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Anatomy_Gray_300 | Anatomy_Gray | the wall, mainly along the inferior margin of each rib (Fig. 3.12A). Running with these vessels are intercostal nerves (the anterior rami of thoracic spinal nerves), which innervate the wall, related parietal pleura, and associated skin. The position of these nerves and vessels relative to the ribs must be considered w... | Anatomy_Gray. the wall, mainly along the inferior margin of each rib (Fig. 3.12A). Running with these vessels are intercostal nerves (the anterior rami of thoracic spinal nerves), which innervate the wall, related parietal pleura, and associated skin. The position of these nerves and vessels relative to the ribs must b... | [
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Anatomy_Gray_301 | Anatomy_Gray | The highest thoracic dermatome on the anterior chest wall is T2, which also extends into the upper limb. In the midline, skin over the xiphoid process is innervated by T6. Dermatomes of T7 to T12 follow the contour of the ribs onto the anterior abdominal wall (Fig. 3.12C). All preganglionic nerve fibers of the sympathe... | Anatomy_Gray. The highest thoracic dermatome on the anterior chest wall is T2, which also extends into the upper limb. In the midline, skin over the xiphoid process is innervated by T6. Dermatomes of T7 to T12 follow the contour of the ribs onto the anterior abdominal wall (Fig. 3.12C). All preganglionic nerve fibers o... | [
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Anatomy_Gray_302 | Anatomy_Gray | The thoracic wall is expandable because most ribs articulate with other components of the wall by true joints that allow movement, and because of the shape and orientation of the ribs (Fig. 3.14). A rib’s posterior attachment is superior to its anterior attachment. Therefore, when a rib is elevated, it moves the anteri... | Anatomy_Gray. The thoracic wall is expandable because most ribs articulate with other components of the wall by true joints that allow movement, and because of the shape and orientation of the ribs (Fig. 3.14). A rib’s posterior attachment is superior to its anterior attachment. Therefore, when a rib is elevated, it mo... | [
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Anatomy_Gray_303 | Anatomy_Gray | Changes in the anterior, lateral, and vertical dimensions of the thoracic cavity are important for breathing. Innervation of the diaphragm The diaphragm is innervated by two phrenic nerves that originate, one on each side, as branches of the cervical plexus in the neck (Fig. 3.15). They arise from the anterior rami of ... | Anatomy_Gray. Changes in the anterior, lateral, and vertical dimensions of the thoracic cavity are important for breathing. Innervation of the diaphragm The diaphragm is innervated by two phrenic nerves that originate, one on each side, as branches of the cervical plexus in the neck (Fig. 3.15). They arise from the ant... | [
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Anatomy_Gray_304 | Anatomy_Gray | The tissues that initially give rise to the diaphragm are in an anterior position on the embryological disc before the head fold develops, which explains the cervical origin of the nerves that innervate the diaphragm. In other words, the tissue that gives rise to the diaphragm originates superior to the ultimate locati... | Anatomy_Gray. The tissues that initially give rise to the diaphragm are in an anterior position on the embryological disc before the head fold develops, which explains the cervical origin of the nerves that innervate the diaphragm. In other words, the tissue that gives rise to the diaphragm originates superior to the u... | [
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Anatomy_Gray_305 | Anatomy_Gray | The cylindrical thorax consists of: a wall, two pleural cavities, the lungs, and the mediastinum. The thorax houses the heart and lungs, acts as a conduit for structures passing between the neck and the abdomen, and plays a principal role in breathing. In addition, the thoracic wall protects the heart and lungs and pro... | Anatomy_Gray. The cylindrical thorax consists of: a wall, two pleural cavities, the lungs, and the mediastinum. The thorax houses the heart and lungs, acts as a conduit for structures passing between the neck and the abdomen, and plays a principal role in breathing. In addition, the thoracic wall protects the heart and... | [
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Anatomy_Gray_306 | Anatomy_Gray | Nerves, vessels, and lymphatics in the superficial compartment emerge from the thoracic wall, the axilla, and the neck. The breasts consist of mammary glands and associated skin and connective tissues. The mammary glands are modified sweat glands in the superficial fascia anterior to the pectoral muscles and the anteri... | Anatomy_Gray. Nerves, vessels, and lymphatics in the superficial compartment emerge from the thoracic wall, the axilla, and the neck. The breasts consist of mammary glands and associated skin and connective tissues. The mammary glands are modified sweat glands in the superficial fascia anterior to the pectoral muscles ... | [
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Anatomy_Gray_307 | Anatomy_Gray | In nonlactating women, the predominant component of the breasts is fat, while glandular tissue is more abundant in lactating women. The breast lies on deep fascia related to the pectoralis major muscle and other surrounding muscles. A layer of loose connective tissue (the retromammary space) separates the breast from t... | Anatomy_Gray. In nonlactating women, the predominant component of the breasts is fat, while glandular tissue is more abundant in lactating women. The breast lies on deep fascia related to the pectoralis major muscle and other surrounding muscles. A layer of loose connective tissue (the retromammary space) separates the... | [
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Anatomy_Gray_308 | Anatomy_Gray | The base, or attached surface, of each breast extends vertically from ribs II to VI, and transversely from the sternum to as far laterally as the midaxillary line. The breast is related to the thoracic wall and to structures associated with the upper limb; therefore, vascular supply and drainage can occur by multiple r... | Anatomy_Gray. The base, or attached surface, of each breast extends vertically from ribs II to VI, and transversely from the sternum to as far laterally as the midaxillary line. The breast is related to the thoracic wall and to structures associated with the upper limb; therefore, vascular supply and drainage can occur... | [
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Anatomy_Gray_309 | Anatomy_Gray | Lymphatic drainage of the breast is as follows: Approximately 75% is via lymphatic vessels that drain laterally and superiorly into axillary nodes (Fig. 3.16). Most of the remaining drainage is into parasternal nodes deep to the anterior thoracic wall and associated with the internal thoracic artery. Some drainage may ... | Anatomy_Gray. Lymphatic drainage of the breast is as follows: Approximately 75% is via lymphatic vessels that drain laterally and superiorly into axillary nodes (Fig. 3.16). Most of the remaining drainage is into parasternal nodes deep to the anterior thoracic wall and associated with the internal thoracic artery. Some... | [
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Anatomy_Gray_310 | Anatomy_Gray | Muscles of the pectoral region Each pectoral region contains the pectoralis major, pectoralis minor, and subclavius muscles (Fig. 3.17 and Table 3.1). All originate from the anterior thoracic wall and insert into bones of the upper limb. The pectoralis major muscle is the largest and most superficial of the pectoral re... | Anatomy_Gray. Muscles of the pectoral region Each pectoral region contains the pectoralis major, pectoralis minor, and subclavius muscles (Fig. 3.17 and Table 3.1). All originate from the anterior thoracic wall and insert into bones of the upper limb. The pectoralis major muscle is the largest and most superficial of t... | [
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Anatomy_Gray_311 | Anatomy_Gray | The pectoralis major adducts, flexes, and medially rotates the arm. The subclavius and pectoralis minor muscles underlie the pectoralis major: The subclavius is small and passes laterally from the anterior and medial part of rib I to the inferior surface of the clavicle. The pectoralis minor passes from the anterior su... | Anatomy_Gray. The pectoralis major adducts, flexes, and medially rotates the arm. The subclavius and pectoralis minor muscles underlie the pectoralis major: The subclavius is small and passes laterally from the anterior and medial part of rib I to the inferior surface of the clavicle. The pectoralis minor passes from t... | [
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Anatomy_Gray_312 | Anatomy_Gray | A continuous layer of deep fascia, the clavipectoral fascia, encloses the subclavius and pectoralis minor and attaches to the clavicle above and to the floor of the axilla below. The muscles of the pectoral region form the anterior wall of the axilla, a region between the upper limb and the neck through which all major... | Anatomy_Gray. A continuous layer of deep fascia, the clavipectoral fascia, encloses the subclavius and pectoralis minor and attaches to the clavicle above and to the floor of the axilla below. The muscles of the pectoral region form the anterior wall of the axilla, a region between the upper limb and the neck through w... | [
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Anatomy_Gray_313 | Anatomy_Gray | The skeletal elements of the thoracic wall consist of the thoracic vertebrae, intervertebral discs, ribs, and sternum. There are twelve thoracic vertebrae, each of which is characterized by articulations with ribs. A typical thoracic vertebra has a heart-shaped vertebral body, with roughly equal dimensions in the trans... | Anatomy_Gray. The skeletal elements of the thoracic wall consist of the thoracic vertebrae, intervertebral discs, ribs, and sternum. There are twelve thoracic vertebrae, each of which is characterized by articulations with ribs. A typical thoracic vertebra has a heart-shaped vertebral body, with roughly equal dimension... | [
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Anatomy_Gray_314 | Anatomy_Gray | Articulation with ribs A typical thoracic vertebra has three sites on each side for articulation with ribs. Two demifacets (i.e., partial facets) are located on the superior and inferior aspects of the body for articulation with corresponding sites on the heads of adjacent ribs. The superior costal facet articulates wi... | Anatomy_Gray. Articulation with ribs A typical thoracic vertebra has three sites on each side for articulation with ribs. Two demifacets (i.e., partial facets) are located on the superior and inferior aspects of the body for articulation with corresponding sites on the heads of adjacent ribs. The superior costal facet ... | [
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Anatomy_Gray_315 | Anatomy_Gray | Similarly, vertebra TX (and often TIX) articulates only with its own ribs and therefore lacks inferior demifacets on the body. Vertebrae TXI and TXII articulate only with the heads of their own ribs—they lack transverse costal facets and have only a single complete facet on each side of their bodies. There are twelve p... | Anatomy_Gray. Similarly, vertebra TX (and often TIX) articulates only with its own ribs and therefore lacks inferior demifacets on the body. Vertebrae TXI and TXII articulate only with the heads of their own ribs—they lack transverse costal facets and have only a single complete facet on each side of their bodies. Ther... | [
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Anatomy_Gray_316 | Anatomy_Gray | Ribs XI and XII have no anterior connection with other ribs or with the sternum and are often called floating ribs. A typical rib consists of a curved shaft with anterior and posterior ends (Fig. 3.21). The anterior end is continuous with its costal cartilage. The posterior end articulates with the vertebral column and... | Anatomy_Gray. Ribs XI and XII have no anterior connection with other ribs or with the sternum and are often called floating ribs. A typical rib consists of a curved shaft with anterior and posterior ends (Fig. 3.21). The anterior end is continuous with its costal cartilage. The posterior end articulates with the verteb... | [
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Anatomy_Gray_317 | Anatomy_Gray | The tubercle projects posteriorly from the junction of the neck with the shaft and consists of two regions, an articular part and a nonarticular part: The articular part is medial and has an oval facet for articulation with a corresponding facet on the transverse process of the associated vertebra. The raised nonarticu... | Anatomy_Gray. The tubercle projects posteriorly from the junction of the neck with the shaft and consists of two regions, an articular part and a nonarticular part: The articular part is medial and has an oval facet for articulation with a corresponding facet on the transverse process of the associated vertebra. The ra... | [
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Anatomy_Gray_318 | Anatomy_Gray | Distinct features of upper and lower ribs The upper and lower ribs have distinct features (Fig. 3.22). Rib I is flat in the horizontal plane and has broad superior and inferior surfaces. From its articulation with vertebra TI, it slopes inferiorly to its attachment to the manubrium of the sternum. The head articulates ... | Anatomy_Gray. Distinct features of upper and lower ribs The upper and lower ribs have distinct features (Fig. 3.22). Rib I is flat in the horizontal plane and has broad superior and inferior surfaces. From its articulation with vertebra TI, it slopes inferiorly to its attachment to the manubrium of the sternum. The hea... | [
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Anatomy_Gray_319 | Anatomy_Gray | Rib II, like rib I, is flat but twice as long. It articulates with the vertebral column in a way typical of most ribs. The head of rib X has a single facet for articulation with its own vertebra. Ribs XI and XII articulate only with the bodies of their own vertebrae and have no tubercles or necks. Both ribs are short, ... | Anatomy_Gray. Rib II, like rib I, is flat but twice as long. It articulates with the vertebral column in a way typical of most ribs. The head of rib X has a single facet for articulation with its own vertebra. Ribs XI and XII articulate only with the bodies of their own vertebrae and have no tubercles or necks. Both ri... | [
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Anatomy_Gray_320 | Anatomy_Gray | The superior surface of the manubrium is expanded laterally and bears a distinct and palpable notch, the jugular notch (suprasternal notch), in the midline. On either side of this notch is a large oval fossa for articulation with the clavicle. Immediately inferior to this fossa, on each lateral surface of the manubrium... | Anatomy_Gray. The superior surface of the manubrium is expanded laterally and bears a distinct and palpable notch, the jugular notch (suprasternal notch), in the midline. On either side of this notch is a large oval fossa for articulation with the clavicle. Immediately inferior to this fossa, on each lateral surface of... | [
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Anatomy_Gray_321 | Anatomy_Gray | The lateral margins of the body of the sternum have articular facets for costal cartilages. Superiorly, each lateral margin has a demifacet for articulation with the inferior aspect of the second costal cartilage. Inferior to this demifacet are four facets for articulation with the costal cartilages of ribs III to VI. ... | Anatomy_Gray. The lateral margins of the body of the sternum have articular facets for costal cartilages. Superiorly, each lateral margin has a demifacet for articulation with the inferior aspect of the second costal cartilage. Inferior to this demifacet are four facets for articulation with the costal cartilages of ri... | [
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Anatomy_Gray_322 | Anatomy_Gray | A typical rib articulates with: the bodies of adjacent vertebrae, forming a joint with the head of the rib; and the transverse process of its related vertebra, forming a costotransverse joint (Fig. 3.24). Together, the costovertebral joints and related ligaments allow the necks of the ribs either to rotate around their... | Anatomy_Gray. A typical rib articulates with: the bodies of adjacent vertebrae, forming a joint with the head of the rib; and the transverse process of its related vertebra, forming a costotransverse joint (Fig. 3.24). Together, the costovertebral joints and related ligaments allow the necks of the ribs either to rotat... | [
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Anatomy_Gray_323 | Anatomy_Gray | Joint with head of rib The two facets on the head of the rib articulate with the superior facet on the body of its own vertebra and with the inferior facet on the body of the vertebra above. This joint is divided into two synovial compartments by an intra-articular ligament, which attaches the crest to the adjacent int... | Anatomy_Gray. Joint with head of rib The two facets on the head of the rib articulate with the superior facet on the body of its own vertebra and with the inferior facet on the body of the vertebra above. This joint is divided into two synovial compartments by an intra-articular ligament, which attaches the crest to th... | [
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Anatomy_Gray_324 | Anatomy_Gray | The costotransverse ligament is medial to the joint and attaches the neck of the rib to the transverse process. The lateral costotransverse ligament is lateral to the joint and attaches the tip of the transverse process to the roughened nonarticular part of the tubercle of the rib. A third ligament, the superior costot... | Anatomy_Gray. The costotransverse ligament is medial to the joint and attaches the neck of the rib to the transverse process. The lateral costotransverse ligament is lateral to the joint and attaches the tip of the transverse process to the roughened nonarticular part of the tubercle of the rib. A third ligament, the s... | [
