General Anatomy 4
Thoracic Cavity
Dr. Wesam Bader
Chest Cavity
The chest cavity is bounded by the
chest wall and below by the diaphragm.
It extends upward into the root of the
neck about one fingerbreadth above
the clavicle on each side.
The diaphragm, which is a very thin
muscle, is the only structure (apart
from the pleura and the peritoneum)
that separates the chest from the
abdominal viscera.
Chest Cavity
The chest cavity can
be divided into:
A. A median partition,
called the
mediastinum.
B. The laterally placed
pleurae and lungs.
The mediastinum
The mediastinum, though
thick, is a movable
partition that extends:
Superiorly to the thoracic
outlet and the root of the
neck
Inferiorly to the
diaphragm.
Anteriorly to the sternum.
Posteriorly to the
vertebral column.
The mediastinum
An imaginary plane passing from the sternal angle
anteriorly to the lower border of the body of the 4th
thoracic vertebra posteriorly, divides the mediastinum
into: superior and inferior mediastina
The inferior mediastinum is further subdivided into :
a. The middle mediastinum, which consists of the
pericardium and heart;
b. The anterior mediastinum, which is a space between
the pericardium and the sternum;
c. The posterior mediastinum, which lies between the
pericardium and the vertebral column.
Inferior Mediastinum
The inferior mediastinum is further subdivided
into :
a. The middle mediastinum, which consists of the
pericardium and heart;
b. The anterior mediastinum, which is a space
between the pericardium and the sternum;
c. The posterior mediastinum, which lies
between the pericardium and the vertebral
column.
Superior Mediastinum
Contents Boundaries
• Thymus,
• Large Veins, • Anteriorly: the
• Large Arteries, manubrium sterni
• Trachea,
• Esophagus And • Posteriorly: the first
Thoracic Duct, four thoracic
• Sympathetic Trunks. vertebrae
Inferior Mediastinum
Contents Boundaries
• Thymus,
• heart within the • Anteriorly: the body
pericardium, of the sternum
• phrenic nerves on
each side, • Posteriorly: the
• esophagus and lower eight thoracic
thoracic duct, vertebrae
• descending aorta,
• sympathetic trunks.
Posterior Mediastinum
Thymus (sail sign)
Trachea
The trachea is a mobile cartilaginous and membranous tube .
It begins in the neck as a continuation of the larynx at the lower
border of the cricoid cartilage at the level of the 6th cervical
vertebra. It descends in the midline of the neck.
In the thorax, the trachea ends below at the carina by dividing into
right and left principal (main) bronchi at the level of the sternal
angle.
In adults, the trachea is about 11.25 cm long and 2.5 cm in
diameter .
The fibroelastic tube is kept patent by the presence of U-shaped
bars (rings) of hyaline cartilage embedded in its wall.
The posterior free ends of the cartilage are connected by smooth
muscle, the trachealis muscle.
Anatomy Of Trachea
The Bronchi
The trachea bifurcates behind the arch
of the aorta into the right and left
principal (primary or main) bronchi.
The bronchi divide dichotomously,
giving rise to several million terminal
bronchioles that terminate in one or
more respiratory bronchioles.
Each respiratory bronchiole divides
into 2 to 11 alveolar ducts that enter
the alveolar sacs.
The alveoli arise from the walls of the
sacs as diverticula.
The Bronchi
The right principal (main) bronchus:
a) Is wider, shorter, and more vertical than
the left and is about 2.5 cm long.
b) Before entering the hilum of the right lung,
the principal bronchus gives off the
superior lobar bronchus. On entering the
hilum, it divides into a middle and an
inferior lobar bronchus.
The left principal (main) bronchus:
a) Is narrower, longer, and more horizontal
than the right and is about 2 in. (5 cm) long.
It passes to the left below the arch of the
aorta and in front of the esophagus.
b) On entering the hilum of the left lung, the
principal bronchus divides into a superior
and an inferior lobar bronchus.
Trachea
The relations of the trachea in the superior
mediastinum of the thorax are as follows:
Anteriorly: The sternum, the thymus, the left
brachiocephalic vein, the origins of the brachiocephalic and
left common carotid arteries, and the arch of the aorta.
Posteriorly: The esophagus and the left recurrent
laryngeal nerve.
Right side: The azygos vein, the right vagus nerve, and the
pleura.
Left side: The arch of the aorta, the left common carotid
and left subclavian arteries, the left vagus and left phrenic
nerves, and the pleura.
Trachea
Blood Supply of the Trachea:
The upper two thirds are supplied by the inferior thyroid
arteries
the lower third is supplied by the bronchial arteries.
