
WALL

VASCULARISATION :
A. Intercostalis
A. Subcostalis
A. Thoracica Interna

INNERVATION :
N. Intercostalis
N. Subcostalis
LYMPHATIC DRAINAGE OF THORACIC WALL
Lymphatic node of thorax wall are
1. Parasternal
2. Phrenic.
3. Intercostal.
PARASTERNAL NODE

Location : along the upper part

Receive lymph from.(Afferent)


1.Medial part of the breast.
2.Diaphragm.
3.Intercostalspace.
4.Costal pleura.

Drains lymph to.(Efferent)


Truncus bronchomediastinalis
PHRENIC NODE

Location. Thoracic surface of diaphragm

Receive lymph from ( afferent)


1. Lower intercostal space.
2. Pericardium.
3. Diaphragm.
4. Liver.

Drain the lymph to (efferent)


Parasternal node.
INTERCOSTAL NODE

Location : vertebral end of intercostal space

Receive lymph from (Afferent)


1. The structure along the adjacent blood vessel.
2. The pleura.

Drain lymph into the thoracic duct.


DIAPHRAGM
Diaphragm divided into
Pars sternalis : have origin at posterior surface of
sternum.
Pars costalis : have origin at inner surface of
cartilage of VII - X th rib and XI XIIth rib.
Pars lumbalis : consist of :
- arcus lumbo-costalis lateralis and medialis
- crura diaphragmatica dexter et sinister
MAJOR OPENINGS AT DIAPHRAGM

Hiatus aortae:
Transmit aorta, n.splanchnicus major and
ductus thoracicus

Hiatus oesophagii
Transmit n.vagus and oesophagus.

Foramen venae cavae


Transmit v.cava inferior and n. phrenicus
dextra.
VASCULARISATION & INNERVATION OF
DIAPHRAGM

Blood Supply :
a.musculophrenica
a. pericardiacophrenica

Innervation : N. Phrenicus
Mechanics of Breathing
(Pulmonary Ventilation)

Two phases
Inspiration flow of air into lung
Expiration air leaving lung
Inspiration

Diaphragm and intercostal muscles contract


The size of the thoracic cavity increases
External air is pulled into the lungs due to an
increase in intrapulmonary volume
Inspiration
Expiration
A passive process
depends on natural lung elasticity
As muscles relax, air is pushed out of the
lungs
Forced expiration can occur by contracting
internal intercostal muscles
Expiration

Figure 13.7b
RESPIRATORY MUSCLES

Inspiration: elevate ribs Expiration: depress ribs


Contraction
External & of diaphragm
internal increases volume of thoracic cavity draws
inercostal Transversus thoracis
air into lungs
SCM; pectoralis minor; scalenes Abdominal obliques
Serratus anterior Rectus abdominis