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Anatomy_Gray_325 | Anatomy_Gray | The joint between the second costal cartilage and the sternum is divided into two compartments by an intraarticular ligament. This ligament attaches the second costal cartilage to the junction of the manubrium and the body of the sternum. Interchondral joints occur between the costal cartilages of adjacent ribs (Fig. 3... | Anatomy_Gray. The joint between the second costal cartilage and the sternum is divided into two compartments by an intraarticular ligament. This ligament attaches the second costal cartilage to the junction of the manubrium and the body of the sternum. Interchondral joints occur between the costal cartilages of adjacen... | [
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Anatomy_Gray_326 | Anatomy_Gray | The joints between the manubrium and the body of the sternum and between the body of the sternum and the xiphoid process are usually symphyses (Fig. 3.25). Only slight angular movements occur between the manubrium and the body of the sternum during respiration. The joint between the body of the sternum and the xiphoid ... | Anatomy_Gray. The joints between the manubrium and the body of the sternum and between the body of the sternum and the xiphoid process are usually symphyses (Fig. 3.25). Only slight angular movements occur between the manubrium and the body of the sternum during respiration. The joint between the body of the sternum an... | [
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Anatomy_Gray_327 | Anatomy_Gray | In addition, the sternal angle lies on a horizontal plane that passes through the intervertebral disc between vertebrae TIV and TV (see Fig. 3.10). This plane separates the superior mediastinum from the inferior mediastinum and marks the superior border of the pericardium. The plane also passes through the end of the a... | Anatomy_Gray. In addition, the sternal angle lies on a horizontal plane that passes through the intervertebral disc between vertebrae TIV and TV (see Fig. 3.10). This plane separates the superior mediastinum from the inferior mediastinum and marks the superior border of the pericardium. The plane also passes through th... | [
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Anatomy_Gray_328 | Anatomy_Gray | Intercostal nerves and associated major arteries and veins lie in the costal groove along the inferior margin of the superior rib and pass in the plane between the inner two layers of muscles. In each space, the vein is the most superior structure and is therefore highest in the costal groove. The artery is inferior to... | Anatomy_Gray. Intercostal nerves and associated major arteries and veins lie in the costal groove along the inferior margin of the superior rib and pass in the plane between the inner two layers of muscles. In each space, the vein is the most superior structure and is therefore highest in the costal groove. The artery ... | [
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Anatomy_Gray_329 | Anatomy_Gray | Superficial to the spaces are deep fascia, superficial fascia, and skin. Muscles associated with the upper limbs and back overlie the spaces. Muscles of the thoracic wall include those that fill and support the intercostal spaces, those that pass between the sternum and the ribs, and those that cross several ribs betwe... | Anatomy_Gray. Superficial to the spaces are deep fascia, superficial fascia, and skin. Muscles associated with the upper limbs and back overlie the spaces. Muscles of the thoracic wall include those that fill and support the intercostal spaces, those that pass between the sternum and the ribs, and those that cross seve... | [
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Anatomy_Gray_330 | Anatomy_Gray | The external intercostal muscles are the most superficial. The internal intercostal muscles are sandwiched between the external and innermost muscles. The innermost intercostal muscles are the deepest of the three muscles. The intercostal muscles are innervated by the related intercostal nerves. As a group, the interco... | Anatomy_Gray. The external intercostal muscles are the most superficial. The internal intercostal muscles are sandwiched between the external and innermost muscles. The innermost intercostal muscles are the deepest of the three muscles. The intercostal muscles are innervated by the related intercostal nerves. As a grou... | [
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Anatomy_Gray_331 | Anatomy_Gray | The eleven pairs of external intercostal muscles extend from the inferior margins (lateral edges of costal grooves) of the ribs above to the superior margins of the ribs below. When the thoracic wall is viewed from a lateral position, the muscle fibers pass obliquely anteroinferiorly (Fig. 3.27). The muscles extend aro... | Anatomy_Gray. The eleven pairs of external intercostal muscles extend from the inferior margins (lateral edges of costal grooves) of the ribs above to the superior margins of the ribs below. When the thoracic wall is viewed from a lateral position, the muscle fibers pass obliquely anteroinferiorly (Fig. 3.27). The musc... | [
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Anatomy_Gray_332 | Anatomy_Gray | The eleven pairs of internal intercostal muscles pass between the most inferior lateral edge of the costal grooves of the ribs above, to the superior margins of the ribs below. They extend from parasternal regions, where the muscles course between adjacent costal cartilages, to the angle of the ribs posteriorly (Fig. 3... | Anatomy_Gray. The eleven pairs of internal intercostal muscles pass between the most inferior lateral edge of the costal grooves of the ribs above, to the superior margins of the ribs below. They extend from parasternal regions, where the muscles course between adjacent costal cartilages, to the angle of the ribs poste... | [
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Anatomy_Gray_333 | Anatomy_Gray | The innermost intercostal muscles are the least distinct of the intercostal muscles, and the fibers have the same orientation as the internal intercostals (Fig. 3.27). These muscles are most evident in the lateral thoracic wall. They extend between the inner surfaces of adjacent ribs from the medial edge of the costal ... | Anatomy_Gray. The innermost intercostal muscles are the least distinct of the intercostal muscles, and the fibers have the same orientation as the internal intercostals (Fig. 3.27). These muscles are most evident in the lateral thoracic wall. They extend between the inner surfaces of adjacent ribs from the medial edge ... | [
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Anatomy_Gray_334 | Anatomy_Gray | The subcostales are in the same plane as the innermost intercostals, span multiple ribs, and are more numerous in lower regions of the posterior thoracic wall (Fig. 3.28A). They extend from the internal surfaces of one rib to the internal surface of the second (next) or third rib below. Their fibers parallel the course... | Anatomy_Gray. The subcostales are in the same plane as the innermost intercostals, span multiple ribs, and are more numerous in lower regions of the posterior thoracic wall (Fig. 3.28A). They extend from the internal surfaces of one rib to the internal surface of the second (next) or third rib below. Their fibers paral... | [
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Anatomy_Gray_335 | Anatomy_Gray | The transversus thoracis muscles lie deep to the internal thoracic vessels and secure these vessels to the wall. Vessels that supply the thoracic wall consist mainly of posterior and anterior intercostal arteries, which pass around the wall between adjacent ribs in intercostal spaces (Fig. 3.29). These arteries origina... | Anatomy_Gray. The transversus thoracis muscles lie deep to the internal thoracic vessels and secure these vessels to the wall. Vessels that supply the thoracic wall consist mainly of posterior and anterior intercostal arteries, which pass around the wall between adjacent ribs in intercostal spaces (Fig. 3.29). These ar... | [
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Anatomy_Gray_336 | Anatomy_Gray | The remaining nine pairs of posterior intercostal arteries arise from the posterior surface of the thoracic aorta. Because the aorta is on the left side of the vertebral column, those posterior intercostal vessels passing to the right side of the thoracic wall cross the midline anterior to the bodies of the vertebrae a... | Anatomy_Gray. The remaining nine pairs of posterior intercostal arteries arise from the posterior surface of the thoracic aorta. Because the aorta is on the left side of the vertebral column, those posterior intercostal vessels passing to the right side of the thoracic wall cross the midline anterior to the bodies of t... | [
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Anatomy_Gray_337 | Anatomy_Gray | The anterior intercostal arteries originate directly or indirectly as lateral branches from the internal thoracic arteries (Fig. 3.29). Each internal thoracic artery arises as a major branch of the subclavian artery in the neck. It passes anteriorly over the cervical dome of the pleura and descends vertically through t... | Anatomy_Gray. The anterior intercostal arteries originate directly or indirectly as lateral branches from the internal thoracic arteries (Fig. 3.29). Each internal thoracic artery arises as a major branch of the subclavian artery in the neck. It passes anteriorly over the cervical dome of the pleura and descends vertic... | [
