Transcript Retromammary space

Chest
Surface and
Pleura
Cavity
Clinical Anatomy
Tony Serino, Ph.D.
Biology Department
Misericordia Univ.
Thoracic
Vertebrae
Vertebrae and Ribs
Rib Types and Sternum
Rib Anomalies
Cervical ribs
Bicipital rib
(rib fusion)
Bifid rib
(two heads)
1st rib
2nd rib
Crest of head
Head
Neck
Tubercle
11th rib
12th rib
Ribs
Clavicle
Scapula
Scapular Fossa
Superficial Muscles
Deltopectoral triangle
(contains Cephalic vein)
Thoracic Apertures
Superior
Inferior
Breast
Male nipple at T4
Dermatome
Female Breast
Retromammary space
Suspensory ligaments
Tail of breast
Glandular tissue and stroma
Female Breast
Retromammary space
Blood supply to the Breast
Lateral thoracic (from
axillary a.)
Internal thoracic a.
(from subclavian)
Anterior intercostals
Post. Intercostals
(from thoracic aorta)
(Venous drainage mostly to axillary v. and internal thoracic v.)
Lymphatic Drainage of Breast
Axillary nodes
Parasternal nodes
Pectoral nodes
Subareolar plexus
Inferior phrenic nodes
Untreated Breast Cancer
Muscles of Thorax
Primary muscles of respiration
Only used during
rapid breathing.
Chest Plate
Pressures affecting Breathing
Pressure changes around lung
Nerves of thoracic wall
Pleura
Cardiac notch
Costomediastinal recess
Costodiaphragmatic recess
Surface to Deep Structure Alignment
Bare Pericardium
Respiration
• External Respiration
– The exchange of gas between the blood and external
environment (usually includes ventilation)
• Internal Respiration
– The exchange of gas between the blood and the tissues
• Cellular Respiration
– Burning of fuel to produce energy within cells
• Ventilation (Breathing)
– Movement of air in and out of the lungs
Respiratory Organs
– Divided into:
• Upper Respiratory Tract
– Includes: nostrils (nares),
nasal cavity, and
nasopharynx
• Lower Respiratory Tract
– Includes: larynx, trachea,
bronchi, and lungs
– Conducting Air passages
include: nares to terminal
bronchioles
• Move air to respiratory
membrane
• Condition the air
– Moisten, Warm, Clean
Trachea
Trachea (x.s.)
Mucous Membrane
(pseudostratified columnar epithelium)
Bronchi
• Primary bronchi
lead to to each
lung (left and
right)
• Secondary (lobar)
bronchi lead to
each lung lobe (3
on right and 2 on
left)
Cadaver Lungs
Lobes of Right Lung
Lobes of Left Lung
Bronchi Branches
Tertiary Bronchi
Primary Bronchi
Secondary Bronchi
Tertiary
(segmental)
bronchi lead to
each lung
bronchopulmonary
segment
Bronchi continue to divide at least 20 more times.
Broncho-pulmonary Segments
Lung Blood Supply
PA
PV
Note: blood supply to respiratory surface; airway blood supplied by
bronchial a. (branch of aorta)
Blood pathways
Bronchi
PA
PV
Bronchioles
• Air passages less than 1 mm in diameter are
bronchioles.
• The terminal bronchioles are the last of the purely
conducting air passages.
Alveoli highly specialized for Gas Exchange
•Lots of Surface Area
•Highly vascular
•Thin walls
Lung Tissue
Alveolus
Neural Control of Breathing
Neural Control Voluntary control located in cerebral
cortex and acts through the corticospinal tract.
of Breathing Involuntary located in pons and medulla acting
through the spinal cord in the roots of the phrenic
nerve (C3-C5) and thoracic cord roots of the
external (inspriation(I)) and internal
(expiration(E)) intercostal nerves
PRG –pontine resp. group (formerly the
apneustic and pneumotaxic centers) –play role in
smoothing between insp. and exp., especially
during sleep, vocalization and exercise.
VRG and DRG – ventral and dorsal resp. group
of the medulla. DRG primarily responsible for
inspiration; VRG mixture of I and E neurons
contains Pre-Botzinger complex which may be
pacemaker cells for respiration
Neural control of Breathing
• Red is inhibitory
• Black is excitatory
PRG
DRG
Hering-Breuer I neurons
Reflex
Ext. Intercostals
& diaphragm
Lung Stretch
Chemoreceptors
VRG
E neurons
Int. Intercostals
Factors Effecting Respiratory Centers
CO2 Drive