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MUSCULI THORACIS Institute of Anatomy 2nd and 1st Medical Faculty R. Druga.

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Presentation on theme: "MUSCULI THORACIS Institute of Anatomy 2nd and 1st Medical Faculty R. Druga."— Presentation transcript:

1 MUSCULI THORACIS Institute of Anatomy 2nd and 1st Medical Faculty R. Druga

2 The muscles of the thorax They are all concerned in the movements of the ribs and hence with respiration The intercostales Transversus thoracis Levatores costarum Pectorales

3 Mm. pectorales Sulcus deltoideo- pectoralis Clavipectoral triangle Trigonum clavipectorale Anterior wall of the axilla M. Pectoralis major Origo : Clavicula, sternum Vagina m. rectorum Insertio : crista tuberculi majoris

4 Clavipectoral fascia

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7 Relations of the pectoralis minor to axillary vessels and brachial plexus

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9 CLAVIPECTORAL FASCIA

10 M. serratus ant. Origo : 1. – 9. Rib Insertio : medial margin of the scapula. N. Thoracicus longus

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12 Mm. Intercostales interni (11) Internal intercostal membrane (depression of the ribs) Exspiratory muscles From posterior costal angles to the sternum Mm.intercostales externi (11) Inspiratory muscles (elevation of ribs) From the tubercles of the ribs to the cartilage of the ribs in front

13 Mm. Intercostales externi External intercostal membrane

14 Spatium intercostale Intercostal space and layers of thoracic wall

15 The intercostales intimi Poorly developed in upper spaces, More extensive in lower spaces Separate intyercostal vessels and nerve from the pleura Action : like the intercostales interni

16 Spatium intercostale Puncture of the pleural cavity Punkce cavum pleurae

17 DIAPHRAGMA THE DIAPHRAGM A dome- shaped muscle which separates the thoracic from the abdominal cavity. Its periphery consists of muscular fibres attached to the central tendon (aponeurotic). LUMBAR PART COSTAL PART STERNAL PART The diaphragmatic aperturtes : Aortic Oesophageal Vena caval Main inspiratory muscle

18 DIAPHRAGMA Hranice mezi dutinou hrudní a břišní

19 Diaphragma Crus mediale L1 – L3 Crus laterale L 1 – L2

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22 Lumbocostal arches Medial and lateral

23 N. Phrenicus (C 4)

24 Inferior phrenic artery Phrenic nerve

25 Diaphragmatic part of the pericard

26 Relations of the diaphragm The upper surface is in relation with the pleura (right and left diaphragmatic pleura) and with the pericardium Lower surface is covered by peritoneum

27 Right dome 4th intercostal space Left dome 5th intercostal space

28 Upper surface and diaphragmatic apertures

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30 Diaphragma - actions Principal muscle of inspiration During inspiration muscular fibres contract and the central tendon and domes move downwards (volume of the thoracic cavity increases)

31 Inspiration Elevation of ribs (external intercostal muscles) Depression of the diaphragm In quiet inspiration the principal muscle is the diaphragm In forced inspiration additional muscles are called into action (pectoral, scalenic)

32 Expiration Relaxation of the diaphragm Contraction of the intercostales interni

33 MUSCULI ABDOMINIS Institute of Anatomy 2nd and 1st Medical Faculty

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35 M. Obliquus ext. 5th – 12th rib (8 slips) Vagina m. rectus abd. Linea alba Inguinal lig. Inguinal ligament

36 M. Obliquus internus Iliac crest, lumbodorsal fascia 9th –12th rib Linea alba, vagina m. rectus abd. M. Rectus abd. ribs, pubis

37 M. Transversus abd. 7th – 12th rib, iliac crest, inguinal lig. Linea alba, vagina mm. rectorum

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39 Vagina of the rectus muscles

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41 Vasa epigastrica inf. M. cremaster

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44 INGUINAL CANAL CANALIS INGUINALIS Lentgh 4 – 5 cm, from anulus inguinalis profundus (deep inguinal ring, entrance) to anulus inguinalis superficialis (superficial inguinal ring, exit) 4 walls Contens : funiculus spermaticus (spermatic cord, lig. teres uteri) Presence of canal appear to weaken the anterior abdominal wall

45 Canalis inguinalis Délka 4 – 5 cm Anulus inguinalis profundus – anulus inguinalis superficialis 4 stěny Obsah – funiculus spermaticus, lig. teres uteri Zeslabené místo přední stěny břišní Hernie !!!

46 Walls of the inguinal canal Anterior wall –aponeurosis of the External oblique (superficial ring) Posterior wall – transversal fascia (deep ring) Lower wall – inguinal ligament Upper wall - Internal oblique and Transversal (lower margins)

47 Stěny canalis inguinalis Přední stěna : aponeurosa m. obliquus externus Zadní stěna : fascia transversalis Dolní stěna : ligamentum inguinale Horní stěna : m. obliquus internus a m. transversus abdominis

48 Canalis inguinalis Inguinal canal Anterior wall (superficial ring) Posterior wall Falx inguinalis Interfoveolar lig. Inguinal triangle

49 Posterior wall from behind Inguinal canal- sagittal section

50 Cremaster muscle

51 Posterior wall of the inguinal canal = transversal fascia Falx inguinalis, lig. interfoveolare

52 Posterior wall of the inguinal canal – ligamentous bands Falx inguinalis (inguinal falx, the conjoint tendon) – is formed by the lower part of the aponeurosis of the transversus and is inserted medially to the pubis Interfoveolar ligament – laterally to falx, from lower margin of the transversus to pubis. Covers inferior epigastric vessels. Laterally to interfoveolar ligament is deep inguinal ring. Between falx and interfoveolar ligament – inguinal triangle

53 Peritoneal folds Peritoneální řasy a jamky

54 Hernial sac Indirect hernia Kýlní vak, Hernia indirecta

55 Inguinal hernia I (indirect, oblique) The viscus is protruded through the inguinal region (canal) Indirect (oblique) hernia – intestine is protruded inside of peritoneal sac - through the lateral inguinal fossa (peritoneum) Enters the inguinal canal at the deep inguinal ring Pass along the inguinal canal Enters the superficial inguinal ring Lastly descends into the scrotum Very frequently acquired variety, less frequently congenital

56 Inguinal hernia II (direct) Protrusion makes its way through – Medial inguinal fossa (peritoneum) Inguinal triangle Superficial inguinal ring (exit of the hernia) Is much less frequent than oblique hernia Occurs more often in men than in women Is always of acquired variety

57 Hernia inguinalis, Tříselná kýla Vychlípený peritoneální vak Uvnitř vaku je kýlní obsah (klička střevní, omentum, močový měchýř) Vak prochází (protlačuje se) zeslabenými místy stěny břišní (může dojít k ruptuře transversální fascie)

58 Herniae inguinales Hernia ing. directa : Vnitřní branka – trig. inguinale Zevní branka – anulus ing. superf. Získaná hernie Hernia ing. indirecta : Vnitřní branka – anulus ing. profundus Zevní branka – anulus ing. Superficialis Většinou získaná, vzácně vrozená hernie

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