1. Parts & Branches of an Aorta a) The Descending aorta b) The veins system of the thorax c) The lymphatics of the thorax 2. The nervous system of the thorax a) anterior and posterior branches of the thoracic nerves b) the phrenic nerve c) the thoracic part of the sympathetic trunk d) the thoracic part of the vagus (10th) nerve

1. The Department of HumanThe Department of Human
anatomyanatomy
LectureLecture
ANATOMY OFANATOMY OF
BLOODBLOOD
VESSELS ANDVESSELS AND
NERVES OFNERVES OF
PECTORALPECTORAL
CAVITYCAVITY

2. PLANPLAN
I. PARTS AND BRANCHES OF AN AORTAI. PARTS AND BRANCHES OF AN AORTA
a) THE DESCENDING AORTAa) THE DESCENDING AORTA
b) THE VEINS SYSTEM OF THE THORAXb) THE VEINS SYSTEM OF THE THORAX
c) THE LYMPHATICS OF THE THORAXc) THE LYMPHATICS OF THE THORAX
II.II.THE NERVOUS SYSTEM OF THE THORAXTHE NERVOUS SYSTEM OF THE THORAX
a) anterior and posterior branches of the thoracica) anterior and posterior branches of the thoracic
nervesnerves
b) the phrenic nerveb) the phrenic nerve
c) the thoracic part of the sympathetic trunkc) the thoracic part of the sympathetic trunk
d) the thoracic part of the vagusd) the thoracic part of the vagus (10(10thth
) nerve) nerve
Topicality: normal functioning of the walls
and the chest cavity depends on their correct
blood supply and innervation.

3.  PARTS AND BRANCHESPARTS AND BRANCHES
OF ANOF AN AORTAAORTA
AortaAorta isis contents of:contents of:
1. ASCENDING PART OF1. ASCENDING PART OF
AN AORTAAN AORTA
22.. ARCH ORARCH OR
AORTIC ARCHAORTIC ARCH
3. DESCENDING PART OF3. DESCENDING PART OF
AN AORTAAN AORTA
All of them have own branches.All of them have own branches.
The arch of aorta, arcus
aortae begins at the level of
sternal angle. It arches
superiorly, posteriorly and
to the left, and then
inferiorly.
On passing over the left
main bronchus, the arch of
aorta descends to the
posterior mediastinum and
reaches the body of Th4 on
the left. Here it becomes
continuous with the
descending part of thoracic
aorta.

4. 1.1. AN ASCENDING AORTAAN ASCENDING AORTA
The ascending aortaThe ascending aorta
begins between the left atriumbegins between the left atrium
and the infundibulum. Thisand the infundibulum. This
the first part of the aorta. Thethe first part of the aorta. The
ascendinq aorta has threeascendinq aorta has three
aortic sinusesaortic sinuses and bulb.and bulb. ItIt
contains of two branches:contains of two branches:
 a) the left coronary arterya) the left coronary artery
(arteria coronaria cordis(arteria coronaria cordis
sinistra)sinistra)
 b) the right coronary arteryb) the right coronary artery
(arteria coronaria cordis(arteria coronaria cordis
dextra).dextra).

5. SponsoredSponsored
Medical Lecture Notes – All SubjectsMedical Lecture Notes – All Subjects
USMLE Exam (America) – PracticeUSMLE Exam (America) – Practice

6. Branches of arch ofBranches of arch of
aortaaorta
1)1) BrachiocephalicBrachiocephalic
trunc (artery)trunc (artery) ::
 Right subclavianRight subclavian
 Right common carotidRight common carotid
2)2) Left commonLeft common
carotidcarotid
 External carotidExternal carotid
 Internal carotidInternal carotid
3)3) Left subclavianLeft subclavian

