Heart, Lungs & Thorax

Part 3

Gross Anatomy II
Pages 23-31
Lec # 5
01-24-07

2007
1
 ANNOUNCEMENTS
• Be sure to get well oriented before removing ribs.
• On page 25 where directed to remove ribs. Rather than as instructed leave only ribs
7,8, 16, 17 and 18. See p r26 for removal of 1st rib (Leave Scalenus with Phrenic N.
Branches) (A change from Book) Be careful on medial side of 1st rib to preserve the
vessels and nerves medial to the 1st rib
• Be very careful not to enter the peritoneal cavity at this time.
• When you remove the lungs, be very careful and try to preserve the vagus and phrenic
nerves.
• Do not remove the heart and other structures of the mediastinum as directed on page
28. Leave the heart in situ.
• Minimum structures on heart to identify: Chambers of the heart, left and right auricle,
the coronary and interventricular grooves, the left and right coronary arteries, the
ligamentum arteriosum, open the left and right atria to identify the coronary sinus,
fossa ovale and left and right AV valves. This may require using paper towels to
remove blood/latex from the atria.
• Remember to share sides and to see the horse from both the right and left
• Corrections on veins in figures 2-9, 2-10, page 27 of lab guide.
• Autonomics: see all possible without transecting the arteries
• 3 enlarged images for slides, 9, 12 & 14

2
 Surface Anatomy of the Lungs
• Apex and base (diaphragmatic surface)
• Costal and medial surface
• Dorsal, ventral & basal borders
• Cardiac notches
• Lobes: left 2 / right 3
• Hilus
• Root: Pulmonary A. & V’s, Bronchus, Bronchial A., Pulmonary
Nerves, Pulmonary Lymphatics
• Pulmonary Ligaments
• Area of Adhesion (Normal)
• Impressions

3
 Apex (Cranial End)
Left
15 Base (Diaphragmatic Surface)
Costal Surface (Not Pictured)
PII140 & 141
Medial View of Horse Lungs

Medial Surface (Visible)

3/4 Dorsal Border
Ventral Border
Basal Border
PII 140 & 141
6/7 Cardiac Notches
1/2 Two Lobes on Left
Right
1/2/3 Three Lobes on Right
Hilus & Root (BAV)
13/19Pulmonary Ligaments
15 Area of Adhesion
20
Impressions
7/11 Tracheal 15/12 Costocervical
8 Aortic 13 Cranial VC
See S520 for Correct Labeling. 9 Esophageal 14 Cardiac
Ventral and Basal Borders on these
figures mislabeled in Popesko 10 Azygous 20 Caudal VC 4
 Review Question
• The pulmonary arteries as they enter the
lung should be located dorsal/ventral to
the pulmonary veins and both vessels will
in general be located dorsal/ventral to the
principal bronchus although on the left
the left pulmonary artery will approach
the lung in a position cranial to the left
principal bronchus.

5
 Lymph Nodes and Divisions of the Lungs

• 1: Left Tracheobronchial L.n’s.

• 2: Right Tracheobronchial L.n’s.
• 3: Middle Tracheobronchial Ln’s.
• 4: Pulmonary Ln’s.
• Left and Right Principal (Primary Bronchi)
– Lobar Branches (Secondary)
• Segmental Bronchus (Tertiary) plus associated
Lung Tissue = Bronchopulmonary Segment
6
S522 Dorsal View of Horse Lungs
Left
Right
S522 LOBES
A Cranial Lobe (apical)
C Caudal Lobe (Diaphragmatic)
A D Accessory Lobe (Intermediate)
A 1
2 LYMPH NODES