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Anatomy_Gray_338 | Anatomy_Gray | Anterior intercostal arteries that supply the upper six intercostal spaces arise as lateral branches from the internal thoracic artery, whereas those supplying the lower spaces arise from the musculophrenic artery. In each intercostal space, the anterior intercostal arteries usually have two branches: One passes below ... | Anatomy_Gray. Anterior intercostal arteries that supply the upper six intercostal spaces arise as lateral branches from the internal thoracic artery, whereas those supplying the lower spaces arise from the musculophrenic artery. In each intercostal space, the anterior intercostal arteries usually have two branches: One... | [
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Anatomy_Gray_339 | Anatomy_Gray | In addition to anterior intercostal arteries and a number of other branches, the internal thoracic arteries give rise to perforating branches that pass directly forward between the costal cartilages to supply structures external to the thoracic wall. These vessels travel with the anterior cutaneous branches of the inte... | Anatomy_Gray. In addition to anterior intercostal arteries and a number of other branches, the internal thoracic arteries give rise to perforating branches that pass directly forward between the costal cartilages to supply structures external to the thoracic wall. These vessels travel with the anterior cutaneous branch... | [
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Anatomy_Gray_340 | Anatomy_Gray | Similarly, the upper posterior intercostal veins on the right side may come together and form the right superior intercostal vein, which empties into the azygos vein. Lymphatic vessels of the thoracic wall drain mainly into lymph nodes associated with the internal thoracic arteries (parasternal nodes), with the heads a... | Anatomy_Gray. Similarly, the upper posterior intercostal veins on the right side may come together and form the right superior intercostal vein, which empties into the azygos vein. Lymphatic vessels of the thoracic wall drain mainly into lymph nodes associated with the internal thoracic arteries (parasternal nodes), wi... | [
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Anatomy_Gray_341 | Anatomy_Gray | Nodes associated with the diaphragm interconnect with parasternal, prevertebral, and juxta-esophageal nodes, brachiocephalic nodes (anterior to the brachiocephalic veins in the superior mediastinum), and lateral aortic/lumbar nodes (in the abdomen). Superficial regions of the thoracic wall drain mainly into axillary ly... | Anatomy_Gray. Nodes associated with the diaphragm interconnect with parasternal, prevertebral, and juxta-esophageal nodes, brachiocephalic nodes (anterior to the brachiocephalic veins in the superior mediastinum), and lateral aortic/lumbar nodes (in the abdomen). Superficial regions of the thoracic wall drain mainly in... | [
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Anatomy_Gray_342 | Anatomy_Gray | The intercostal nerves end as anterior cutaneous branches, which emerge either parasternally, between adjacent costal cartilages, or laterally to the midline, on the anterior abdominal wall, to supply the skin. In addition to these major branches, small collateral branches can be found in the intercostal space running ... | Anatomy_Gray. The intercostal nerves end as anterior cutaneous branches, which emerge either parasternally, between adjacent costal cartilages, or laterally to the midline, on the anterior abdominal wall, to supply the skin. In addition to these major branches, small collateral branches can be found in the intercostal ... | [
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Anatomy_Gray_343 | Anatomy_Gray | In addition to innervating the thoracic wall, intercostal nerves innervate other regions: The anterior ramus of T1 contributes to the brachial plexus. The lateral cutaneous branch of the second intercostal nerve (the intercostobrachial nerve) contributes to cutaneous innervation of the medial surface of the upper arm. ... | Anatomy_Gray. In addition to innervating the thoracic wall, intercostal nerves innervate other regions: The anterior ramus of T1 contributes to the brachial plexus. The lateral cutaneous branch of the second intercostal nerve (the intercostobrachial nerve) contributes to cutaneous innervation of the medial surface of t... | [
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Anatomy_Gray_344 | Anatomy_Gray | From these peripheral attachments, muscle fibers converge to join the central tendon. The pericardium is attached to the middle part of the central tendon. In the median sagittal plane, the diaphragm slopes inferiorly from its anterior attachment to the xiphoid, approximately at vertebral level TVIII/IX, to its posteri... | Anatomy_Gray. From these peripheral attachments, muscle fibers converge to join the central tendon. The pericardium is attached to the middle part of the central tendon. In the median sagittal plane, the diaphragm slopes inferiorly from its anterior attachment to the xiphoid, approximately at vertebral level TVIII/IX, ... | [
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Anatomy_Gray_345 | Anatomy_Gray | The vagus nerves pass through the diaphragm with the esophagus. The aorta passes behind the posterior attachment of the diaphragm at vertebral level TXII. The thoracic duct passes behind the diaphragm with the aorta. The azygos and hemiazygos veins may also pass through the aortic hiatus or through the crura of the dia... | Anatomy_Gray. The vagus nerves pass through the diaphragm with the esophagus. The aorta passes behind the posterior attachment of the diaphragm at vertebral level TXII. The thoracic duct passes behind the diaphragm with the aorta. The azygos and hemiazygos veins may also pass through the aortic hiatus or through the cr... | [
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Anatomy_Gray_346 | Anatomy_Gray | Other structures outside the posterior attachments of the diaphragm lateral to the aortic hiatus include the sympathetic trunks. The greater, lesser, and least splanchnic nerves penetrate the crura. The arterial supply to the diaphragm is from vessels that arise superiorly and inferiorly to it (see Fig. 3.34). From abo... | Anatomy_Gray. Other structures outside the posterior attachments of the diaphragm lateral to the aortic hiatus include the sympathetic trunks. The greater, lesser, and least splanchnic nerves penetrate the crura. The arterial supply to the diaphragm is from vessels that arise superiorly and inferiorly to it (see Fig. 3... | [
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Anatomy_Gray_347 | Anatomy_Gray | Venous drainage of the diaphragm is by veins that generally parallel the arteries. The veins drain into: the brachiocephalic veins in the neck, the azygos system of veins, or abdominal veins (left suprarenal vein and inferior vena cava). The diaphragm is innervated by the phrenic nerves (C3, C4, and C5), which penetrat... | Anatomy_Gray. Venous drainage of the diaphragm is by veins that generally parallel the arteries. The veins drain into: the brachiocephalic veins in the neck, the azygos system of veins, or abdominal veins (left suprarenal vein and inferior vena cava). The diaphragm is innervated by the phrenic nerves (C3, C4, and C5), ... | [
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Anatomy_Gray_348 | Anatomy_Gray | During breathing, the dimensions of the thorax change in the vertical, lateral, and anteroposterior directions. Elevation and depression of the diaphragm significantly alter the vertical dimensions of the thorax. Depression results when the muscle fibers of the diaphragm contract. Elevation occurs when the diaphragm re... | Anatomy_Gray. During breathing, the dimensions of the thorax change in the vertical, lateral, and anteroposterior directions. Elevation and depression of the diaphragm significantly alter the vertical dimensions of the thorax. Depression results when the muscle fibers of the diaphragm contract. Elevation occurs when th... | [
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Anatomy_Gray_349 | Anatomy_Gray | Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, they move the sternum upward and forward. Also, the angle between the body of the sternum and the manubrium may become slightly less acute. When the ribs are depressed, the sternum moves downward and backward. This “pu... | Anatomy_Gray. Because the anterior ends of the ribs are inferior to the posterior ends, when the ribs are elevated, they move the sternum upward and forward. Also, the angle between the body of the sternum and the manubrium may become slightly less acute. When the ribs are depressed, the sternum moves downward and back... | [
