This document discusses the anatomy of several thoracic structures including the sympathetic chain, autonomic plexuses, lymphatic drainage, thoracic duct, and esophagus. It describes the course, branches, and relations of the thoracic sympathetic chain. It also outlines the locations and tributaries of the main autonomic plexuses in the thorax, pathways of thoracic lymphatic drainage, course and tributaries of the thoracic duct, as well as the parts, curves, relations, and blood supply of the esophagus.

1. Thoracic Part of
Sympathetic Chain
(Page 128)
Dr.Sherif Fahmy

2. Course & Relations
Dr.Sherif Fahmy

3. Thoracic part of
Sympathetic
chain
Cervical part of
sympathetic
chain
Medial arcuate
lig. of diaphragm
Abdominal part of
sympathetic chain
Neck of 1st
rib
Dr.Sherif Fahmy

4. Sympathetic
chain
Medial arcuate
ligament
Dr.Sherif Fahmy

5. Structure
Dr.Sherif Fahmy

6. Sympathetic
ganglion
Dr.Sherif Fahmy

7. Branches
- Rami communicants to
corresponding intercostal nerves.
- To autonomic plexuses in thorax.
- To aorta.
- To abdominal organs through
splanchnic nerves.
Dr.Sherif Fahmy

8. Dr.Sherif Fahmy

9. Dr.Sherif Fahmy

10. Dr.Sherif Fahmy

11. Dr.Sherif Fahmy

12. Greater
splanchnic nerve
Dr.Sherif Fahmy

13. Applied Anatomy
1- Spinal anesthesia at high level may
lead to temporary drop of blood
pressure.
2- In case of essential hypertension,
cutting of sympathetic chain between
T2 & T5 will lead to drop of blood
pressure.
Dr.Sherif Fahmy

14. Autonomic Plexes
(Page 136)
1- Pulmonary Plexuses.
2-Oesophageal plexuses.
3- Cardiac plexuses
(superficial and deep).
Dr.Sherif Fahmy

15. 1- Pulmonary Plexus
(Posterior & Anterior)
Dr.Sherif Fahmy

16. Dr.Sherif Fahmy

17. Dr.Sherif Fahmy

18. 2- Oesophageal Plexus
(Anterior & Posterior)
Dr.Sherif Fahmy

19. Dr.Sherif Fahmy

20. 3- Cardiac Plexus
(Superficial & Deep)
Dr.Sherif Fahmy

21. Dr.Sherif Fahmy

22. Dr.Sherif Fahmy

23. Lymphatic Drainage
Dr.Sherif Fahmy

24. Dr.Sherif Fahmy

25. Thoracic Lymph
Drainage
A- From Chest wall.
B- From thoracic contents.
Dr.Sherif Fahmy

26. A- From Chest Wall
1- Superficial lymph vessels:
- From front of chest to pectoral
lymph nodes, parasternal or lower
deep cervical lymph nodes.
- From back of chest to subscapular
nodes. Dr.Sherif Fahmy

27. 2- Deep lymph vessels:
A- From anterior chest wall to
parasternal nodes.
B- Posterior part of chest wall to
intercostal lymph nodes (opposite
neck of ribs).
C- Four diaphragmatic nodes
(anterior, posterior and 2 lateral)
which drain diaphragm and liver.
Dr.Sherif Fahmy

28. B- from Thoracic
Contents
1- Anterior mediastinal nodes.
2- Posterior mediastinal nodes.
3- Nodes of lungs, bronchi and
trachea.
Dr.Sherif Fahmy

29. •Lymph vessels from:
-Anterior mediastinal nodes.
-Tracheal lymph nodes.
-Parasternal lymph nodes.
Will unit together to form broncho-
medistinal lymph vessels which joins
thoracic duct on left side and right
lymphatic duct in right side.
Dr.Sherif Fahmy

30. Deep lymph nodes of chest wall
Dr.Sherif Fahmy

31. Anterior
mediastinal
nodes
Dr.Sherif Fahmy

32. Dr.Sherif Fahmy

33. Dr.Sherif Fahmy

34. Dr.Sherif Fahmy

35. Thoracic Duct
(Page 121)
Dr.Sherif Fahmy

36. Dr.Sherif Fahmy

37. Cisterna chyli
Aortic opening
of diaphragme
Left brachio-cephalic
vein
Dr.Sherif Fahmy

38. Dr.Sherif Fahmy

39. Tributaries of Thoracic Duct
1- Lymph from intestine, abdominal wall
and lower limb through cisterna chyli.
2- Left broncho-mediastinal lymph
vessels.
3- Left subclavian lymph vessels.
4- left jugular lymph vessels.
5- posterior mediatinal lymph nodes.
Dr.Sherif Fahmy

40. Dr.Sherif Fahmy

41. Esophagus
(Page 117)
Dr.Sherif Fahmy

42. Parts & Course
Dr.Sherif Fahmy

43. Level of C6 vertebra
Diaphragm
Dr.Sherif Fahmy

44. Shape, Size and
Curves
Dr.Sherif Fahmy

45. Dr.Sherif Fahmy

46. Relations
Dr.Sherif Fahmy

47. Posterior
Dr.Sherif Fahmy

48. Anterior
Dr.Sherif Fahmy

49. Left & Right
Dr.Sherif Fahmy

50. Constrictions
Dr.Sherif Fahmy

51. Beginning
Esophageal
openning of
diaphragme
At level of left
bronchus
Dr.Sherif Fahmy

52. Dr.Sherif Fahmy

53. Nerve Supply
Dr.Sherif Fahmy

54. Dr.Sherif Fahmy

55. Dr.Sherif Fahmy

56. Blood Supply
Dr.Sherif Fahmy

57. Left & Right
Dr.Sherif Fahmy

58. Applied Anatomy
1- Impaction of food.
2- Barium swallow to
determine enlargement of
left atrium.
3- Esophageal varices.
Dr.Sherif Fahmy