3 1 Left Tracheobronchial
2 Right Tracheobronchial
D 3 Middle Tracheobronchial
C
4 Pulmonary
4 C Left Tracheobronchial into
Cranial Mediastinal. Right
Tracheobronchial into Middle
& Cranial Mediastinal. Middle
TB into Right TB and Cr., Mid.
& Caudal Mediastinal 7
 Lymphatics of the Thorax
• Left, Right & Middle Tracheobronchial
– Tend to be ventral to esophagus
• Cranial, Middle & Caudal Mediastinal
– Tend to be dorsal to the esophagus except possibly for cranial
mediastinal ln’s
• Cranial & Caudal Sternal
• Intercostals
• Thoracic Aortic
• Caudally located intercostal and thoracic aortic ln’s may drain
through aortic hiatus into celiac ln’s of the abdomen
• Lymphatic vessels from the diaphragm and liver may
drain to the caudal and cranial sternal and caudal
mediastinal lymph nodes i.e. into the thorax
8
 Lymphatics of the Thorax S622

Esophagus
S622

1’
5 Thoracic Aortic
6 Middle and Caudal
1,1’ Cranial & Caudal Sternal Mediastinal
2 Cranial Mediastinal 7 Middle Tracheobronchial
3 Nuchal 8 Left Tracheobronchial
4 Intercostal g Thoracic Duct
9
 Clarification Question
• A Kupffer cell sarcoma of the liver might
reasonably metastasize and produce an
opacity in the cranial mediastinum in
both the horse and dog. True/False

10
 Right View of Thorax
• Vagus Nerve and branches including Recurrent Laryngeal Nerve
• Phrenic Nerve
• Sympathetics
• Brachiocephalic Trunk
– (Left Subclavian Artery)
– Costocervical Trunk (right)
• Deep Cervical (1st space)
• Dorsal Scapular (2nd space)
– Supreme Intercostal
– Vertebral Artery (right) (cranial to 1st rib)
– Internal Thoracic (right) (may arise after Bicarotid Trunk)
– Bicarotid Trunk
• Right Subclavian
– Superficial Cervical (right)
• Vena azygous (right azygous)
• Chambers of the heart 11
 PII129

Brachiocephalic Trunk:
Origin of Costocervical
PII129
Trunk & Vertebral A. on the
Right

Costocervical Trunk with

Dorsal Scapular & Deep
Cervical
Vertebral Artery
Bicarotid Trunk
Right Subclavian A.
Vagus, Recurrent Laryngeal, D&V Vagal Trunks Internal Thoracic
18 Esophagus, 12 Aorta & 13 Azygous Superficial Cervical
Phrenic Nerve & Sympathetic Trunk
27,28,29 Chambers of Heart, 25 Pulmonary Veins
Thorax from Right
12
 Left View of Thorax
• Vagus Nerve and branches including Recurrent Laryngeal Nerve
• Phrenic Nerve
• Sympathetics
• Left Subclavian
– Costocervical Trunk
• Dorsal Scapular (2nd space)
– Supreme Intercostal
– Deep Cervical (1st space)
– Vertebral Artery
– Internal Thoracic
– Superficial Cervical
• Thoracic duct
• Chambers of the heart
13
 PII130
Thorax from Left

19 Brachiocephalic Trunk
22 Left Subclavian
Costocervical Trunk,
Dorsal Scapular &
Supreme Intercostal A’s
Deep Cervical A.
Vertebral A.
Internal Thoracic A.
Vagus, Recurrent Laryngeal, D&V Vagal Trunks Superficial Cervical A.
Esophagus, Aorta & Left Pulmonary Artery Axillary Artery
Phrenic Nerve & Sympathetic Trunk
39, 40, 41, 43 Chambers of Heart, 42 Pulmonary V’s
Thoracic Duct 14
 Review Question
• The thoracic duct originates from the
________________ in the craniodorsal
________________ cavity, and passes
through the _________________ to run
on the left/right dorsolateral side of the
aorta to about T7 levels (+/-) and then
passes to the left/right to run over the
left/right side of the esophagus before
empting into the _____________ .
15
 Anatomical Correlates, JAVMAmay01001441

