shoulder region and thorax2

8/8/2019 Shoulder Region and Thorax2

1/24

1

Thorax Part 2

Gross Anatomy II

Pages 20-22Lec # 4

01-22-07

2007


2/24

2

ANNOUNCEMENTS

Be sure to ID the branches of the BrachialPlexus andDO NOTremove the limb until afterlab exam today.

When you remove the limb, cut the pectoralmuscles, axillary vessels and brachial plexus

close to the thorax so that they will remain attheir maximum length and be associated with

the pectoral limb when you start dissecting thelimb in a later laboratory.

Enlarged unmarked images for slides 13, 18 &19


3/24

3

Muscles and Structures of Trunk

Heave line: RAO or COPD heaves Review item Pathologic: Due to hypertrophy of EAO, Intercostals, and/or

maybe the Serratus Ventralis. Exact location debatable, butwe will put at muscle/aponeurosis intersection of EAO

Intercostobrachial nerves A second look before removing

Lateral thoracic nerve

Try to identify and at least leave stump as you remove thelimb

Intercostal muscles

Note external and internal intercostal muscles

Note dorsal ventral level of these muscles

Note endothoracic fascia and Parietal Pleura


4/24

4

S667

Heave Line

External Intercostals

External Abdominal Oblique

Serratus Ventralis (Thoracic)

EI

EAO

SVT

Intercostobrachial Plexus

External Thoracic Vein

Lateral Thoracic Nerve

Cutaneous Muscles

Removed


5/24

5

Explanation/Review Question How many ribs and thoracic vertebrae in

a horse, and thus how many intercostal

spaces, and between which two vertebrae

does the first rib articulate?


6/24

6

Auscultation Triangle

Again !

Know boundaries

Know relationship to heart and lungs

Know relationship to recesses and diaphragmaticline of pleural reflection


7/24

7

S667

Auscultation Triangle (Again)


8/24

8

Left View of Thorax 1: Outline of heart: 2nd Space-6th Space

2: Basal border of lung

3: Diaphragmatic line of pleural reflection

Area of absolute cardiac dullness (3rd rib to 6th rib+/-)

Cardiac notch of the lungs P A M: I3rd,H4th, L5th on Left

Costomediastinal Recess: ventral border of lungs

Phrenicocostal Recess (Costodiaphragmatic): basal

border of the lungs

Thoracocentesis at 7th space

Cupola of diaphragm: Ventral to middle of 6th rib

Cupola of pleura: Cranial to 1st rib on right


9/24

9

7TH RIB

D495

Landmarks:LeftThorax

1 Outline of Heart

2 Basal Border of Lung = +/-

Hypotenuse of Auscultation Triangle

3 Diaphragmatic Line of Pleural Reflection

Area of Absolute

Cardiac Dullness

Cardiac Notch

P = I3rd

A = H4th

M = L5th

CM Recess

V. Border of Lungs

PC Recess

B. Border of Lungs

Thoracocentesis at 7th Space

Cupola of Diaphragm,

See right view

Cupola of Pleura, See

right View

P

A

M


10/24

10

Right View of Thorax 1: Outline of heart

2: Basal border of lung

3: Diaphragmatic line of pleural reflection

Area of absolute cardiac dullness (3rd rib to 5th space +/-)

Cardiac notch of the lungs T: L4th

Costomediastinal recess: ventral border of lungs

Phrenicocostal recess (costodiaphragmatic): basal

border of the lungs

Thoracocentesis at 7th space (6th +/-)

Cupola of diaphragm

Cupola of pleura


11/24

11

D520B1

7TH RIBLandmarks: Right Thorax

T

See also Left View

1 Outline of Heart

2 Basal Border of Lung = +/-

Hypotenuse of Auscultation Triangle

3 Diaphragmatic Line of Pleural Reflection

Area of AbsoluteCardiac Dullness

Cardiac Notch

CM Recess

V. Border of Lungs

PC Recess

B. Border of Lungs

Thoracocentesis at 6th or 7th Space

Cupola of Diaphragm

Cupola of Pleura

Tricuspid Valve


12/24

12

The Brachial Plexus Nerves at Proximal Levels

C6 - T2

Musculocutaneous + Median

Ansa Axillaris (Mainly MC also Cran. Pect. Ns)