7. TheThe descending aortadescending aorta
 TheThe descending aortadescending aorta,, parspars
descendens aortae runs alongdescendens aortae runs along
the vertebral column on the left.the vertebral column on the left.
Its upper portion resides withinIts upper portion resides within
the posterior mediastinum (thethe posterior mediastinum (the
thoracic aorta),thoracic aorta), on passing theon passing the
aortic hiatus,aortic hiatus, the thoracic aortathe thoracic aorta
becomes continuous with thebecomes continuous with the
abdominal aorta.abdominal aorta. The abdominalThe abdominal
aortaaorta ends by splitting intoends by splitting into
common iliac arteries at thecommon iliac arteries at the
level oflevel of L4L4 (the(the aorticaortic
bifurcation,bifurcation, bifurcatio aortae).bifurcatio aortae).

8. THE THORACIC AORTATHE THORACIC AORTA (PARS THORACICA(PARS THORACICA
AORTAE)AORTAE)
is a continuation of the aortic arch. Itis a continuation of the aortic arch. It
resides within the posterior mediastinumresides within the posterior mediastinum
next to the vertebral column. The aortanext to the vertebral column. The aorta
resides to the left and then posteriorlyresides to the left and then posteriorly
from the esophagus. The thoracic aortafrom the esophagus. The thoracic aorta
passes through the aortic hiatus topasses through the aortic hiatus to
become continuous with the abdominalbecome continuous with the abdominal
aorta. Other neighboring organs are theaorta. Other neighboring organs are the
thoracic duct (found on the left) thethoracic duct (found on the left) the
azygos and hemiazygos veins and the leftazygos and hemiazygos veins and the left
sympathetic trunk. The branches ofsympathetic trunk. The branches of
thoracic aorta are subdivided into thethoracic aorta are subdivided into the
parietal and the visceral.parietal and the visceral.

9. The parietal branches are only the
posterior intercostal and the superior
phrenic arteries:
- the posterior intercostal arteries,
arteriae intercostales posteriores
(10 pairs) run along intercostal spaces 3
through 11. The branches running below
the 12 rib are the subcostal arteries
(arteriae subcostales).
- the superior phrenic arteries, arteriae
phrenicae arise from the lower portion of
the thoracic aorta. They supply the lumbar
part of diaphragm.

10. The visceral branchesThe visceral branches supplysupply
the thoracic viscera:the thoracic viscera:
-- thethe bronchial branches,bronchial branches, ramirami
bronchiales accompany thebronchiales accompany the
bronchi on their way to the lungsbronchi on their way to the lungs
- the- the esophageal branches,esophageal branches,
rami oesophagcalcs arise fromrami oesophagcalcs arise from
the anterior surface of thethe anterior surface of the
thoracic aorta. The upperthoracic aorta. The upper
esophageal branchesesophageal branches
anastomose with the inferioranastomose with the inferior
thyroid artery and the lower withthyroid artery and the lower with
the left gastric artery;the left gastric artery;
- the- the pericardial branchespericardial branches,, ramirami
pericardiac are the smallpericardiac are the small
branches that reach the posteriorbranches that reach the posterior
surface of pericardium;surface of pericardium;
- the- the mediastinal branches,mediastinal branches, ramirami
mediastinals are the smallmediastinals are the small
branches that supply mediastinalbranches that supply mediastinal
fat.fat.

11. THE VEINS SYSTEM OF THE THORAXTHE VEINS SYSTEM OF THE THORAX
The superior vena cavaThe superior vena cava
the great vein draining bloodthe great vein draining blood
from the head and neck isfrom the head and neck is
located in the superiorlocated in the superior
mediastinum. About 7cmmediastinum. About 7cm
long, this large vessel enterslong, this large vessel enters
the right atrium of the heartthe right atrium of the heart
vertically from its superiorvertically from its superior
aspect.aspect.
The brachiocephalic veinsThe brachiocephalic veins
are located in the superiorare located in the superior
mediastinum.mediastinum.
a)a) THETHE INTERNAL JUGULAR VEININTERNAL JUGULAR VEIN
b) THEb) THE SUBCLAVIAN VEINSUBCLAVIAN VEIN

