Thorax Part 2

Gross Anatomy II Pages 20-22 Lec # 4 01-22-07
2007

1

ANNOUNCEMENTS
‡ Be sure to ID the branches of the Brachial Plexus and DO NOT remove the limb until after lab exam today. ‡ When you remove the limb, cut the pectoral muscles, axillary vessels and brachial plexus close to the thorax so that they will remain at their maximum length and be associated with the pectoral limb when you start dissecting the limb in a later laboratory. ‡ Enlarged unmarked images for slides 13, 18 & 19
2

Muscles and Structures of Trunk
‡ Heave line: RAO or COPD ³heaves´ Review item
± Pathologic: Due to hypertrophy of EAO, Intercostals, and/or maybe the Serratus Ventralis. Exact location debatable, but we will put at muscle/aponeurosis intersection of EAO

‡ Intercostobrachial nerves
± A second look before removing

‡ Lateral thoracic nerve
± Try to identify and at least leave stump as you remove the limb

‡ Intercostal muscles
± Note external and internal intercostal muscles ± Note dorsal ventral level of these muscles ± Note endothoracic fascia and Parietal Pleura
3

Cutaneous Muscles Removed

³Heave Line´
S667

EI SVT EAO

External Intercostals External Abdominal Oblique Serratus Ventralis (Thoracic)

Intercostobrachial Plexus External Thoracic Vein Lateral Thoracic Nerve
4

Explanation/Review Question
‡ How many ribs and thoracic vertebrae in a horse, and thus how many intercostal spaces, and between which two vertebrae does the first rib articulate?

5

Auscultation Triangle Again !
‡ Know boundaries ‡ Know relationship to heart and lungs ‡ Know relationship to recesses and diaphragmatic line of pleural reflection

6

Auscultation Triangle (Again)
S667

7

Left View of Thorax
‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ 1: Outline of heart: 2nd Space-6th Space 2: Basal border of lung 3: Diaphragmatic line of pleural reflection Area of absolute cardiac dullness (3rd rib to 6th rib+/-) Cardiac notch of the lungs P A M: I3rd,H4th, L5th on Left Costomediastinal Recess: ventral border of lungs Phrenicocostal Recess (Costodiaphragmatic): basal border of the lungs ‡ Thoracocentesis at 7th space ‡ Cupola of diaphragm: Ventral to middle of 6th rib ‡ Cupola of pleura: Cranial to 1st rib on right

8

Landmarks: Left Thorax
7TH RIB
D495

A P M

1 Outline of Heart 2 Basal Border of Lung = +/Hypotenuse of Auscultation Triangle 3 Diaphragmatic Line of Pleural Reflection

Area of Absolute Cardiac Dullness Cardiac Notch P = I3rd A = H4th M = L5th CM Recess V. Border of Lungs PC Recess B. Border of Lungs Thoracocentesis at 7th Space Cupola of Diaphragm, See right view Cupola of Pleura, See right View
9

Right View of Thorax
‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ 1: Outline of heart 2: Basal border of lung 3: Diaphragmatic line of pleural reflection Area of absolute cardiac dullness (3rd rib to 5th space +/-) Cardiac notch of the lungs T: L4th Costomediastinal recess: ventral border of lungs Phrenicocostal recess (costodiaphragmatic): basal border of the lungs ‡ Thoracocentesis at 7th space (6th +/-) ‡ Cupola of diaphragm ‡ Cupola of pleura 10

Landmarks: Right Thorax
See also Left View Area of Absolute Cardiac Dullness Cardiac Notch CM Recess V. Border of Lungs PC Recess B. Border of Lungs Thoracocentesis at 6th or 7th Space Cupola of Diaphragm Cupola of Pleura Tricuspid Valve
D520B1

7TH RIB

T

1 Outline of Heart 2 Basal Border of Lung = +/Hypotenuse of Auscultation Triangle 3 Diaphragmatic Line of Pleural Reflection
11

