1. A-THE THORACIC WALL A-THE THORACIC WALL Boundaries Boundaries
Posteriorly
by the thoracic part of the vertebral column
Posteriorly
by the thoracic part of the vertebral column
Anteriorly
by the sternum and costal cartilages
Anteriorly
by the sternum and costal cartilages
Laterally
by the ribs and intercostal spaces
Laterally
by the ribs and intercostal spaces
Superiorly
by the suprapleural membrane
Superiorly
by the suprapleural membrane
Inferiorly
by the diaphragm, which separates
the thoracic cavity from the abdominal cavity
Inferiorly
by the diaphragm, which separates
the thoracic cavity from the abdominal cavity

2. Divides into three parts:
1- STERNUM
It is a flat bone
Divides into three parts:
1-Manubrium sterni
2-Body of the sternum
3- Xiphoid process

3. second costal cartilage
The sternal angle
(angle of Louis)
formed by the articulation of the manubrium with the body of the sternum
Lies at the level of
second costal cartilage
The point from which all costal cartilages and ribs are counted

4. 2-Ribs
There are 12 pairs of ribs, all of which are attached posteriorly to the thoracic vertebrae.
The ribs are divided into three categories according to their relation to the sternum:
True ribs: The upper seven pairs are attached anteriorly to the sternum by their costal cartilages
False ribs: The 8th, 9th, and 10th pairs of ribs are attached anteriorly to each other and to the 7th rib by means of their costal cartilages.
Floating ribs: The 11th and 12th pairs have no anterior attachment

5. A rib has a head, neck, tubercle, shaft, and angle
Typical Rib
A typical rib is a long, twisted, flat bone
having a rounded, smooth superior border
and
a sharp, thin inferior border
The inferior border forms
THE COSTAL GROOVE
which accommodates the intercostal vessels and nerve.
intercostal vein
intercostal artery
intercostal nerve
VAN
important
A rib has a head, neck, tubercle, shaft, and angle

6. (fused to form the sacrum) (the lower 3 are commonly fused)
3-The Vertebral Column
is composed of 33 vertebrae
7 cervical
12 thoracic
5 lumbar
5 sacral
(fused to form the sacrum)
4 coccygeal
(the lower 3 are commonly fused)

7. 2-a vertebral arch posteriorly. (protect the spinal cord)
A typical thoracic vertebra consists of:
1-a rounded body anteriorly (body bearing)
2-a vertebral arch posteriorly.
(protect the spinal cord)
They enclose a space called
The vertebral foramen
through which run the spinal cord and its coverings
The vertebral arch gives rise
to seven processes:
a-One spinous
b-Two transverse
c- Four articular
(2 superior 2 inferior)

8. Characteristics of a Typical Thoracic Vertebra
The body is heart shaped
The vertebral foramen is small and circular
The spines are long and inclined downward
Costal facets are present on the sides of the bodies for articulation with the heads of the ribs
Costal facets are present on the transverse processes for articulation with the tubercles of the ribs

9. The body and the vertebral arch are connected by means of pedicles

10. upper and lower borders the superior and inferior
The pedicles
are notched on their
upper and lower borders
Forming
the superior and inferior
vertebral notches.
On each side
the superior notch of one vertebra and the inferior notch of an adjacent vertebra together form an intervertebral foramen.
These foramina, in an articulated skeleton, serve to transmit the spinal nerves and blood vessels.

11. 4-The diaphragm
The diaphragm is a thin muscular and tendinous septum that separates
the chest cavity above
from
the abdominal cavity below
The diaphragm is the most important muscle of respiration.
It is dome shaped and consists of a
peripheral muscular part
and a centrally placed tendon

12. passes through the central tendon at approximately vertebral
Main Openings in the diaphragm
The inferior vena cava
passes through the central tendon at approximately vertebral
level T8
The esophagus
passes through the muscular part of the diaphragm, approximately at vertebral
level T10
The aorta passes behind the posterior attachment of the diaphragm at vertebral
level T12

