秋年制局解Thorax.ppt

Regional anatomy of thorax 青岛大学医学院 解剖教研室 2014.9 Ⅰ. Boundaries 境界 Superior－jugular notch, sternoclavicular joint, superior border of clavicle, acromion, spinous processes of C7 Inferior－xiphoid process, costal arch, 12th and 11th ribs, vertebra T12 Ⅱ. Regions Thoracic wall Thoracic cavity Lymphatic drainage of breast Into pectoral ln. from lateral and central parts of breast Into apical and supraclavicular ln. from superior part of breast Into parasternal ln. from medial part of breast Into interpectoral ln. from deep part of breast The lymphatic capillaries of breast form an anastomosing network which is continuous across the midline with that of the opposite side and with that of the abdominal wall lymph nodes－arranged in five groups Lateral lymph nodes － lie around the distal end of axillary vein , receiving drainage from the arm, forearm, and hand Pectoral lymph nodes －lie along lateral thoracic vessels, receive afferents from anterior thoracic wall including central and lateral portion of mamma Subscapular lymph node －along subscapular vessels, receive lymph from nape and scapular region Efferents above three groups pass to central lymph node Central lymph node－lie in fat of axillary fossa, receive drainage from all the above nodes, efferents pass to apical lymph node Apical lymph node Lie in the apex of the axilla, along the proximal end of axillary vessels Receive drainage chiefly from central lymph node , upper portion of mamma Efferents form subclavian trunk, the right subclavian trunk joints the right lymphatic duct; left usually drains directly into thoracic duct The muscles of thorax Extrinsic muscles Pectoralis major Pectoralis minor Serratus anterior The muscles of thorax Extrinsic muscles Pectoralis major Pectoralis minor Serratus anterior Intrinsic muscles Intercostales externi Intercostales interni Intercostales intimi Transverses thoracis Intercostales externi Origin: lower border of rib Insertion: upper border of rib below orig