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Anatomy_Gray_350 | Anatomy_Gray | Two pleural cavities, one on either side of the mediastinum, surround the lungs (Fig. 3.37): Superiorly, they extend above rib I into the root of the neck. Inferiorly, they extend to a level just above the costal margin. The medial wall of each pleural cavity is the mediastinum. Each pleural cavity is lined by a single... | Anatomy_Gray. Two pleural cavities, one on either side of the mediastinum, surround the lungs (Fig. 3.37): Superiorly, they extend above rib I into the root of the neck. Inferiorly, they extend to a level just above the costal margin. The medial wall of each pleural cavity is the mediastinum. Each pleural cavity is lin... | [
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Anatomy_Gray_351 | Anatomy_Gray | Pleura that reflects from the medial wall and onto the surface of the lung is visceral pleura (Fig. 3.37), which adheres to and covers the lung. Each pleural cavity is the potential space enclosed between the visceral and parietal pleurae. They normally contain only a very thin layer of serous fluid. As a result, the s... | Anatomy_Gray. Pleura that reflects from the medial wall and onto the surface of the lung is visceral pleura (Fig. 3.37), which adheres to and covers the lung. Each pleural cavity is the potential space enclosed between the visceral and parietal pleurae. They normally contain only a very thin layer of serous fluid. As a... | [
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Anatomy_Gray_352 | Anatomy_Gray | The dome-shaped layer of parietal pleura lining the cervical extension of the pleural cavity is cervical pleura (dome of pleura or pleural cupola). Covering the superior surface of the cervical pleura is a distinct dome-like layer of fascia, the suprapleural membrane (Fig. 3.38). This connective tissue membrane is atta... | Anatomy_Gray. The dome-shaped layer of parietal pleura lining the cervical extension of the pleural cavity is cervical pleura (dome of pleura or pleural cupola). Covering the superior surface of the cervical pleura is a distinct dome-like layer of fascia, the suprapleural membrane (Fig. 3.38). This connective tissue me... | [
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Anatomy_Gray_353 | Anatomy_Gray | In the region of vertebrae TV to TVII, the mediastinal pleura reflects off the mediastinum as a tubular, sleeve-like covering for structures (i.e., airway, vessels, nerves, lymphatics) that pass between the lung and mediastinum. This sleeve-like covering and the structures it contains forms the root of the lung. The ro... | Anatomy_Gray. In the region of vertebrae TV to TVII, the mediastinal pleura reflects off the mediastinum as a tubular, sleeve-like covering for structures (i.e., airway, vessels, nerves, lymphatics) that pass between the lung and mediastinum. This sleeve-like covering and the structures it contains forms the root of th... | [
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Anatomy_Gray_354 | Anatomy_Gray | The peripheral reflections of parietal pleura mark the extent of the pleural cavities (Fig. 3.39). Superiorly, the pleural cavity can project as much as 3 to 4 cm above the first costal cartilage but does not extend above the neck of rib I. This limitation is caused by the inferior slope of rib I to its articulation wi... | Anatomy_Gray. The peripheral reflections of parietal pleura mark the extent of the pleural cavities (Fig. 3.39). Superiorly, the pleural cavity can project as much as 3 to 4 cm above the first costal cartilage but does not extend above the neck of rib I. This limitation is caused by the inferior slope of rib I to its a... | [
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Anatomy_Gray_355 | Anatomy_Gray | Inferiorly, the costal pleura reflects onto the diaphragm above the costal margin. In the midclavicular line, the pleural cavity extends inferiorly to approximately rib VIII. In the midaxillary line, it extends to rib X. From this point, the inferior margin courses somewhat horizontally, crossing ribs XI and XII to rea... | Anatomy_Gray. Inferiorly, the costal pleura reflects onto the diaphragm above the costal margin. In the midclavicular line, the pleural cavity extends inferiorly to approximately rib VIII. In the midaxillary line, it extends to rib X. From this point, the inferior margin courses somewhat horizontally, crossing ribs XI ... | [
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Anatomy_Gray_356 | Anatomy_Gray | Although the visceral pleura is innervated by visceral afferent nerves that accompany bronchial vessels, pain is generally not elicited from this tissue. The lungs do not completely fill the anterior or posterior inferior regions of the pleural cavities (Fig. 3.40). This results in recesses in which two layers of parie... | Anatomy_Gray. Although the visceral pleura is innervated by visceral afferent nerves that accompany bronchial vessels, pain is generally not elicited from this tissue. The lungs do not completely fill the anterior or posterior inferior regions of the pleural cavities (Fig. 3.40). This results in recesses in which two l... | [
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Anatomy_Gray_357 | Anatomy_Gray | Anteriorly, a costomediastinal recess occurs on each side where costal pleura is opposed to mediastinal pleura. The largest is on the left side in the region overlying the heart (Fig. 3.40). The largest and clinically most important recesses are the costodiaphragmatic recesses, which occur in each pleural cavity betwee... | Anatomy_Gray. Anteriorly, a costomediastinal recess occurs on each side where costal pleura is opposed to mediastinal pleura. The largest is on the left side in the region overlying the heart (Fig. 3.40). The largest and clinically most important recesses are the costodiaphragmatic recesses, which occur in each pleural... | [
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Anatomy_Gray_358 | Anatomy_Gray | During quiet respiration, the inferior margin of the lung crosses rib VI in the midclavicular line and rib VIII in the midaxillary line, and then courses somewhat horizontally to reach the vertebral column at vertebral level TX. Thus, from the midclavicular line and around the thoracic wall to the vertebral column, the... | Anatomy_Gray. During quiet respiration, the inferior margin of the lung crosses rib VI in the midclavicular line and rib VIII in the midaxillary line, and then courses somewhat horizontally to reach the vertebral column at vertebral level TX. Thus, from the midclavicular line and around the thoracic wall to the vertebr... | [
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Anatomy_Gray_359 | Anatomy_Gray | The pulmonary arteries deliver deoxygenated blood to the lungs from the right ventricle of the heart. Oxygenated blood returns to the left atrium via the pulmonary veins. The right lung is normally a little larger than the left lung because the middle mediastinum, containing the heart, bulges more to the left than to t... | Anatomy_Gray. The pulmonary arteries deliver deoxygenated blood to the lungs from the right ventricle of the heart. Oxygenated blood returns to the left atrium via the pulmonary veins. The right lung is normally a little larger than the left lung because the middle mediastinum, containing the heart, bulges more to the ... | [
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Anatomy_Gray_360 | Anatomy_Gray | The three borders—the inferior border of the lung is sharp and separates the base from the costal surface. The anterior and posterior borders separate the costal surface from the medial surface. Unlike the anterior and inferior borders, which are sharp, the posterior border is smooth and rounded. The lungs lie directly... | Anatomy_Gray. The three borders—the inferior border of the lung is sharp and separates the base from the costal surface. The anterior and posterior borders separate the costal surface from the medial surface. Unlike the anterior and inferior borders, which are sharp, the posterior border is smooth and rounded. The lung... | [
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Anatomy_Gray_361 | Anatomy_Gray | The root of each lung is a short tubular collection of structures that together attach the lung to structures in the mediastinum (Fig. 3.44). It is covered by a sleeve of mediastinal pleura that reflects onto the surface of the lung as visceral pleura. The region outlined by this pleural reflection on the medial surfac... | Anatomy_Gray. The root of each lung is a short tubular collection of structures that together attach the lung to structures in the mediastinum (Fig. 3.44). It is covered by a sleeve of mediastinal pleura that reflects onto the surface of the lung as visceral pleura. The region outlined by this pleural reflection on the... | [
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Anatomy_Gray_362 | Anatomy_Gray | In the mediastinum, the vagus nerves pass immediately posterior to the roots of the lungs, while the phrenic nerves pass immediately anterior to them. Within each root and located in the hilum are: a pulmonary artery, two pulmonary veins, a main bronchus, bronchial vessels, nerves, and lymphatics. Generally, the pulmon... | Anatomy_Gray. In the mediastinum, the vagus nerves pass immediately posterior to the roots of the lungs, while the phrenic nerves pass immediately anterior to them. Within each root and located in the hilum are: a pulmonary artery, two pulmonary veins, a main bronchus, bronchial vessels, nerves, and lymphatics. General... | [