• Heart murmurs were detected in 686 of 846 (81.1%) thoroughbred racehorses

– 48.7% 1 murmur; 24.8% 2 murmurs; 3 murmurs 6.7%; 4 murmurs 0.8%
– Tricuspid Systolic 28.5%; Tricuspid Diastolic 13.7%
– Pulmonary Systolic 43.1%; Pulmonary Diastolic 8.2%
– Mitral Systolic 3.8%; Mitral Diastolic 1.7%
– Aortic Systolic 27.4%; Aortic Diastolic 11.7%

• Functional Systolic Murmurs: 57.7% of the 846 horses (81.1-57.7 = 23.4)

– Was not made clear the exact criteria used for distinguishing functional murmurs
• ECG’s were done on a few horses with arrhythmias and Echocardiography done on 30 horses to
further evaluate murmurs
• Analysis of Race Records did not reveal a significant association between murmurs and
performance
– Examination of the medical records of those against which the horses in this study were
competing found that many had such conditions as: exercise induced pulmonary hemorrhage,
laryngeal hemiplegia, lameness, and COPD that were also probably performance limiting
problems
• Conclusion of Study: Heart Murmurs are a common finding in racehorses and most do
not appear to be clinically significant

16
 SA NODE: VENTRAL TO CRANIAL VENA CAVA OPENING

AV NODE IN INTERATRIAL SEPTUM CRANIAL TO

OPENING OF CORONARY SINUS

Components of SubAV
Node Conduction
System
1 1 Atrioventricular Bundle
2 Right & Left Bundles
RIGHT 2
LEFT 3 Trabecula
Septomarginalis

ND225 (2nd ed.) &

NND225 (3rd ed.)
Cardiac Conduction System
17
 CIRCULATION OF BLOOD
• Systemic Capillaries
• Systemic Veins
• Cr. & Cd. Vena Cava
• Right Atrium ABDOMINAL
HEPATIC VEINS
• Rt.. Ventricle VISCERA

• Pulmonary Trunk
• Lungs PORTAL V.

• Pulmonary Capillaries
• Pulmonary Veins LIVER

• Left Atrium
• Left Ventricle HEPATIC A.

• Aorta
UNPAIRED ABDOMINAL BRANCHES
18
 Review Question
• The liver receives a nutritional blood
supply from the ____________ (Vessel)
and a functional blood supply from the
______________ (vessel), and is most
likely to become congested and
edematous if there is left/right sided
heart failure.

19
 Lymphatics of the Thorax S622

Esophagus
S622

Corresponds to slide 9

1,1’ Cranial & Caudal Sternal
2 Cranial Mediastinal
3 Nuchal
4 Intercostal
5 Thoracic Aortic
6 Middle and Caudal
Mediastinal
7 Middle Tracheobronchial
8 Left Tracheobronchial
g Thoracic Duct
20
 PII129
Brachiocephalic Trunk:
Origin of Costocervical
Trunk & Vertebral A. on the
PII129
Right

Corresponds to slide 12

Costocervical Trunk with

Dorsal Scapular & Deep
Cervical
Vertebral Artery
Bicarotid Trunk
Right Subclavian A.
Vagus, Recurrent Laryngeal, D&V Vagal Trunks Internal Thoracic
18 Esophagus, 12 Aorta & 13 Azygous Superficial Cervical
Phrenic Nerve & Sympathetic Trunk
27,28,29 Chambers of Heart, 25 Pulmonary Veins
Thorax from Right
21
 PII130
Thorax from Left

19 Brachiocephalic Trunk
22 Left Subclavian
Costocervical Trunk,
Dorsal Scapular &
Supreme Intercostal A’s
Deep Cervical A.
Vertebral A.
Internal Thoracic A.
Vagus, Recurrent Laryngeal, D&V Vagal Trunks Superficial Cervical A.
Esophagus, Aorta & Left Pulmonary Artery Axillary Artery
Phrenic Nerve & Sympathetic Trunk
Corresponds to slide 14
39, 40, 41, 43 Chambers of Heart, 42 Pulmonary V’s
Thoracic Duct 22