topographical anatomy of the thorax - univerzita...

TOPOGRAPHICAL ANATOMY OF THE THORAX

Václav Báča, David KachlíkTereza Smržová, Martin Holek, Katarina

Hubčíkova, Radek Jakša

Department of

Anatomy 3rd Faculty

of

Medicine, Charles University in Prague

supported by grant FRVS 1101/2008/F3

MEDIASTINUM SUPERIUSMEDIASTINUM SUPERIUSBORDERS:

CRANIAL:apertura thoracis

sup. (Th1, first

rbs, upper

border

of

sternum)

VENTRAL:manubrium

sterni, ribs

+ muscles

DORSAL:spine, ribs

+ muscles

VENTRAL:pleura

mediastinalis

CAUDAL:theoretical

level

between

angulus

sterni

and

intervertebral

disc

of

Th4-5

CONTENT:Structures in 5 layers mentioned

deepwards:

1. thymus, insertions

of

mm. sternothyroideus

and

sternohyoideus, vasa

thoracica

int. + their

branches

2. layer of veins: vv. brachiocephalicae

(plexusthyroideus

impar, v. intercostalis

sup. sin.) connect

to form

v. cava

sup., ductus

thoracicus,nn. phrenici

3. layer of arteries: arcus

aortae

+ its

branches

4. organs: trachea + its

bifurcation

(at

the

levelof

Th4 vertebral

body), bronchi

principales, esophageus

+ nn. vagi, rr. cardiaci, n. laryngeusreccurens

sin., nodi

lymphoidei

tracheobronchiales, nodi

lymphoidei

paratracheales, membrana

bronchopericardiaca

5. truncus

sympathicus

dx. et

sin, nn. cardiaci, nodi

lymphoidei

juxtaesophageales, m.longus

colli

MEDIASTINUM INFERIUSMEDIASTINUM INFERIUS

Mediastinum anterius

Mediastinum medium

Mediastinum posterius

MEDIASTINUM ANTERIUSMEDIASTINUM ANTERIUSBORDERS:CRANIAL:theoretical

level

between

angulus

sterni

and

intervertebral

disc

of Th4-5

VENTRAL:corpus sterni, ribs

+muscles

DORSAL:pericardium

CAUDAL:diaphragma

CONTENT:

ligg. sternopericardiaca

nodi

lymphoidei

parasternales,prepericardiaci

vasa

thoracica

int. + their

branches

musculus

transversus

thoracis

MEDIASTINUM MEDIUMMEDIASTINUM MEDIUMBORDERS:CRANIAL:theoretical

level

between

angulus

sterni

and

intervertebral

disc

ofTh4-5

VENTRAL:pericardium

DORSAL:pericardium

CAUDAL:diaphragma

CONTENT:heart

in the

pericard

aorta ascendenstruncus

pulmonalis

vena

cava

sup. (+ estuary

of

v.azygos)v. cava

inf.

nervi phrenicivasa

percardiacophrenica

plexus

cardiacus

venae

pulmonalesnodi

lymphoidei

pericardiaci

laterales

MEDIASTINUM POSTERIUSMEDIASTINUM POSTERIUSBORDERS:CRANIAL:theoretical

level

between

angulus

sterni

and

intervertebral

disc

ofTh4-5

VENTRAL:pericardium

DORSAL:spine, ribs

+ muscles

CAUDAL:diaphragma

CONTENT:

oesophagus

+

plexus

esophageus

truncus

sympathicus

+ nn. splanchnici

(major, minor, imus)

nodi

lymphoidei

prevertebrales, juxtaesophageales

ductus

thoracicus

v. azygos, hemiazygos

ethemiazygos

accessoria

(+ its

tributaries)

aorta thoracica

+ its

branches

RECESSUS PLEURALESRECESSUS PLEURALESrecessus

costodiaphragmaticus

(the

most caudal

place

of

pleural

cavity)

recessus

costomediastinalis

recessus

phrenicomediastinalis

recessus

vertebromediastinalis

DIAPHRAGMADIAPHRAGMABORDERS:PARS LUMBALIS (crus

sin.,dx.)

hiatus

aorticus

(between

cruradiaphragmatis, bordered

by lig. Arcuatummedianum)

hiatus

oesophageus

(in cruradiaphragmatis)

foramen

v. cavae

inferioris( in centrumtendineum)

PARS COSTALIS, PARS STERNALIS

trigonum

strenocostale, lumbocostal

CONTENT:

pars

lumbalis

(crus

sin.,dx.)

hiatus

aorticus

(between

cruradiaphragmatis, bordered

by lig.arcuatum

medianum)

hiatus

oesophageus

(in cruradiaphragmatis)

foramen

v. cavae

inferioris( in centrumtendineum)

pars

costalis, pars

sternalis

trigonum

strenocostale, lumbocostal

SPATIUM INTERCOSTALESPATIUM INTERCOSTALE

BORDERS:

between

two

neighbouring

ribs

CONTENT:

mm. intercostales

ext

(+ membranaintercostalis

ext.)

mm. intercostales

int.(+ membranaintercostalis

int.)

vena

+ arteria

intercostalis

ant. et

post. + n. intercostalis

ramus

collateralis

a. intercostalis

post. + r. collateralis

n. intercostalis

mm. intercostales

intimi

mm. subcostales