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Anatomy_Gray_363 | Anatomy_Gray | The oblique fissure separates the inferior lobe (lower lobe) from the superior lobe and the middle lobe of the right lung. The horizontal fissure separates the superior lobe (upper lobe) from the middle lobe. The approximate position of the oblique fissure on a patient, in quiet respiration, can be marked by a curved l... | Anatomy_Gray. The oblique fissure separates the inferior lobe (lower lobe) from the superior lobe and the middle lobe of the right lung. The horizontal fissure separates the superior lobe (upper lobe) from the middle lobe. The approximate position of the oblique fissure on a patient, in quiet respiration, can be marked... | [
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Anatomy_Gray_364 | Anatomy_Gray | The orientations of the oblique and horizontal fissures determine where clinicians should listen for lung sounds from each lobe. The largest surface of the superior lobe is in contact with the upper part of the anterolateral wall and the apex of this lobe projects into the root of the neck. The surface of the middle lo... | Anatomy_Gray. The orientations of the oblique and horizontal fissures determine where clinicians should listen for lung sounds from each lobe. The largest surface of the superior lobe is in contact with the upper part of the anterolateral wall and the apex of this lobe projects into the root of the neck. The surface of... | [
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Anatomy_Gray_365 | Anatomy_Gray | The right subclavian artery and vein arch over and are related to the superior lobe of the right lung as they pass over the dome of the cervical pleura and into the axilla. The left lung is smaller than the right lung and has two lobes separated by an oblique fissure (Fig. 3.46A). The oblique fissure of the left lung i... | Anatomy_Gray. The right subclavian artery and vein arch over and are related to the superior lobe of the right lung as they pass over the dome of the cervical pleura and into the axilla. The left lung is smaller than the right lung and has two lobes separated by an oblique fissure (Fig. 3.46A). The oblique fissure of t... | [
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Anatomy_Gray_366 | Anatomy_Gray | As with the right lung, the orientation of the oblique fissure determines where to listen for lung sounds from each lobe. The largest surface of the superior lobe is in contact with the upper part of the anterolateral wall, and the apex of this lobe projects into the root of the neck. The costal surface of the inferior... | Anatomy_Gray. As with the right lung, the orientation of the oblique fissure determines where to listen for lung sounds from each lobe. The largest surface of the superior lobe is in contact with the upper part of the anterolateral wall, and the apex of this lobe projects into the root of the neck. The costal surface o... | [
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Anatomy_Gray_367 | Anatomy_Gray | From the anterior border of the lower part of the superior lobe a tongue-like extension (the lingula of the left lung) projects over the heart bulge. The medial surface of the left lung lies adjacent to a number of important structures in the mediastinum and root of the neck (Fig. 3.46B). These include the: heart, aort... | Anatomy_Gray. From the anterior border of the lower part of the superior lobe a tongue-like extension (the lingula of the left lung) projects over the heart bulge. The medial surface of the left lung lies adjacent to a number of important structures in the mediastinum and root of the neck (Fig. 3.46B). These include th... | [
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Anatomy_Gray_368 | Anatomy_Gray | The left subclavian artery and vein arch over and are related to the superior lobe of the left lung as they pass over the dome of the cervical pleura and into the axilla. The trachea is a flexible tube that extends from vertebral level CVI in the lower neck to vertebral level TIV/V in the mediastinum where it bifurcate... | Anatomy_Gray. The left subclavian artery and vein arch over and are related to the superior lobe of the left lung as they pass over the dome of the cervical pleura and into the axilla. The trachea is a flexible tube that extends from vertebral level CVI in the lower neck to vertebral level TIV/V in the mediastinum wher... | [
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Anatomy_Gray_369 | Anatomy_Gray | Each main bronchus enters the root of a lung and passes through the hilum into the lung itself. The right main bronchus is wider and takes a more vertical course through the root and hilum than the left main bronchus (Fig. 3.47A). Therefore, inhaled foreign bodies tend to lodge more frequently on the right side than on... | Anatomy_Gray. Each main bronchus enters the root of a lung and passes through the hilum into the lung itself. The right main bronchus is wider and takes a more vertical course through the root and hilum than the left main bronchus (Fig. 3.47A). Therefore, inhaled foreign bodies tend to lodge more frequently on the righ... | [
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Anatomy_Gray_370 | Anatomy_Gray | The lobar bronchi further divide into segmental bronchi (tertiary bronchi), which supply bronchopulmonary segments (Fig. 3.47B). Within each bronchopulmonary segment, the segmental bronchi give rise to multiple generations of divisions and, ultimately, to bronchioles, which further subdivide and supply the respiratory ... | Anatomy_Gray. The lobar bronchi further divide into segmental bronchi (tertiary bronchi), which supply bronchopulmonary segments (Fig. 3.47B). Within each bronchopulmonary segment, the segmental bronchi give rise to multiple generations of divisions and, ultimately, to bronchioles, which further subdivide and supply th... | [
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Anatomy_Gray_371 | Anatomy_Gray | Each bronchopulmonary segment is shaped like an irregular cone, with the apex at the origin of the segmental bronchus and the base projected peripherally onto the surface of the lung. A bronchopulmonary segment is the smallest functionally independent region of a lung and the smallest area of lung that can be isolated ... | Anatomy_Gray. Each bronchopulmonary segment is shaped like an irregular cone, with the apex at the origin of the segmental bronchus and the base projected peripherally onto the surface of the lung. A bronchopulmonary segment is the smallest functionally independent region of a lung and the smallest area of lung that ca... | [
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Anatomy_Gray_372 | Anatomy_Gray | The right pulmonary artery is longer than the left and passes horizontally across the mediastinum (Fig. 3.49). It passes: anteriorly and slightly inferiorly to the tracheal bifurcation and anteriorly to the right main bronchus, and posteriorly to the ascending aorta, superior vena cava, and upper right pulmonary vein. ... | Anatomy_Gray. The right pulmonary artery is longer than the left and passes horizontally across the mediastinum (Fig. 3.49). It passes: anteriorly and slightly inferiorly to the tracheal bifurcation and anteriorly to the right main bronchus, and posteriorly to the ascending aorta, superior vena cava, and upper right pu... | [
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Anatomy_Gray_373 | Anatomy_Gray | On each side a superior pulmonary vein and an inferior pulmonary vein carry oxygenated blood from the lungs back to the heart (Fig. 3.49). The veins begin at the hilum of the lung, pass through the root of the lung, and immediately drain into the left atrium. The bronchial arteries (Fig. 3.49) and veins constitute the ... | Anatomy_Gray. On each side a superior pulmonary vein and an inferior pulmonary vein carry oxygenated blood from the lungs back to the heart (Fig. 3.49). The veins begin at the hilum of the lung, pass through the root of the lung, and immediately drain into the left atrium. The bronchial arteries (Fig. 3.49) and veins c... | [
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Anatomy_Gray_374 | Anatomy_Gray | The bronchial arteries run on the posterior surfaces of the bronchi and ramify in the lungs to supply pulmonary tissues. The bronchial veins drain into: either the pulmonary veins or the left atrium, and into the azygos vein on the right or into the superior intercostal vein or hemiazygos vein on the left. Structures o... | Anatomy_Gray. The bronchial arteries run on the posterior surfaces of the bronchi and ramify in the lungs to supply pulmonary tissues. The bronchial veins drain into: either the pulmonary veins or the left atrium, and into the azygos vein on the right or into the superior intercostal vein or hemiazygos vein on the left... | [
