Course Hero Logo

أنا أتشارك 'Anatomy of Thorax third week lecture' معك

Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. This preview shows page 1 - 8 out of 27 pages.

The Intercostal nerveIt is formed by theventral primary ramusof the thoracicspinal nerves. It gives off the following branches:1.Collateral branch2.Lateral cutaneous branch (LCB). The LCBof the T1 segment participates in thebrachialplexusof the upper limb. The LCBof the T2 segment iscalledIntercostobrachialnervesupplies theaxilla and the medial side of the arm.3.Anterior cutaneous branch .It divides intomedial and lateral branches.4.Whit ramus communicansis a bundle ofpreganglionic sympathetic fiberswhichleaves the spinal nerve to the sympatheticganglion.5.Grey ramus communicans is a bundle ofpostgagnglionic fibers which rejointhespinal nerveafter arising from thesympathetic ganglionThe cutaneous branches of the intercostalnerve supply adermatomeof skin around thethoracic nerveIntercostal nervesfrom T7 to T12 areatypicalintercostal nervesbecause they also supplythe abdominal wallنيملاعلا بر هلل دمحلا
Surgical access to thechestThere are two main methods:1.Median sternotomy2.Lateral thoracotomyMedian sternotomy:The sternum may be cutopen completely or only in the manubriumThis enables access to the mediastinal structures.It may be extended laterally above the clavicle toaccess the subclavian and carotid vesselsLateral thoracotomy: this enables access to thelungs and structures in the posterior mediastinum.The incision starts in the anterior axillary linepasses below the scapula then between the scapulaand the vertebral column.This involves division of the intercostal muscleswhich may cause difficulty in breathing .نيملاعلا بر هلل دمحلا
Thoracostomy (chest tubeplacement)A tube is placed in the thoracic cavitythrough the thoracic wall to relievepneumothorax, hemothorax,hemopneumothorax, chylothorax,malignant pleural effusion,hydrothorax and empyema.It is usually placed in the fourth orfifth intercostal space between theanterior axillary line and posterioraxillary line.نيملاعلا بر هلل دمحلا
نيملاعلا بر هلل دمحلا
Intercostal nerve blockThis is performed in order to produceanaesthesiain the thoracic wall andparietal pleuraAnaesthetic agent is injected near theinferior border of the rib proximal tothe origin of the lateral cutaneousbranch.Rib counting is done from the sternalangleNeedle is directed towards the inferiorborder of the rib between the internaland innermost intercostal muscles.The procedure is done with ultrasoundguidanceنيملاعلا بر هلل دمحلا
DiaphragmOrigin:1. Crura(single is crus).The rightcrusarises from L1-L3 vertebralbodies.The left crusarises fromthe L1-L2 vertebral bodies.2.Medial arcuate ligamentwhichstretches between the crus of thediaphragmand the tip oftransverse process of L1.3.Thelateral arcuate ligamentstretched between the tip oftransverse process of L1 to the tipof the 12thrib.4.Costal marginof lower six ribs5. XiphoidprocessInsertion: Central tendonInnervation: Phrenic nerve C3-5نيملاعلا بر هلل دمحلا
Openings in theDiaphragmMajor openings:1.Caval opening

Upload your study docs or become a

Course Hero member to access this document

Upload your study docs or become a

Course Hero member to access this document

End of preview. Want to read all 27 pages?

Upload your study docs or become a

Course Hero member to access this document

Term
Fall
Professor
NoProfessor
Tags
thoracic cavity, Pneumothorax, Pleural cavity, phrenic nerve

Newly uploaded documents

Show More

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture