Thoracic organs 陳 建 榮

Ventral view of thorax

Heart: rib3~rib7

Wall of thorax Thoracic vertebrae胸椎 (T1~T13) Sternum 胸骨 Ribs肋骨 (13 pairs)

Ribs (13 pairs) Sternum Contains head, neck, tubercle, angle of rib head肋骨頭  body of thoracic veterbra tubercle肋骨結  transverse process 2. Costal cartilage肋軟骨  sternum 3. Sternal ribs (1~9 ribs)= true ribs真肋 4. Asternal ribs (10~13 ribs)= false ribs假肋 (10~12 ribs) + floating rib (13 rib) 5. Costal arch肋弓 6. Floating rib浮肋 7. Intercostal space肋骨間隙 Sternum Contain 8 sternebrae胸骨片 (manubrium胸骨柄, second ~ seventh sternebra, xiphoid process劍突, xiphoid cartilage劍突軟骨) The cartilaginous joints (intersternebral cartilage) between the sternebrae may ossify in old individuals.

Thoracic inlet胸腔入口

Thoracic outlet

Muscles of the thoracic wall External intercostal m.外肋間肌 (external intercartilage m.) Internal intercostal m.內肋間肌 Draw the ribs together Innervate by intercostal n. Transversus thoracic m.橫胸肌 2~8 costal cartilage  sternum Function: expiration呼氣 Diaphragm橫膈膜 Central tendon (V shape) Muscular part: pars lumbalis腰椎部, pars costalis肋骨部, pars sternalis胸骨部 Caval foramen腔靜脈孔, Esophageal hiatus食道裂孔, Aortic hiatus主動脈裂孔 Function: inspiration Innervate by phrenic n.膈神經 (C5~C7)

Internal thoracic a.內胸動脈 derive from subclavian a.鎖骨下動脈 lying between transversus thoracic m. and internal intercostal m. ventral intercostal a.腹肋間動脈: anastomosis with dorsal intercostal a. Pericardiocophrenic a.心包膜橫膈動脈 Branch to thymus Mediastinal a.縱隔動脈 Ventral cutaneous br. 腹側皮分枝(perforating br.) Cranial epigastric a. Musculophrenic a.

Thoracic cavity胸腔 2 Pleura cavity胸膜腔 Mediastinum 縱膈

Pleura胸膜 Parietal pleura壁層胸膜: line the walls of the thoracic cavity Costal pleura肋胸膜 Mediastinal pleura縱膈胸膜 Diaphragmatic pleura橫膈胸膜 Recess隱窩 Costomediastinal recess肋縱膈隱窩 Costodiaphragmatic recess 肋橫膈隱窩 Viseral pleura臟層胸膜(pulmonary pleura): coverthe lungs Plica vena cavae腔靜脈襞: surrounds the caudal vena cava - Mediastinal recess縱膈隱窩 Pleural cavity胸膜腔 Pleural cupula胸膜圓頂(apical portion of pleural sac)

Pulmonary lig. Costomediastinal recess Pleural cupula Costodiaphragmatic recess Pulmonary lig.

Pneumothorax氣胸

Mediastinal recess Costomediastinal recess

Lungs 三角形構造 Apex (cupula) Base (diaphragm) 外觀 Costal surface Medial surface Diaphragmatic surface Interlobar surface Root of lung肺門 Pulmonary a. Pulmonary v. Bronchi Bronchial a. - Pulmonary lig.肺韌帶 Oblique fissure斜裂

Horizontal fissure Oblique fissure Oblique fissure

1. Left lung 由 oblique fissure 將其分成兩葉 Cranial lobe前葉 and caudal lobe後葉 Cranial lobe 包含cranial part and caudal part兩部份 2. Right lung 表面有 oblique fissure斜裂, horizontal fissure水平裂 and cardiac notch Cranial lobe前葉, middle lobe中葉, caudal lobe後葉 and accessory lobe副葉 3. Impression and groove

Left lung

Right lung

Bronchial tree Principal bronchus主支氣管 bronchi支氣管 lobar bronchi (secondary bronchi) segmental bronchi (tertiary bronchi) large subsegmental bronchi small subsegmental bronchi bronchiole細支氣管 terminal bronchiole respiratory bronchiole alveolar duct肺泡管 alveolar sac肺泡囊

試描繪左或右任一肺之外形、壓跡及分葉情形。 解剖步驟 先移除兩側胸壁（1～8肋骨） 觀察胸膜及胸膜腔之構造後，取下兩側肺臟（由肺門處縱切） 觀察左右肺臟之外觀、分葉情形及表面壓迹，比對胸膜囊內之相對構造 觀察胸膜在胸膜囊內之分佈情形（注意各反褶位置及隱窩） 作業 試描繪左或右任一肺之外形、壓跡及分葉情形。