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Anatomy_Gray_375 | Anatomy_Gray | Visceral efferents from: the vagus nerves constrict the bronchioles; the sympathetic system dilates the bronchioles. Superficial, or subpleural, and deep lymphatics of the lung drain into lymph nodes called tracheobronchial nodes around the roots of lobar and main bronchi and along the sides of the trachea (Fig. 3.51).... | Anatomy_Gray. Visceral efferents from: the vagus nerves constrict the bronchioles; the sympathetic system dilates the bronchioles. Superficial, or subpleural, and deep lymphatics of the lung drain into lymph nodes called tracheobronchial nodes around the roots of lobar and main bronchi and along the sides of the trache... | [
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Anatomy_Gray_376 | Anatomy_Gray | The mediastinum is a broad central partition that separates the two laterally placed pleural cavities (Fig. 3.55). It extends: from the sternum to the bodies of the vertebrae, and from the superior thoracic aperture to the diaphragm (Fig. 3.56). The mediastinum contains the thymus gland, the pericardial sac, the heart,... | Anatomy_Gray. The mediastinum is a broad central partition that separates the two laterally placed pleural cavities (Fig. 3.55). It extends: from the sternum to the bodies of the vertebrae, and from the superior thoracic aperture to the diaphragm (Fig. 3.56). The mediastinum contains the thymus gland, the pericardial s... | [
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Anatomy_Gray_377 | Anatomy_Gray | For organizational purposes, the mediastinum is subdivided into several smaller regions. A transverse plane extending from the sternal angle (the junction between the manubrium and the body of the sternum) to the intervertebral disc between vertebrae TIV and TV separates the mediastinum into the: superior mediastinum, ... | Anatomy_Gray. For organizational purposes, the mediastinum is subdivided into several smaller regions. A transverse plane extending from the sternal angle (the junction between the manubrium and the body of the sternum) to the intervertebral disc between vertebrae TIV and TV separates the mediastinum into the: superior... | [
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Anatomy_Gray_378 | Anatomy_Gray | The anterior mediastinum is posterior to the body of the sternum and anterior to the pericardial sac (see Fig. 3.57). Its superior boundary is a transverse plane passing from the sternal angle to the intervertebral disc between vertebra TIV and TV, separating it from the superior mediastinum. Its inferior boundary is t... | Anatomy_Gray. The anterior mediastinum is posterior to the body of the sternum and anterior to the pericardial sac (see Fig. 3.57). Its superior boundary is a transverse plane passing from the sternal angle to the intervertebral disc between vertebra TIV and TV, separating it from the superior mediastinum. Its inferior... | [
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Anatomy_Gray_379 | Anatomy_Gray | The middle mediastinum is centrally located in the thoracic cavity. It contains the pericardium, heart, origins of the great vessels, various nerves, and smaller vessels. The pericardium is a fibroserous sac surrounding the heart and the roots of the great vessels. It consists of two components, the fibrous pericardium... | Anatomy_Gray. The middle mediastinum is centrally located in the thoracic cavity. It contains the pericardium, heart, origins of the great vessels, various nerves, and smaller vessels. The pericardium is a fibroserous sac surrounding the heart and the roots of the great vessels. It consists of two components, the fibro... | [
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Anatomy_Gray_380 | Anatomy_Gray | The parietal layer of serous pericardium lines the inner surface of the fibrous pericardium. The visceral layer (epicardium) of serous pericardium adheres to the heart and forms its outer covering. The parietal and visceral layers of serous pericardium are continuous at the roots of the great vessels. The narrow space ... | Anatomy_Gray. The parietal layer of serous pericardium lines the inner surface of the fibrous pericardium. The visceral layer (epicardium) of serous pericardium adheres to the heart and forms its outer covering. The parietal and visceral layers of serous pericardium are continuous at the roots of the great vessels. The... | [
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Anatomy_Gray_381 | Anatomy_Gray | The fibrous pericardium is a cone-shaped bag with its base on the diaphragm and its apex continuous with the adventitia of the great vessels (Fig. 3.59). The base is attached to the central tendon of the diaphragm and to a small muscular area of the diaphragm on the left side. Anteriorly, it is attached to the posterio... | Anatomy_Gray. The fibrous pericardium is a cone-shaped bag with its base on the diaphragm and its apex continuous with the adventitia of the great vessels (Fig. 3.59). The base is attached to the central tendon of the diaphragm and to a small muscular area of the diaphragm on the left side. Anteriorly, it is attached t... | [
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Anatomy_Gray_382 | Anatomy_Gray | The phrenic nerves, which innervate the diaphragm and originate from spinal cord levels C3 to C5, pass through the fibrous pericardium and innervate the fibrous pericardium as they travel from their point of origin to their final destination (Fig. 3.60). Their location, within the fibrous pericardium, is directly relat... | Anatomy_Gray. The phrenic nerves, which innervate the diaphragm and originate from spinal cord levels C3 to C5, pass through the fibrous pericardium and innervate the fibrous pericardium as they travel from their point of origin to their final destination (Fig. 3.60). Their location, within the fibrous pericardium, is ... | [
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Anatomy_Gray_383 | Anatomy_Gray | The zone of reflection surrounding the veins is J-shaped, and the cul-de-sac formed within the J, posterior to the left atrium, is the oblique pericardial sinus. A passage between the two sites of reflected serous pericardium is the transverse pericardial sinus. This sinus lies posterior to the ascending aorta and the ... | Anatomy_Gray. The zone of reflection surrounding the veins is J-shaped, and the cul-de-sac formed within the J, posterior to the left atrium, is the oblique pericardial sinus. A passage between the two sites of reflected serous pericardium is the transverse pericardial sinus. This sinus lies posterior to the ascending ... | [
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Anatomy_Gray_384 | Anatomy_Gray | Veins from the pericardium enter the azygos system of veins and the internal thoracic and superior phrenic veins. Nerves supplying the pericardium arise from the vagus nerve [X], the sympathetic trunks, and the phrenic nerves. It is important to note that the source of somatic sensation (pain) from the parietal pericar... | Anatomy_Gray. Veins from the pericardium enter the azygos system of veins and the internal thoracic and superior phrenic veins. Nerves supplying the pericardium arise from the vagus nerve [X], the sympathetic trunks, and the phrenic nerves. It is important to note that the source of somatic sensation (pain) from the pa... | [
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Anatomy_Gray_385 | Anatomy_Gray | C3, C4, and C5. The general shape and orientation of the heart are that of a pyramid that has fallen over and is resting on one of its sides. Placed in the thoracic cavity, the apex of this pyramid projects forward, downward, and to the left, whereas the base is opposite the apex and faces in a posterior direction (Fig... | Anatomy_Gray. C3, C4, and C5. The general shape and orientation of the heart are that of a pyramid that has fallen over and is resting on one of its sides. Placed in the thoracic cavity, the apex of this pyramid projects forward, downward, and to the left, whereas the base is opposite the apex and faces in a posterior ... | [
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Anatomy_Gray_386 | Anatomy_Gray | Because the great veins enter the base of the heart, with the pulmonary veins entering the right and left sides of the left atrium and the superior and inferior venae cavae at the upper and lower ends of the right atrium, the base of the heart is fixed posteriorly to the pericardial wall, opposite the bodies of vertebr... | Anatomy_Gray. Because the great veins enter the base of the heart, with the pulmonary veins entering the right and left sides of the left atrium and the superior and inferior venae cavae at the upper and lower ends of the right atrium, the base of the heart is fixed posteriorly to the pericardial wall, opposite the bod... | [
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Anatomy_Gray_387 | Anatomy_Gray | The anterior surface faces anteriorly and consists mostly of the right ventricle, with some of the right atrium on the right and some of the left ventricle on the left (Fig. 3.65). The heart in the anatomical position rests on the diaphragmatic surface, which consists of the left ventricle and a small portion of the ri... | Anatomy_Gray. The anterior surface faces anteriorly and consists mostly of the right ventricle, with some of the right atrium on the right and some of the left ventricle on the left (Fig. 3.65). The heart in the anatomical position rests on the diaphragmatic surface, which consists of the left ventricle and a small por... | [