13. Nerve supply of the diaphragm
The phrenic nerves

14. INTERCOSTAL VEIN INTERCOSTAL ARTERY INTERCOSTAL NERVE (VAN)
5-Intercostal Spaces
1-SKIN
2-SUPERFISCIAL FASCIA
3- THREE MUSCLES OF RESPIRATION:
THE EXTERNAL INTERCOSTAL
THE INTERNAL INTERCOSTAL
THE INNERMOST INTERCOSTAL MUSCLE
4-THE ENDOTHORACIC FASCIA
5-THE PARIETAL PLEURA.
The intercostal nerves and blood vessels run between
the intermediate (internal intercostal) and deepest layers (innermost intercostal) of muscles
They are arranged in the following order from above downward:
INTERCOSTAL VEIN
INTERCOSTAL ARTERY
INTERCOSTAL NERVE
(VAN)

15. Its fibers are directed
The external intercostal muscle
the most superficial layer.
Its fibers are directed
downward and forward
The Internal Intercostal Muscle
forms the intermediate layer.
Its fibers are directed
downward and backward

16. The innermost intercostal muscle
Forms the deepest layer
It is an incomplete muscle layer and crosses more than one intercostal space within the ribs.

17. B-CHEST CAVITY
The chest cavity is bounded by the chest wall and below by the diaphragm

18. The chest cavity can be divided into
MEDIAN PARTITION
CALLED
THE MEDIASTINUM
LATERALLY PLACED PLEURAE AND LUNGS

19. 2-Pleurae
The pleurae and lungs lie on either side of the mediastinum within the chest cavity
FORMATION OF THE LUNGS
Each lung bud invaginates the wall of the cavity and then grows to fill a greater part of the cavity
the lung is covered with visceral pleura and the thoracic wall is lined with parietal pleura
The original cavity is reduced to a slitlike space called the pleural cavity as a result of the growth of the lung.

20. 1- Parietal layer, which lines
Each pleura has two parts:
1- Parietal layer, which lines
A-The thoracic wall
2- Visceral layer:
completely covers the outer surfaces of
The lungs

21. The Pleural Cavity The parietal and visceral layers of pleura
are separated from one another
by a slit like space
The Pleural Cavity

22. The trachea is a mobile cartilaginous and membranous tube
It begins in the neck as a continuation of the larynx at the lower border of the cricoid cartilage at the level of the sixth cervical vertebra
ends at the carina by dividing into right and left principal (main) bronchi at the level of the sternal angle (opposite the disc between the fourth and fifth thoracic vertebrae).

23. The right principal (main) bronchus 3- more vertical than the left
Principal Bronchi
The right principal (main) bronchus
1-wider
2-shorter
3- more vertical than the left
4-is about 1 in. (2.5 cm) long
The left principal (main) bronchus is
1-narrower
2-longer
3-more horizontal than the right
4- is about 2 in. (5 cm) long.

24. INHALED FOREIGN BODIES the right instead of the left bronchus
Inhalation of foreign bodies into the lower respiratory tract is common, especially in children
Because the right bronchus is the wider and more direct continuation of the trachea foreign bodies tend to enter
the right instead of the left bronchus

25. Each lung is conical, covered with visceral pleura
Lungs
In the child, they are pink, but with age, they become dark because of the inhalation of dust particles that become trapped in the phagocytes of the lung.
The lungs are situated so that one lies on each side of the mediastinum.
Each lung is conical, covered with visceral pleura

26. At about the middle of mediastinal surface is the hilum
Each lung has a blunt apex, which projects upward into the neck for about 1 in. (2.5 cm) above the clavicle
a concave base that sits on the diaphragm
a convex costal surface, which corresponds to the concave chest wall
a concave mediastinal surface, which is molded to the pericardium and other mediastinal structures
At about the middle of mediastinal surface is the hilum
a depression in which the bronchi, vessels, and nerves that form the root enter and leave the lung.
The anterior border is thin and overlaps the heart
The posterior border is thick and lies beside the vertebral column

27. the oblique and horizontal
Right Lung
The right lung is
slightly larger than the left
is divided by
the oblique and horizontal
fissures into three lobes:
THE UPPER
MIDDLE
LOWER LOBES

28. The left lung is divided by a similar oblique fissure into two lobes:
the upper and lower lobes There is no horizontal fissure in the left lung

29. For the Practical sessions you do need to recognize the following
superior
1-Pulmonary artery
Superior
in position
For the Practical sessions you do need to recognize the following
(1, 2 & 3) according to their anatomical positions
3-Main bronchus
Posterior
in position
2-Pulmonary veins
Inferior
in position
posterior
anterior
inferior