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Thoracic wall -Skin -Superficial fascia -deep fascia. Muscles of respiration: It includes muscles which are used in ordinary respiratiratory effort This group includes 3 groups of muscles: 1- 3 muscles which connect vertebral column to the ribs -Serratus posterior superior
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Thoracic wall -Skin -Superficial fascia -deep fascia
Muscles of respiration: It includes muscles which are used in ordinary respiratiratory effort This group includes 3 groups of muscles: 1- 3 muscles which connect vertebral column to the ribs -Serratus posterior superior -Serratus posterior inferior -Levator costorum 2- 3 groups of muscles which connect adjacent ribs: -External intercostal muscles (11 pairs) -Internal intercostal muscles (11 pairs) -Innermost intercostal 3- The muscle which fill-in the thoracic outlet: the diaphragm which forms the thoraco-abdominal partition
Intercostal muscles: 1- External intercostal muscle: Origin, insertion, direction 2- Internal intercostal muscle: Origin, insertion, direction 3- Innermost intercostal muscle + transversus thoracic Origin, insertion, direction Nerve supply and action 3 2 1
Respiratory Movement: A- Quite inspiration: During inspiration, movements of thoracic wall and diaphragm result in an increase in all diameters of the thorax: 1- Vertical diameter: It is increased by contraction (descent) of the diaphragm 2- Transverse diameter: Bucket-handle movements 3- Anteroposterior diameter: Pump- handle movements B- Forced inspiration: more muscles are called in action; as muscles of head and neck and upper limb C- Quite expiration: elastic recoil D- Forced expiration: forcible contraction of muscles of anterior abdominal wall
Intercostal nerves: .They are the ventral rami of thoracic nerves .They are 11 pairs + subcostal nerves .3- 6 are called typical intercostal nerves . First, second and lower 5 intercostals are atypical intercostal nerves VAN
Intercostal arteries: Anterior intercostal arteries: -2 in each space except lower 2 spaces - They are branches of internal thoracic artery and musculophrenic artery Posterior intercostal arteries: - One in each space (11 in No) - They are branches of thoracic Aorta and costocervical trunk Thoracic Aorta VAN Internal thoracic artery
Interernal mammary artery: Originates from the 1st part of subclavian artery Terminates at the 6th CC-------and gives musculophrenic and superior epigastric arteries
Intercostal veins: Anterior intercostal veins -----internal thoracic vein Posterior intercostal veins: Rt-----azygos vein Lt----hemiazygos vein superior vena cava Hemiazygos vein Azygos vein VAN