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Thoracic inlet & outlet
This document outlines learning objectives for understanding the thoracic cage and diaphragm. The key points are: - Describe the boundaries of the thoracic cage, openings of the thorax, and components of the diaphragm including its origin, direction of fibers, blood supply and nerve supply. - List the structures that pass through openings in the thorax and diaphragm. - Explain the functions of the diaphragm in respiration and other acts. - Enumerate conditions related to damage of the phrenic nerve including diaphragmatic paralysis and hernias.
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Thoracic inlet & outlet
- 2. 2 Learning objectives At theend of session students should be able to • Describe the thoracic cage and its boundaries, thoracic Inlet and outlet. • Describe the position & component of muscular & tendinous part of diaphragm • Describe the attachments of diaphragm along with its blood supply and nerve supply • Describe the openings present in the diaphragm and their respective levels • Enumerate the structures passing through the openings and piercing the diaphragm. • List the functions of diaphragm • Enumerate the conditions related to damage to Phrenic Nerve • Describe the main features of these condition
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- 8. Suprapleural membrane/ Sibson’sfascia 8
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- 10. Trachea Oesophagus Thoracic duct Apices ofthe lungs Nerves Phrenic nerve Vagus nerve Recurrent laryngeal nerves Sympathetic trunks Vessels Arteries left and right common carotid arteries left Subclavian arteries Veins internal jugular veins brachiocephalic veins subclavian veins Lymph nodes and Lymphatic vessels Structures that pass through the superior thoracic aperture include:
- 12. Inf thoracic aperture-Diaphragm-ant view 12
- 13. Thoracic skeleton antview 13
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- 24. Diaphragm •Greek, from dia'through, apart' + phragma 'a fence'. •Fibro-muscular sheet •Separates the thoracic cavity from the abdominal cavity •Performs an important function in respiration.
- 25. Origin 3 Parts:- 1. Sternal 2.Costal 3. lumbar
- 27. Direction of muscle fibres Upwards& inwards Right and leftdome
- 28. Nerve Supply Motor –Phrenic nerve(C3,4,5) Sensory – 1.central part- phrenic nerve 2.peripheral part- lower six thoracic nerve
- 29. Blood Supply 1. Musculophrenicartery 2. Superior phrenic arteries 3. Lower 5 intercostal arteries + subcostal artey 4. Inferior phrenicartery
- 30. Actions 1. Principal muscleof Inspiration.
- 32. 2. Helps inexpulsiveacts- Sneezing, Coughing, Laughing, Crying,Vomiting Micturition, Defaecation OrParturation. 3. May have sphincteric action on the lower oesophagus.
- 34. Position of Diaphragm 3Factors :- 1.The elastic recoil of Lung 2.Thepressureexerted byabdominal viscera 3.The muscles of abdominalwall Highest- in supineposition Lowest- in sitting Intermediate- in standing
- 35. Relations Superiorly- pleurae pericardium Inferiorly - peritoneum liver fundus ofstomach spleen kidneys suprarenal
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- 37. Minoropenings 2 aperture inrightcrus 3 lesser aperture in leftcrus under the medial lumbocostal arches under the lateral lumbocostal arches foramina of Morgagni
- 38. Developme nt The Diaphragm 'developsfrom the followingsources. 1. Septum transversum 2. Pleuroperitoneal membranes 3. Lateral thoracicwall 4. Dorsal mesentery of oesophagus
- 39. Applied Anatomy 1. Hiccough- a)peripheral b)central 2.Shoulder tip pain 3. Unilateral paralysis of Diaphragm 4. Eventration 5. Diaphragmatic hernia – a)Congenital b) Acquired
- 40. Congenital Hernia a) Morgagni herniaor Retrosternalhernia b) Bochdalek hernia orPosterolateral c) Central hernia
- 41. e) Congenital hiatalhernia d) Posteriorhernia
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- 43. Acquired Hernia a) Traumatic hernia b)Acquired hiatal hernia