review of the thorax
DESCRIPTION
AnatomyTRANSCRIPT
REVIEW OF THE THORAX
AND ABDOMEN
Shawn Beaudette, MSc Candidate
Jordan Knapman, MSc Candidate
Course Evaluations
• Tomorrow is the last day! <http://courseeval.uoguelph.ca >
THORACIC ANATOMY
Patrick J. Lynch; illustrator; C. Carl Jaffe; MD; cardiologist Yale University Center for Advanced Instructional Media Medical
Illustrations by Patrick Lynch, generated for multimedia teaching projects by the Yale University School of Medicine, Center for
Advanced Instructional Media, 1987-2000
Thoracic Osteology (Anterior View)
Ref: Sharp Labs Inc. <http://www.growtall.com/what-makes-our-bones-
grow.htm>
SUPERIOIR THORACIC APETURE
MANUBRIUM
STERNAL ANGLE
STERNAL BODY
XIPHOID PROCESS
INFERIOR THORACIC APETURE
Sternal Osteology
JUGULAR NOTCH
CLAVICULAR NOTCH
FIRST COSTAL FACET
DEMIFACETS
FOR RIBS II & VII
Costal Articulations
• Anterior Articulation:
• Costal Cartilage (True and False Ribs)
• Posterior Articulation:
• Between Articular Facets of Ribs and costal facets of
thoracic vertebra
Costal Classifications
1
2
3
4
5
6
7
8 9
TRUE RIBS
FALSE RIBS
FLOATING RIBS
Ref: Sharp Labs Inc. <http://www.growtall.com/what-makes-our-bones-
grow.htm>
RIBS 1-7 (ARTICULATE /W
STERNUM)
RIBS 8-10 (ARTICULATE /W
COSTAL CARTILAGE OF
ABOVE RIBS)
RIBS 11-12 (NO ANTERIOR
ARTICULATION)
Muscles of Respiration
Vascularization and Innervation of the
Thoracic Wall
The Diaphragm
• Origin
• Insertion
• Innervation
Ref:<http://www.helloquizzy.com/quizzy/results?quizzyid
=16531707804588161990&resultid=426802604>
XIPHOID, COSTAL MARGIN, RIBS 11-
12, LUMBAR VERTEBRAE
CENTRAL TENDON
C3,4,5 KEEPS THE DIAPHRAM
ALIVE!!!! (PHRENIC N.)
Lung Anatomy – Left vs. Right
20th U.S. edition of Gray's Anatomy of the Human Body
LEFT RIGHT
HORIZONTAL
FISSURE
OBLIQUE
FISSURE
Trachea
20th U.S. edition of Gray's Anatomy of the Human Body
TRACHEALIS SMOOTH
MUSCLE
CARTILAGINOUS
RINGS
CARNIA
1O BRONCHUS
2O LOBAR
BRONCHUS
Parietal vs. Visceral Pleura
Lines of Plural Reflection:
• Sternal Line
• Costal Line
• Vertebral Line
SUPRAPLEURAL
MEMBRANE
REFLECTION OF PARIETAL
PLEURA @ LUNG ROOT
Mediastinum Contents
Ref: <http://medicinexplained.blogspot.ca/2011/06/mediastinum.html>
Middle Mediastinum: Pericardium
• Pericardial Layers
• A:
• B:
• C:
• Structures Associated
with outermost layer:
• Phrenic N.
• Pericardiacophrenic A.
A
B
C
VISCERAL LAYER OF
SEROUS PERICARDIUM
PARIETAL LAYER OF
SEROUS PERICARDIUM
FIBROUS PERICARDIUM
Middle Mediastinum: Cardiac Anatomy
Ref: <http://tube.medchrome.com/2011/04/coronary-circulation-anatomy.html>
AORTIC ARCH
PULMONARY TRUNK
LEFT ATRIUM
CIRCUMFLEX ART.
LEFT CORONARY ART.
ANT. INTERVENTRICULAR
ART. (LAD)
LEFT VENTRICLE
SVC
AORTIC SEMILUNAR VALVE
RIGHT ATRIUM
RIGHT CORONARY ART.
POST. INTERVENTRICULAR ART.
RIGHT MARGINAL ART.