The Brachial Plexus Nerves at Proximal Levels
‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ C6 - T2 Musculocutaneous + Median Ansa Axillaris (Mainly MC also Cran. Pect. N¶s) Ulnar and Radial Suprascapular Subscapular Thoracodorsal Lateral Thoracic and Caudal Pectorals Axillary Long Thoracic Vessels: Axillary Vein and Artery
12

Brachial Plexus
PIII128 C6-T-2 Musculocutaneous Median Median + Musculocutaneous Ansa Axillaris, Cranial Pectoral Ulnar Radial Suprascapular Subscapular Thoracodorsal Lateral Thoracic & Caudal Pectoral Axillary Long Thoracic (Not Pictured) Vessels: Axillary Artery and Vein 13

Anatomical Correlates,

JAVMAapr15001285a

Left figure is an abscess in the caudodorsal lung field, the right figure is an abscess in the caudoventral lung field with the arrows showing the fluid/air interface in the abscess
The location of the usually solitary abscesses in 15 of 25 Standardbreds and 14 of 20 Thoroughbreds was in the caudodorsal lung field. For horses appropriately treated that had raced prior to therapy their post therapy racing performance was not significantly different from their performance prior to surgery.
14

‡ Pleura: visceral and parietal ‡ Pleura: pulmonary = visceral ‡ Pleura: parietal
± Costal Mediastinum and Serosal ± Diaphragmatic Structures of the Thorax ± Mediastinal ‡ Pericardial (mediastinal) pleura

‡ Plica vena cava: contains Caudal Vena Cava & Right Phrenic Nerve ‡ Pericardium
± ± ± ± Fibrous pericardium Parietal pericardium Pericardial cavity Visceral pericardium (epicardium)

‡ Mediastinum: All Structures except lungs, plica vena cava and its contents
15

Review/Clarification Question
‡ What is cardiac Tamponade, which major pumping chamber is most susceptible to its effects, and what effect might it have on superficial veins?

16

Structures and Areas within the Thoracic Cavity on X-Section ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ ‡ Phrenicocostal recess Costomediastinal recess Vagus nerve and branches Phrenic nerve Ansa subclavia Orientation of the heart Chambers of the heart Cupola of the diaphragm up to 6th rib Mediastinum and Subdivisions

17

X-Section of Thorax at T5
Right Lung Left Lung Esophagus Carina (3) of Trachea Aorta Bifurcation of Pulmonary Trunk Right Atrium Right Ventricle Left Atrium Left Ventricle

ND p523

D498B

The Horse is Facing You

18

ND p521

Pleura and Mediastinum
D496

Mediastinum
Cranial Mediastinum (Precardial) Middle Mediastinum (Cardial) Phrenicocostal Recess Costomediastinal Recess Vagus Nerve & Branches Phrenic Nerve Ansa Subclavia Cupola of Diaphragm Right Auricle Right Ventricle Left Atrium Left Ventricle Caudal Mediastinum (Postcardial)

19

Review Question
‡ In what intercostal space and at what dorsal-ventral level is a thoracocentesis performed on the left or on the right in all the domestic animals except the ____________.

20

Dorsal Scapular Ligament
‡ Formed by: thoracolumbar (lumbodorsal) fascia (this portion is elastic) ‡ Extends from T3 to T5 between supraspinous ligament and spinous processes to perforate the serratus ventralis and attach to the scapula ‡ Sends lamellae between the epaxial muscles of the area ‡ Supplies attachment for the Splenius, Rhomboideus, Semispinalis Capitis ‡ Unique to the Equine Species
21

Brachial Plexus

Corresponds to slide 13

PIII128 C6-T-2 Musculocutaneous Median Median + Musculocutaneous Ansa Axillaris, Cranial Pectoral Ulnar Radial Suprascapular Subscapular Thoracodorsal Lateral Thoracic & Caudal Pectoral Axillary Long Thoracic (Not Pictured) Vessels: Axillary Artery and Vein 22

Original Corresponding to Slide 18 (D498B, ND523,NND520)
Corresponds to slide 18

23

Original Corresponding to Slide 19 (D496, ND521, NND517)
Corresponds to slide 19

24

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