12.  The thoracic wall andThe thoracic wall and
upper lumbar regionupper lumbar region
are drained by theare drained by the
posterior intercostalposterior intercostal
and lumbar veins intoand lumbar veins into
thethe azygous veinazygous vein..
These consist ofThese consist of
longitudinal trunkslongitudinal trunks
on right and lefton right and left
sides. There is asides. There is a
single trunk on thesingle trunk on the
right. On the left sideright. On the left side
thethe hemiazygoushemiazygous

13. The lymphatic glandsThe lymphatic glands ((nodulesnodules)) of theof the
viscera of the thorax are:viscera of the thorax are:
 1)The bronchial lymphatic glands-are situated1)The bronchial lymphatic glands-are situated
round the bifurcation of the trachea and rootsround the bifurcation of the trachea and roots
of the lungs. They are ten or twelve in number,of the lungs. They are ten or twelve in number,
the largest being placed opposite thethe largest being placed opposite the
bifurcation of the trachea. The smallest roundbifurcation of the trachea. The smallest round
the bronchi and their primary divisions forthe bronchi and their primary divisions for
some little distance within the substance of thesome little distance within the substance of the
lungs.lungs.
 2) The superior mediastinal or cardiac glands2) The superior mediastinal or cardiac glands
- lie in front of the transverse aorta and left- lie in front of the transverse aorta and left
innominate vein.innominate vein.
:

14. The lymphatic glands of theThe lymphatic glands of the
thoracic wall are:thoracic wall are:
 The intercostal lymphaticThe intercostal lymphatic
glands - are small, andglands - are small, and
situated on each side of thesituated on each side of the
spine near the costo-spine near the costo-
vertebral articulations. Theyvertebral articulations. They
vary from one to three invary from one to three in
each space.each space.
 The sternal or internalThe sternal or internal
mammary lymphatic glands -mammary lymphatic glands -
are placed at the anteriorare placed at the anterior
extremity of each intercostalextremity of each intercostal
space, by the side of thespace, by the side of the
internal mammary vessels.internal mammary vessels.

15. The SUPERFICiAl LYMPHATIC VESSELSThe SUPERFICiAl LYMPHATIC VESSELS -- of theof the
front of the thorax run across the greatfront of the thorax run across the great
pectoral muscle, and those on the backpectoral muscle, and those on the back
part of this cavity lie upon the trapeziuspart of this cavity lie upon the trapezius
and latissimus dorsi.and latissimus dorsi.
THE DEEP LYMPHATIC VESSELS OF THETHE DEEP LYMPHATIC VESSELS OF THE
THORACIC WALLTHORACIC WALL areare
 I) The intercostal lymphatic vesselsI) The intercostal lymphatic vessels
 2) Tne internal mammary lymphatic2) Tne internal mammary lymphatic
vesselsvessels
 3)The lymphatic vessels of the3)The lymphatic vessels of the
diaphragmdiaphragm
LYMPHATIC VESSELS OF THE THORAXLYMPHATIC VESSELS OF THE THORAX areare
 1)The lymphatic vessels of the lung1)The lymphatic vessels of the lung
 2)2) The cardiac lymphatic vesselsThe cardiac lymphatic vessels
 3)3) The thymic lymphatic vesselsThe thymic lymphatic vessels
 4)4) The lymphatic vessels of theThe lymphatic vessels of the
oesophagusoesophagus

16. THE INNERVATION OF THE WALLS OFTHE INNERVATION OF THE WALLS OF
THORATIC CAVITYTHORATIC CAVITY
 The anterior branchesThe anterior branches (rami(rami
ventrales)ventrales) of the spinal nervesof the spinal nerves
innervate the skin and musclesinnervate the skin and muscles
of the ventral wall of the bodyof the ventral wall of the body
and both pairs of limbs. Theand both pairs of limbs. The
anterior branches of the spinalanterior branches of the spinal
nerves preserve their originalnerves preserve their original
metameric structure only in themetameric structure only in the
thoracic segment (nn.thoracic segment (nn.
intercostales). In the otherintercostales). In the other
segments connected with thesegments connected with the
limbs in whose development thelimbs in whose development the
segmentary character is lost, thesegmentary character is lost, the
nerves arising from the anteriornerves arising from the anterior
spinal branches intertwine.spinal branches intertwine.