RIGHT VENTRICLE
Cardiac Innervations:
• Sympathetic Innervation:
• Parasympathetic Innervation:
RIGHT/ LEFT
SYMPATHETIC TRUNK
RIGHT/LEFT VAGUS N.
**GIVES BRANCHES FOR GREAT, LESSER
AND LEAST SPLANCHNIC N.
Cardiac Anatomy: Right or Left Side?
Patrick J. Lynch; illustrator; C. Carl Jaffe; MD; cardiologist Yale University Center for Advanced Instructional Media Medical Illustrations by
Patrick Lynch, generated for multimedia teaching projects by the Yale University School of Medicine, Center for Advanced Instructional Media,
1987-2000
RIGHT SIDE!!
AORTA
SVC
FOSSA OVALIS
PECTINATE
MUSCLE
PULMONARY TRUNK
PULMONARY VALVE
INTERVENTRICULAR
SEPTUM
RIGHT ATRIO-
VENTRICULAR
ORFICE
TRABECULAE
CARNEAE M.
CRISTA TERMINALIS
Heart Valves
• A:
• B:
• C:
• D:
A
B
C D
PULMONARY SEMILUNAR VALVE
AORTIC SEMILUNAR VALVE
MITRAL (BICUSPED) VALVE
TRICUSPED VALVE
Remnants of the Fetal Circulation
PLACENTA 20th U.S. edition of Gray's Anatomy of
the Human Body
DUCTUS ARTERIOSUM
LIGAMENTUM ARTERIOSUM
FORAMEN OVALE
FOSSA OVALIS
DUCTUS VENOSUS
LIGAMENTUM VENOSUM
UMBILICAL VEIN
LIGAMENTUM TERES
ABDOMINAL ANATOMY
The Abdominal Wall
• Layers: • 1:
• 2:
• 3:
• 4:
• 5:
• 6:
• 7:
• 8:
• 9:
• 10:
Ref: <http://teleanatomy.com/introductiontoanatomy-Fascia.html>
SKIN
CAMPER’S FASCIA
SCARPA’S FASCIA
EXTERNAL OBLIQUE M.
INTERNAL OBLIQUE M.
TRANSVERSUS ABDOMINUS M.
FASCIA TRANSVERSALIS
EXTRA-PERITONEAL FAT
PARIETAL PERITONEUM
RECTUS ABDOMINUS M.
*2&3 combine to form
superficial layer of fascia
The Rectus Sheath
Ref:<http://academic.amc.edu/martino/grossanatomy/site/Medical/Lab%20M
anual/Gastrointestinal/answers/anterior%20wall3.htm>
Fusion of Aponeurosis @ Midline=
LINEA ALBA
Inguinal Canal
• Boundaries:
• Roof:
• Transversalis Fascia
• Internal Oblique
• Transversus Abdominus
• Anterior Wall:
• External Oblique (Aponeurosis)
• Internal Oblique
• Floor:
• Inguinal Ligament
• Posterior Wall:
• Transversalis Fascia
Layers of the Testis
Peritoneum
• Peritoneal Types:
• Contents of the
Peritoneal Cavity?
GREATER SAC
LESSER SAC
PARIETAL PERITONEUM &
VISCERAL PERITONEUM
Peritoneal Folding: Omenta
• Peritoneal Folding
Results in:
• Omenta:
• A:
• B:
• C:
• Mesentaries
• Ligaments
A B
C
Ref: <http://science.tjc.edu/Course/BIOLOGY/lsch/lsch2401/AtlasA.htm>
HEPATOGASTRIC LIG.
HEPATODUODENAL LIG.
GREATER OMENTUM.
(GASTROCOLIC LIG.)
Peritoneal Folding: Mesentaries
• Types:
• A: • Distinguishes Supracolic
from Infracolic
compartment
• B: A
B
Ref: <http://medical-
dictionary.thefreedictionary.com/_/viewer.aspx?path=dorland&name=mes
enterium.jpg>
TRANSVERSE MESOCOLON
MESENTARY OF THE
SMALL INTESTINE
Arterial Arcades
• Jejunum
• Prominent Vasa Recta
• Less Prominent Arterial
Arcades
• Ileum
• Prominent Arterial
Arcades
• Less Prominent Vasa
Recta
Ref: <http://www.studyblue.com/notes/note/n/an2-11-peritoneal-cavity-
and-abdominal-organs-part-2-clinical-correlations-etc/deck/1055200>
The Stomach
• A:
• B:
• C:
• D:
• E:
• F:
• G:
A B
C
D
E F
G
ESOPHAGUS
FUNDUS
GASTRO-OMENTAL ART. & VEIN
GREATER CURVATURE
LESSER CURVATURE
PYLORIC SPHINCTER
DUODENUM
Stomach Blood Supply – Celiac Trunk
A B
C
Ref:<http://www.med.umich.edu/lrc/coursepages/m1/anatomy2010/html/modules/peritoneal_dev_module/p
eritoneal_01.html>
A: B: C:
LEFT GASTRIC
ART.