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Anatomy_Gray_388 | Anatomy_Gray | Some general descriptions of cardiac orientation refer to right, left, inferior (acute), and obtuse margins: The right and left margins are the same as the right and left pulmonary surfaces of the heart. The inferior margin is defined as the sharp edge between the anterior and diaphragmatic surfaces of the heart (Figs ... | Anatomy_Gray. Some general descriptions of cardiac orientation refer to right, left, inferior (acute), and obtuse margins: The right and left margins are the same as the right and left pulmonary surfaces of the heart. The inferior margin is defined as the sharp edge between the anterior and diaphragmatic surfaces of th... | [
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Anatomy_Gray_389 | Anatomy_Gray | For radiological evaluations, a thorough understanding of the structures defining the cardiac borders is critical. The right border in a standard posteroanterior view consists of the superior vena cava, the right atrium, and the inferior vena cava (Fig. 3.67A). The left border in a similar view consists of the arch of ... | Anatomy_Gray. For radiological evaluations, a thorough understanding of the structures defining the cardiac borders is critical. The right border in a standard posteroanterior view consists of the superior vena cava, the right atrium, and the inferior vena cava (Fig. 3.67A). The left border in a similar view consists o... | [
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Anatomy_Gray_390 | Anatomy_Gray | Internal partitions divide the heart into four chambers (i.e., two atria and two ventricles) and produce surface or external grooves referred to as sulci. The coronary sulcus circles the heart, separating the atria from the ventricles (Fig. 3.68). As it circles the heart, it contains the right coronary artery, the smal... | Anatomy_Gray. Internal partitions divide the heart into four chambers (i.e., two atria and two ventricles) and produce surface or external grooves referred to as sulci. The coronary sulcus circles the heart, separating the atria from the ventricles (Fig. 3.68). As it circles the heart, it contains the right coronary ar... | [
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Anatomy_Gray_391 | Anatomy_Gray | These sulci are continuous inferiorly, just to the right of the apex of the heart. The heart functionally consists of two pumps separated by a partition (Fig. 3.69A). The right pump receives deoxygenated blood from the body and sends it to the lungs. The left pump receives oxygenated blood from the lungs and sends it t... | Anatomy_Gray. These sulci are continuous inferiorly, just to the right of the apex of the heart. The heart functionally consists of two pumps separated by a partition (Fig. 3.69A). The right pump receives deoxygenated blood from the body and sends it to the lungs. The left pump receives oxygenated blood from the lungs ... | [
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Anatomy_Gray_392 | Anatomy_Gray | Interatrial, interventricular, and atrioventricular septa separate the four chambers of the heart (Fig. 3.69B). The internal anatomy of each chamber is critical to its function. In the anatomical position, the right border of the heart is formed by the right atrium. This chamber also contributes to the right portion of... | Anatomy_Gray. Interatrial, interventricular, and atrioventricular septa separate the four chambers of the heart (Fig. 3.69B). The internal anatomy of each chamber is critical to its function. In the anatomical position, the right border of the heart is formed by the right atrium. This chamber also contributes to the ri... | [
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Anatomy_Gray_393 | Anatomy_Gray | The superior vena cava enters the upper posterior portion of the right atrium, and the inferior vena cava and coronary sinus enter the lower posterior portion of the right atrium. From the right atrium, blood passes into the right ventricle through the right atrioventricular orifice. This opening faces forward and medi... | Anatomy_Gray. The superior vena cava enters the upper posterior portion of the right atrium, and the inferior vena cava and coronary sinus enter the lower posterior portion of the right atrium. From the right atrium, blood passes into the right ventricle through the right atrioventricular orifice. This opening faces fo... | [
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Anatomy_Gray_394 | Anatomy_Gray | The space posterior to the crista is the sinus of venae cavae and is derived embryologically from the right horn of the sinus venosus. This component of the right atrium has smooth, thin walls, and both venae cavae empty into this space. The space anterior to the crista, including the right auricle, is sometimes referr... | Anatomy_Gray. The space posterior to the crista is the sinus of venae cavae and is derived embryologically from the right horn of the sinus venosus. This component of the right atrium has smooth, thin walls, and both venae cavae empty into this space. The space anterior to the crista, including the right auricle, is so... | [
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Anatomy_Gray_395 | Anatomy_Gray | An additional structure in the right atrium is the opening of the coronary sinus, which receives blood from most of the cardiac veins and opens medially to the opening of the inferior vena cava. Associated with these openings are small folds of tissue derived from the valve of the embryonic sinus venosus (the valve of ... | Anatomy_Gray. An additional structure in the right atrium is the opening of the coronary sinus, which receives blood from most of the cardiac veins and opens medially to the opening of the inferior vena cava. Associated with these openings are small folds of tissue derived from the valve of the embryonic sinus venosus ... | [
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Anatomy_Gray_396 | Anatomy_Gray | The fossa ovalis marks the location of the embryonic foramen ovale, which is an important part of fetal circulation. The foramen ovale allows oxygenated blood entering the right atrium through the inferior vena cava to pass directly to the left atrium and so bypass the lungs, which are nonfunctional before birth. Final... | Anatomy_Gray. The fossa ovalis marks the location of the embryonic foramen ovale, which is an important part of fetal circulation. The foramen ovale allows oxygenated blood entering the right atrium through the inferior vena cava to pass directly to the left atrium and so bypass the lungs, which are nonfunctional befor... | [
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Anatomy_Gray_397 | Anatomy_Gray | The outflow tract of the right ventricle, which leads to the pulmonary trunk, is the conus arteriosus (infundibulum). This area has smooth walls and derives from the embryonic bulbus cordis. The walls of the inflow portion of the right ventricle have numerous muscular, irregular structures called trabeculae carneae (Fi... | Anatomy_Gray. The outflow tract of the right ventricle, which leads to the pulmonary trunk, is the conus arteriosus (infundibulum). This area has smooth walls and derives from the embryonic bulbus cordis. The walls of the inflow portion of the right ventricle have numerous muscular, irregular structures called trabecul... | [
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-0.7107263803482056... |
Anatomy_Gray_398 | Anatomy_Gray | There are three papillary muscles in the right ventricle. Named relative to their point of origin on the ventricular surface, they are the anterior, posterior, and septal papillary muscles: The anterior papillary muscle is the largest and most constant papillary muscle, and arises from the anterior wall of the ventricl... | Anatomy_Gray. There are three papillary muscles in the right ventricle. Named relative to their point of origin on the ventricular surface, they are the anterior, posterior, and septal papillary muscles: The anterior papillary muscle is the largest and most constant papillary muscle, and arises from the anterior wall o... | [
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-0.76052260398864... |
Anatomy_Gray_399 | Anatomy_Gray | The septal papillary muscle is the most inconsistent papillary muscle, being either small or absent, with chordae tendineae emerging directly from the septal wall. A single specialized trabeculum, the septomarginal trabecula (moderator band), forms a bridge between the lower portion of the interventricular septum and t... | Anatomy_Gray. The septal papillary muscle is the most inconsistent papillary muscle, being either small or absent, with chordae tendineae emerging directly from the septal wall. A single specialized trabeculum, the septomarginal trabecula (moderator band), forms a bridge between the lower portion of the interventricula... | [
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-0.7049386501312256,
-0.19658297300338745,
-0.6299952864646912,
... |
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