Anatomical and Physiological Anatomical and Physiological Substantiations of the Substantiations of the

Operative Interventions on the Operative Interventions on the ThoraxThorax

Associate-professor Slabyy O.B.

Configuration of the ChestConfiguration of the Chest1&3-long narrow 1&3-long narrow ((asthenicasthenic thoraxthorax););

2&4-broad short 2&4-broad short ((hypersthenic thoraxhypersthenic thorax))

Regions of the ThoraxRegions of the Thorax

Thoracic LinesThoracic Lines

Thoracic Lines Thoracic Lines

• 1-linea axillaris posterior1-linea axillaris posterior; ; • 22-linea axillaris media-linea axillaris media;;• 3-3-linea axillaris anteriorlinea axillaris anterior;;• 4-4-linea medioclavicularislinea medioclavicularis;;• 5-5-linea parasternalislinea parasternalis;;• 6-6-linea sternalislinea sternalis;;• 77-linea mediana anterior-linea mediana anterior;;• 8-8-linea mediana posteriorlinea mediana posterior;;• 9-9-linea vertebralislinea vertebralis;;• 10-10-linea paravertebralislinea paravertebralis;;• 11-11-lineascapularislineascapularis

Subclavicular & Mammary Gland Subclavicular & Mammary Gland RegionsRegions

Tissue structureTissue structure

Subclavicular & Mammary Gland Subclavicular & Mammary Gland Regions.Regions.Vessels and nerves of the Pectoralis Vessels and nerves of the Pectoralis Major, Clavio-Pectoral Fascia as a Major, Clavio-Pectoral Fascia as a Sheath of the Pectoralis Mior. Sheath of the Pectoralis Mior.

Arteries & Veins of the Arteries & Veins of the Mammary GlandMammary Gland

Lymphatic Vessels & Nodes of Lymphatic Vessels & Nodes of Mammary Gland. Mammary Gland.

Layer Structure of the Mammary Gland. Layer Structure of the Mammary Gland. Potential Places of Mastitis.Potential Places of Mastitis.

Radical Mastectomy IRadical Mastectomy I

Radical Mastectomy IIRadical Mastectomy II

Internal Surface of Anterior Internal Surface of Anterior Thoracic WallThoracic Wall

Muscles, Fasciae & Nerves of Muscles, Fasciae & Nerves of the Anterior Thoracic Wallthe Anterior Thoracic Wall

Contents of an Intercostal Space & Structures Contents of an Intercostal Space & Structures penetrated by a needle when it passes from skin penetrated by a needle when it passes from skin surface to pleural cavity into seventh intercostal surface to pleural cavity into seventh intercostal

space in midaxillary line.space in midaxillary line.

An Intercostal SpaceAn Intercostal Space

• This diagram shows relationshipsThis diagram shows relationships::

• 1.From above downward1.From above downward: : vein, vein, artery, nerve artery, nerve ((VANVAN).).

• 2.Order of entry from medial to 2.Order of entry from medial to laterallateral::artery, vein, nerve.artery, vein, nerve.

Lateral View (right side)Lateral View (right side)

Lateral View (left side)Lateral View (left side)

Thank You for Thank You for AttentionAttention