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T HORACIC W ALL Benish Islam Lecturer / coordinator Surgical IPMS/KMU.

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Presentation on theme: "T HORACIC W ALL Benish Islam Lecturer / coordinator Surgical IPMS/KMU."— Presentation transcript:

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2 T HORACIC W ALL Benish Islam Lecturer / coordinator Surgical IPMS/KMU

3 S TRUCTURE O F THORACIC W ALL

4 S TERNUM Manubrium Body of sternum: Manibriusternal joint Xipibhisternal joint Sternal angle Xiphoid process

5 R IBS Total 12 pair of ribs True ribs: upper 7 False: 8,9,10 th ribs Floating ribs: 11,12 ribs Typical rib:Costal Groove,head,neck, tubercle shaft,angle Atypical rib: 1 st rib

6 T HORACIC OUTLET Opening at root of neck. Oesophagus, trachea and blood vessels pass through it

7 E NDOTHORACIC FASCIA Loose connective tissue Separate parietal pleura from thoracic wall

8 I NTERCOSTAL MUSCLES (3 TYPES ) 1. External intercostal muscle: Fibers directed downward and forward From inferior border of rib above to superior border of rib below Aponerosis: Ant.(external) intercostal membrane

9 2. I NTERNAL INTERCOSTAL MUSCLE Intermediate layer Fibers directed downward and backward From subcostal groove of rib above to upper border of rib below Aponeurosis: post. (internal) intercostal membrane

10 3.I NNERMOST I NTERCOSTAL MUSCLE Deepest layer Corresponds to transversus abdominis in abdominal wall Croses more than one intercostal space Related to endothoracic fascia. Blood vessels,nerves pass between intermediate and deepest layer.

11 R ESPIRATION MECHANISM : Inter costal nerves Intercostal Arteries and veins: Post. Intercostal arteries Ant. intercostal veins ActionSupply

12 D IAPHRAGM

13 O RIGIN OF DIAPHRAGM Thin muscular tendinous septum,separate chest cavity above from abdominal cavity. Sternl part:arises from post. Surface of xiphoid process Costal Part:arise from deep surface of lower six ribs and costal cartilage. Verterbral part:arises from vertebral column nd arcuate ligament. Inserted into central tendon Rt.dome: upper border of 5 th rib Lt. dome: lower border of5th rib

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15 D IAPHRAGM Nerve/Action Motor nerves: rt,lt. phrenic nerves C3,4,5 Sensory nerves: Phrenic nerve and lower six intercostal nerves Action:On contraction, diaphragm pulls down central tendon and inc. vertical diameter of thorax. Function Muscle of Inspiration Muscle of Abdominal Straining Weight lifting muscle Thoracoabdominal pump

16 3 MAJOR OPENING IN DIAPHRAGM

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18 A NTERIOR VIEW OF THORAX

19 L INES OF ORIENTATION

20 P OSTERIOR CHEST WALL

21 S URFACE A NATOMY

22 T HANK YOU


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