Ulnar and Radial

Suprascapular

Subscapular

Thoracodorsal

Lateral Thoracic and Caudal Pectorals Axillary

Long Thoracic

Vessels: Axillary Vein and Artery


13/24

13

PIII128

Brachial PlexusC6-T-2

Musculocutaneous

Median

Median + Musculocutaneous

Ansa Axillaris, Cranial Pectoral

Ulnar

Radial

Suprascapular

Subscapular

ThoracodorsalLateral Thoracic & Caudal Pectoral

Axillary

Long Thoracic (Not Pictured)

Vessels: Axillary Artery and Vein


14/24

14

The location of the usually solitary abscesses in 15 of 25 Standardbreds and 14 of 20

Thoroughbreds was in the caudodorsal lung field. For horses appropriately treated that had

raced prior to therapy their post therapy racing performance was not significantly different

from their performance prior to surgery.

Anatomical Correlates, JAVMAapr15001285a

Left figure is an abscess in the caudodorsal lung field, the right figure is an abscess

in the caudoventral lung field with the arrows showing the fluid/air interface in theabscess


15/24

15

Pleura: visceral and parietal

Pleura: pulmonary = visceral

Pleura: parietal Costal

Diaphragmatic

Mediastinal

Pericardial (mediastinal) pleura Plica vena cava: contains Caudal Vena Cava & Right Phrenic Nerve

Pericardium

Fibrous pericardium

Parietal pericardium Pericardial cavity

Visceral pericardium (epicardium)

Mediastinum: All Structures except lungs, plica vena cava and its contents

Mediastinum and Serosal

Structures of the Thorax


16/24

16

Review/Clarification Question What is cardiac Tamponade, which

major pumping chamber is most

susceptible to its effects, and what effect

might it have on superficial veins?


17/24

17

Structures and Areas within the Thoracic Cavity

on X-Section

Phrenicocostal recess

Costomediastinal recess

Vagus nerve and branches

Phrenic nerve

Ansa subclavia

Orientation of the heart

Chambers of the heart

Cupola of the diaphragm up to 6th rib

Mediastinum and Subdivisions


18/24

18

D498B

X-Section of

Thorax at T5

ND p523

Right Lung

Left Lung

EsophagusCarina (3) of Trachea

Aorta

Bifurcation of Pulmonary

Trunk

Right Atrium

Right Ventricle

Left Atrium

Left Ventricle

The Horse is

Facing You


19/24

19

D496

Pleuraand

Mediastinum

ND p521

Phrenicocostal Recess

Costomediastinal Recess

Vagus Nerve & Branches

Phrenic Nerve

Ansa Subclavia

Cupola of Diaphragm

Right Auricle

Right Ventricle

Left Atrium

Left Ventricle

MediastinumCranial Mediastinum

(Precardial)

Middle Mediastinum

(Cardial)

Caudal Mediastinum

(Postcardial)


20/24

20

Review Question In what intercostal space and at what

dorsal-ventral level is a thoracocentesis

performed on the left or on the right in

all the domestic animals except the

____________.


21/24

21

Dorsal Scapular Ligament

Formed by: thoracolumbar (lumbodorsal) fascia(this portion is elastic)

Extends from T3 to T5 between supraspinous

ligament and spinous processes to perforate the

serratus ventralis and attach to the scapula

Sends lamellae between the epaxial muscles of the

area

Supplies attachment for the Splenius,

Rhomboideus, Semispinalis Capitis

Unique to the Equine Species


22/24

22

PIII128

Brachial PlexusC6-T-2

Musculocutaneous

Median

Median + Musculocutaneous

Ansa Axillaris, Cranial Pectoral

Ulnar

Radial

Suprascapular

Subscapular

ThoracodorsalLateral Thoracic & Caudal Pectoral

Axillary

Long Thoracic (Not Pictured)

Vessels: Axillary Artery and Vein

Corresponds to slide 13


23/24

23

Original Corresponding to Slide 18 (D498B, ND523,NND520)



24/24

24

Original Corresponding to Slide 19 (D496, ND521, NND517)


shoulder region and thorax2

Documents