17. THE POSTERIORTHE POSTERIOR BRANCHESBRANCHES
(rami dorsales)(rami dorsales) of the thoracicof the thoracic
nerves divide into medialnerves divide into medial
and lateral / branchesand lateral / branches
giving rise to branchesgiving rise to branches
running to therunning to the
autochthonous muscles;autochthonous muscles;
the skin branches of thethe skin branches of the
superior thoracic nervessuperior thoracic nerves
originate only from ramioriginate only from rami
mediales, while those ofmediales, while those of
the inferior thoracicthe inferior thoracic
nerves, from raminerves, from rami
laterales.laterales.

18. TheThe phrenic nervephrenic nerve
TheThe phrenic nervephrenic nerve is theis the
mixed branches of themixed branches of the
cervical plexus- its motorcervical plexus- its motor
branches innervate thebranches innervate the
diaphragm. It sendsdiaphragm. It sends
sensory nerves to the pleurasensory nerves to the pleura
and pericardium.and pericardium.
Some of the terminal branchesSome of the terminal branches
of the nerve pass throughof the nerve pass through
the diaphragm into thethe diaphragm into the
abdominal cavitiabdominal caviti
(NN.PHRENICOABDOMINALES(NN.PHRENICOABDOMINALES))

19. The thoracic part of the sympatheticThe thoracic part of the sympathetic
trunktrunk
The thoracic part of the sympathetic trunkThe thoracic part of the sympathetic trunk consists of 10 toconsists of 10 to
12 ganglia of a more or less triangular shape. The thoracic12 ganglia of a more or less triangular shape. The thoracic
part is characterized by the presence ofpart is characterized by the presence of whitewhite
communicating branches (rami communicantes albicommunicating branches (rami communicantes albi) which) which
connect the anterior roots of the spinal nerves with theconnect the anterior roots of the spinal nerves with the
sympathetic trunk ganglia.sympathetic trunk ganglia.
The branches of the thoracic part are as follows:The branches of the thoracic part are as follows:
- the cardiac branches- the cardiac branches (nervi cardiaci thoracici);(nervi cardiaci thoracici);
-- the grey communicating branchesthe grey communicating branches (rami communicantes grisei(rami communicantes grisei));;
-- the pulmonar branchesthe pulmonar branches (rami pulmonales);(rami pulmonales);
- the aortic branches- the aortic branches (rami aorlici)(rami aorlici) form a thoracic aortic plexusform a thoracic aortic plexus (plexus(plexus
aorticus thoracicus),aorticus thoracicus), partly on the oesophagus - oesophageal plexuspartly on the oesophagus - oesophageal plexus
(plexus esophageus(plexus esophageus), and on the thoracic duct (the vagus nerve also), and on the thoracic duct (the vagus nerve also
contributes to the formation of these plexuses);contributes to the formation of these plexuses);
- the greater and lesser splanchnic nerves- the greater and lesser splanchnic nerves (nervi splanchnici major(nervi splanchnici major andand
minor).minor).

20. The thoracic part of the sympathetic trunkThe thoracic part of the sympathetic trunk

21. The thoracic part of theThe thoracic part of the vagusvagus
nerve:nerve:
1. The recurrent laryngeal
nerve (n. laryngeus recurrens)
2.Cardiac branches (lower)
(ramus cardiaci cervicales
inferiores)
3.Pulmonary and tracheal
branches (rami bronchiales
and tracheales)
4.Thoracic cardiac branches
(rami cardiaci thoracici)
5.Oesophageal branches
(rami esophagei)

22. Thank
you for
attention!
http://4anosia.ru/http://4anosia.ru/