Lymph Drainage of the Trachea:
The lymph drains into the pretracheal and paratracheal
lymph nodes and the deep cervical nodes.
Nerve Supply of the Trachea:
The sensory nerve supply is from the vagi and the recurrent
laryngeal nerves.
Sympathetic nerves supply the trachealis muscle.
Lungs
During life, the right and left lungs are soft
and spongy and very elastic.
In the child, they are pink, but with age,
they become dark and mottled because of
the inhalation of dust particles that
become trapped in the phagocytes of the
lung.
The lungs are situated so that one lies on
each side of the mediastinum. They are
therefore separated from each other by
the heart and great vessels and other
structures in the mediastinum.
Each lung is conical, covered with visceral
pleura, and suspended free in its own
pleural cavity, being attached to the
mediastinum only by its root.
Lungs
Each lung has:
A blunt apex, which projects upward into the neck
for 2.5 cm above the clavicle.
A concave base that sits on the diaphragm.
A convex costal surface, which corresponds to the
concave chest wall.
A concave mediastinal surface, which is molded to
the pericardium and other mediastinal structures .
At about the middle of this surface is the hilum, a
depression in which the bronchi, vessels, and
nerves that form the root enter and leave the lung.
The anterior border is thin and overlaps the heart;
it is here on the left lung that the cardiac notch is
found.
The posterior border is thick and lies beside the
vertebral column.
Lobes and Fissures
Right Lung:
The right lung is slightly larger than the left lung.
Is divided by the oblique and horizontal fissures
into three lobes:
The upper, middle, and lower lobes.
The middle lobe is thus a small triangular lobe
bounded by the horizontal and oblique fissures.
Left Lung:
The left lung is divided by a similar oblique fissure
into two lobes: the upper and lower lobes . There
is no horizontal fissure in the left lung.
Pleurae
Each pleura has two parts:
Parietal layer, which lines the thoracic wall, covers the thoracic
surface of the diaphragm and the lateral aspect of the
mediastinum and extends into the root of the neck to line the
undersurface of the suprapleural membrane at the thoracic outlet.
Visceral layer, which completely covers the outer surfaces of the
lungs and extends into the depths of the interlobar fissures.
The parietal and visceral layers of pleura are separated from one
another by a slitlike space, the pleural cavity.
The pleural cavity normally contains a small amount of tissue fluid,
the pleural fluid, which covers the surfaces of the pleura as a thin
film and permits the two layers to move on each other with the
minimum of friction.
Nerve Supply of the Pleura
The parietal pleura is sensitive to pain,
temperature, touch, and pressure and is
supplied as follows:
a) The costal pleura is segmentally supplied by
the intercostal nerves.
b) The mediastinal pleura is supplied by the
phrenic nerve.
c) The diaphragmatic pleura is supplied over the
domes by the phrenic nerve and around the
periphery by the lower six intercostal nerves.
The visceral pleura covering the lungs is
sensitive to stretch.
Pleurisy
Inflammation of the
pleura (pleuritis or
pleurisy), secondary to
inflammation of the lung
(e.g., pneumonia.
Blood Supply of the Lungs
The bronchi, the connective tissue of the lung, and
the visceral pleura receive their blood supply from
the bronchial arteries, which are branches of the
descending aorta.
The bronchial veins (which communicate with the
pulmonary veins) drain into the azygos and
hemiazygos veins.
The alveoli receive deoxygenated blood from the
terminal branches of the pulmonary arteries.
The oxygenated blood leaving the alveolar
capillaries drains into the tributaries of the
pulmonary veins, which follow the intersegmental
connective tissue septa to the lung root.
Two pulmonary veins leave each lung root to
empty into the left atrium of the heart.
pleural effusion
Lymph Drainage of the Lungs
The superficial (subpleural) plexus lies beneath the
visceral pleura and drains over the surface of the lung
toward the hilum, where the lymph vessels enter the
bronchopulmonary nodes.
The deep plexus travels along the bronchi and
pulmonary vessels toward the hilum of the lung,
passing through pulmonary nodes located within the
lung substance; the lymph then enters the
bronchopulmonary nodes in the hilum of the lung.
All the lymph from the lung leaves the hilum and
drains into the tracheobronchial nodes and then into
the bronchomediastinal lymph trunks.
Nerve Supply of the Lungs
At the root of each lung is a pulmonary
plexus composed of efferent and afferent
autonomic nerve fibers.
The plexus is formed from branches of the
sympathetic trunk and receives
parasympathetic fibers from the vagus
nerve.
The sympathetic efferent fibers produce
bronchodilatation and vasoconstriction.
The parasympathetic efferent fibers produce
bronchoconstriction, vasodilatation, and
increased glandular secretion.