LEFT GASTRO-
OMENTAL ART.
RIGHT GASTRO-
OMENTAL ART.
CELIAC TRUNK
RIGHT GASTRIC ART.
COMMON HEPATIC
ART.
LEFT GASTRIC ART. SPLENIC ART.
Duodenum
• A:
• B:
• C:
• D:
• E:
A
B
C
D
E
Ref: <http://msk-anatomy.blogspot.ca/2012/07/anatomy-of-
duodenum.html>
SUPERIOR DUODENUM
DESCENDING DUODENUM
MAJOR DUODENAL PAPILLA
INFERIOR DUODENUM
ASCENDING DUODENUM
Duodenal Blood Supply
• From the Celiac Trunk:
• A:
• B:
• C:
• From the SMA:
• D:
A
B
C
GASTRODUODENAL ART.
SUPERIOR
PANCREATICODUODENAL
ART. (ANT/POST)
INFERIOR
PANCREATICODUODENAL
ART. (ANT/POST) D
SUPRADUODENAL ART.
Ileum and Jejunum Blood Supply
VASA RECTA
ARTERIAL ARCADES
JEJUNAL AND ILIAL
BRANCHES OF SMA
The Large Intestine
Ref: <http://www.allposters.com/-sp/This-Illustration-Depicts-the-Anatomy-of-the-Large-
Intestine-Colon-Posters_i9013176_.htm>
APPENDIX
CECUM
MESOAPPENDIX
ASCENDING COLON
RIGHT COLIC FLEXTURE TRANSVERSE
COLON
LEFT COLIC
FLEXTURE
DESCENDING
COLON
SIGMOID COLON
RECTUM
Features of the Large Intestine
HAUSTRA
OMENTAL APPENDICES
TAENIAE COLI
Colonic Blood Supply
• SMA:
• A:
• Ant/Post Cecal Art.
• Appendicular Art.
• B:
• C:
• IMA:
• D:
• E:
• F:
A
B
C
D
E
F
ILEOCOLIC ART.
RIGHT COLIC ART.
MIDDLE COLIC ART.
LEFT COLIC ART.
SIGMOIDAL ART.
SUPERIOR RECTAL ART.
Rectal Blood Supply
• IMA:
• A:
• Internal Iliac Art:
• B:
• Pudendal Art:
• C:
A
B
C
SUPERIOR RECTAL ART.
MIDDLE RECTAL ART.
INFERIOR RECTAL ART.
*B) & C) stay tuned for next
semester!
Pancreatic Blood Supply
• From Gastroduodenal Art.:
• A:
• B:
• From SMA:
• C:
• D:
• From Splenic Art.:
• E:
• F:
GASTRODUODENAL
ART.
SPLENIC ART
ART.
SMA
A B
C D
E F
ANT. SUP. PANCREATICODUODENAL
POST. SUP. PANCREATICODUODENAL
ANT. INF. PANCREATICODUODENAL
POST. INF. PANCREATICODUODENAL
DORSAL PANCREATIC ART.
GREAT PANCREATIC ART.
*Don’t worry about E) & F) for
exam!
The Spleen
• Highly vascularized
organ
• Blood supply:
• Splenic Art.
• Affected by Epstein-
Barr Virus
• Mononucleosis
Ref : Madoff D.C. et al. (2005). Splenic Arterial Interventions:
Anatomy, Indications, Technical Considerations, and Potential
Complications. RadioGraphics 25, S191-S211.
The Gallbladder
• Collects an stores bile
which aids in fat
digestion in the small
intestine
• Bile:
• 85% Water
• 10% Bile salts
• <1% cholesterol
• Gallstones vs. Kidney
Stones???
Hand Anatomy