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THORACIC
CAGE SUPERIOR THORALIC INIET Anteriorly: Steenum Nation: Seep. border of manubrium Posteriorly: Thoracicvertebrac sterni
intervening intervertebral dises Posterior:Ant border of step.^ Surface Laterally: Ribs e
costal
cartilage of
T.
on each^ side Lateral:Isrib^ costal cartilage
Rib (^) articulation & & Anteriorly: -> INFERIOR (^) TRORACIC ANERTURE 1st to it^ a sternum THORAX Anterially: Xiphoidprocess sta,qtu,
10tha with each other
Postinarly: Body of Tic
vertebra
lith,
12th a
free Laterally:
Costal
margin (costal
Posteriorly. All are joined collages of^
7thto^10
ribs)
& 11th& 12th
to the thoracicvertebrae
ribs
THORACIC INIET SYNDROME
a)
Muscles:
· Compressionof subclavian
R · Sternohyoid
lower
part of
brachialplenus
·
Sternothyroid
SUPERIOR
THORALIC INIET by
hypertrophied
scalerant.
Longue
colli
nterior:
Seep.border
of
manubrium
orcivicalrib.
·
Numbness,
tingling,
pain along
batteries
sterni ·
Left
common carotid
Posterior:
Ant border^
of step.^ Surface
medialside
offorearm
hand.
Brachiveephalic
trunk
wastingof hand^ muscle^
due
of
T.
to involvement of i
· Subcairan (left)
Lateral:
Isrib
costal
cartilage.
Ischemie
symp-Pallor
coldnen
of upper limb a^ weak radial ↑
ItRRt.
int Thoracin
pulse
·
It. PRt.
seep
intercostal
NERVES
SUPERIOR
THORACIC
· Rt.Lt.
vague
INLET
· It recurrent largel
· It&Rt plenic
L
de
·
ItIRtT,
SIBSON'S FASCIA ·
It PDt
sympathetu
Apen
attached to
tip of
FUNCTIONS:
a)
veins
transverse
process (^) of
C
· Protects
the
underlying
~ Brachiocephali(Rel,
Base (^) attached to inner cervical
pleura
·
Suf. Thyroid
border
of first^
rib ·^ Resists
intrathoracic
, se postintercostal
sep. (^) senface related^
to
pressure.
As a result
S
e)
OTHERS
subclavianvessels
root
of
neck (^) isnot
·
oesophagus
Trachea
ouf, surface
related
to
puffed
up
& down
· At (^) Pht. Cervicalpleura
dome
cervical
pleura duringresp^
· Ant.
longitudinal
lig.
· Rt& (^) It.
lung
apices
MAJOR (^) OPENINGS:
LYMPHATIC DRAIN AGE ·
Daphragmatic
. (^) vena caval-Ts
(might (^) planein
At
diaphragmatic
Behind
paralysis-
due to
in thecentral tendon, (^) niphordprocess bilateral^ damage of
right
to (^) median plane
blu (^) Post
diaphragmatica
Near
phenie
nerves
central (^) tendon & post.
It
leaflet
aartra
orifice
·
Hiccups (^) involuntary
·
oesophageal
Rightlaterala^
caral
openingspasmodic
contraction orophageal branches^ of
It gastic artery) Left
'I R
oesophageal
associated with
It of
median plane right
cus
diaphragmatodes opening
closure of
glotti
fibres
splitaround-pinch
cock effect
· Houte-Te (^) (Agora
Thoracic
duct, ~disparital
phene
in
Behindthe (^) median arcuate
ligament
DIAPHRAGM
MINOR OPENINGS:
ACTIONS:
· Muscle of inspiration
·
Sup
epigastrostate artilage
pace
for · Thoraco^ abdominal pump:
process.
venous (^) return
of
zuc
· Musculophrenie
·
Pinch-cock
effectof orophages
· Greate, (^) lessen, least splauchnie
vessels
· muscle
of
abdominal
straining:
·
Lower 5
intercostal I (^) subcostal newessels
↑ intraabdominal
pressure
to
empty
·
sympathetic
chain pelvic^
contents
·
Kemiazygous
vein
· muscle
of weightlifting:supports
the
· subcostal newer^
vessels postvertebral muscles
DEVELOPMENT:
DESCENT
OF DIAPHRAGM
DIAPURAGMATIC HERNIAS
·
septum
transversum a
ventrally
· Arises
from C, Ly, (^) (
· Acquired:
central tendon myotomes
inthe^ neck a)
Traumatu:
Open/closed
· Dorsal
mesentry
of
oesophagus (^) region. inguy
whichlead to sudder
dorsally
·
moves
downwards
during
severe inintraabdominal
part of diaphragm^
around (^) development
to current
pressure
oesophagus
position b)^ Hiatal^ (Sliding):
Gastro-
·
Body
Wall (^) Peripheral ocophageal junction
cardiac
peripheral part of diaphragm
DIAPHRAGM
end
of
stomach slides up
into
·
Pleuroperitoneal
membrane
thoracic
carrity,
but
only
atthe
sides antirolateral surface is
doner
of (^) diaphragm
covered by
hernial
sac
-coured
by
muscle (^) weakness
DIAPURAGMATIC HERNIAS:
whichleads to intra
CONGENITAC:
abdominal pressure.
· Posterolateral:
Foramen
of
'Most common
-Acid
reflux-pepte
Bochdalek (^) a
pleuroperitoneal
heart (^) burn oesophagites
left
side
mostly
-short
oesophagen
· Retrosternal: Space of Larry
or
foramen
of Morgagnin
Xiphisternume(th cartilage
right
side
(dysphagia, discomfort
a
adults)
·
Paraossophageal:Right
Pantto
asophageal
opening
a ant surface of
stomach become upside
down in
TC
normal relationship
blw gastro-oesophageal (^) junction
diaphragm
