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Thoracic organs

Thoracic organs. 陳 建 榮. Ventral view of thorax. Heart: rib3~rib7. Wall of thorax. Thoracic vertebrae 胸椎 (T1~T13) Sternum 胸骨 Ribs 肋骨 (13 pairs). Ribs (13 pairs). Contains head, neck, tubercle, angle of rib head 肋骨頭  body of thoracic veterbra tubercle 肋骨結  transverse process

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Thoracic organs

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  1. Thoracic organs 陳 建 榮

  2. Ventral view of thorax

  3. Heart: rib3~rib7

  4. Wall of thorax Thoracic vertebrae胸椎 (T1~T13) Sternum 胸骨 Ribs肋骨 (13 pairs)

  5. Ribs (13 pairs) • Contains head, neck, tubercle, angle of rib • head肋骨頭  body of thoracic veterbra • tubercle肋骨結  transverse process • 2. Costal cartilage肋軟骨  sternum • 3. Sternal ribs (1~9 ribs)= true ribs真肋 • 4. Asternal ribs (10~13 ribs)= false ribs假肋 (10~12 ribs) + floating rib (13 rib) • 5. Costal arch肋弓 • 6. Floating rib浮肋 • 7. Intercostal space肋骨間隙 Sternum • Contain 8 sternebrae胸骨片 (manubrium胸骨柄, second ~ seventh sternebra, xiphoid process劍突, xiphoid cartilage劍突軟骨) • The cartilaginous joints (intersternebral cartilage) between the sternebrae may ossify in old individuals.

  6. Thoracic inlet胸腔入口

  7. Thoracic outlet

  8. Muscles of the thoracic wall • External intercostal m.外肋間肌 (external intercartilage m.) • Internal intercostal m.內肋間肌 • Draw the ribs together • Innervate by intercostal n. • Transversus thoracic m.橫胸肌 • 2~8 costal cartilage  sternum • Function: expiration呼氣 • Diaphragm橫膈膜 • Central tendon (V shape) • Muscular part: pars lumbalis腰椎部, pars costalis肋骨部, pars sternalis胸骨部 • Caval foramen腔靜脈孔, Esophageal hiatus食道裂孔, Aortic hiatus主動脈裂孔 • Function: inspiration • Innervate by phrenic n.膈神經 (C5~C7)

  9. Internal thoracic a.內胸動脈 • derive from subclavian a.鎖骨下動脈 • lying between transversus thoracic m. and internal intercostal m. • ventral intercostal a.腹肋間動脈: anastomosis with dorsal intercostal a. • Pericardiocophrenic a.心包膜橫膈動脈 • Branch to thymus • Mediastinal a.縱隔動脈 • Ventral cutaneous br. 腹側皮分枝(perforating br.) • Cranial epigastric a. • Musculophrenic a.

  10. Thoracic cavity胸腔 • 2 Pleura cavity胸膜腔 • Mediastinum 縱膈

  11. Pleura胸膜 • Parietal pleura壁層胸膜: line the walls of the thoracic cavity • Costal pleura肋胸膜 • Mediastinal pleura縱膈胸膜 • Diaphragmatic pleura橫膈胸膜 • Recess隱窩 • Costomediastinal recess肋縱膈隱窩 • Costodiaphragmatic recess 肋橫膈隱窩 • Viseral pleura臟層胸膜(pulmonary pleura): coverthe lungs • Plica vena cavae腔靜脈襞: surrounds the caudal vena cava • - Mediastinal recess縱膈隱窩 • Pleural cavity胸膜腔 • Pleural cupula胸膜圓頂(apical portion of pleural sac)

  12. Costomediastinal recess Pleural cupula Costodiaphragmatic recess Pulmonary lig.

  13. Pneumothorax氣胸

  14. Mediastinal recess Costomediastinal recess

  15. Lungs • 三角形構造 • Apex (cupula) • Base (diaphragm) • 外觀 • Costal surface • Medial surface • Diaphragmatic surface • Interlobar surface • Root of lung肺門 • Pulmonary a. • Pulmonary v. • Bronchi • Bronchial a. • - Pulmonary lig.肺韌帶 • Oblique fissure斜裂

  16. Horizontal fissure Oblique fissure Oblique fissure

  17. 1. Left lung 由 oblique fissure 將其分成兩葉 • Cranial lobe前葉 and caudal lobe後葉 • Cranial lobe 包含cranial part and caudal part兩部份 • 2. Right lung • 表面有 oblique fissure斜裂, horizontal fissure水平裂 and cardiac notch • Cranial lobe前葉, middle lobe中葉, caudal lobe後葉 and accessory lobe副葉 • 3. Impression and groove

  18. Left lung

  19. Right lung

  20. Bronchial tree • Principal bronchus主支氣管 • bronchi支氣管 • lobar bronchi (secondary bronchi) • segmental bronchi (tertiary bronchi) • large subsegmental bronchi • small subsegmental bronchi • bronchiole細支氣管 • terminal bronchiole • respiratory bronchiole • alveolar duct肺泡管 • alveolar sac肺泡囊

  21. 解剖步驟 • 先移除兩側胸壁（1～8肋骨） • 觀察胸膜及胸膜腔之構造後，取下兩側肺臟（由肺門處縱切） • 觀察左右肺臟之外觀、分葉情形及表面壓迹，比對胸膜囊內之相對構造 • 觀察胸膜在胸膜囊內之分佈情形（注意各反褶位置及隱窩） 作業 試描繪左或右任一肺之外形、壓跡及分葉情形。

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