1. precentral gyrus postcentral gyrus

5. Main Contents The thoracic wall Breast Intercostal spaces Mediastinum
Concept, boundaries, division
Superior mediastinum
Posterior mediastinum

6. Introduction 1 formation 2 division： Thoracic wall—
Anterior region of thorax, anterolateral region of thorax and posterior region of thorax.
Thoracic cavity—mediastinum, left and right lung and pleura cavity.

7. The thoracic wall superficial structures 1)skin 2)superficial fascia
3)cutaneous nerve ：
The supraclavicular nerve
Anterior cutaneous branches of intercostal nerve
Lateral cutaneous branches of intercostal nerve

8. superficial structures
4) superficial vessels
artery:
perforating branches of internal thoracic artery
the branches of posterior intercostal A.
Vein：
→ internal thoracic V. and posterior intercostal V.
The V. of thoracic and abdominal wall→lateral thoracic V.

9. Deep structures Intercostal spaces Position Contents:
1) The intercostal externus
2) The intercostal internus
3) The intercostal intimus
4) The intercostal nerves:

12. Intercostal spaces 5) Veins and Arteries
6)The relationship of the intercostal nerve and vessels in the costal groove:
— V. A. N..

13. Mediastinum Boundaries Anterior: the sternum and costal cartilages.
Posterior: the thoracic vertebrae
Two sides: the mediastinal pleurae.
Superior: the thoracic inlet.
Inferior: the diaphragm

14. Mediastinum
2 Division
four parts of the
mediastinum

15. superior mediastinum glandular plane venous plane arterial-nervous plane visceral plane lymphatic plane
anterior layer
thymus or its rudiment;
right and left brachiocephalic V.;
superior vena cava;
middle layer(arterial layer)
aorta and its three branches;
right and left phrenic and vagus nerves;
posterior layer
trachea;
esophagus;
Left recurrent laryngeal nerve
thoracic duct.

17. superior mediastinum 1) Thymus Relationship ―two side:
―upper boundary:
―lower boundary:
External feature
―two unequal lateral lobes and a pyramidal lob.
2) Superior vena cava
3) The aortic arch and its branches

19. superior mediastinum 4)The thoracic part of trachea
in front of the the thoracic part of trachea :
① the sternal manubrium;
② origins of sternohyoid and sternothyroid muscles;
③ thymus;
④ left brachiocephalic V.,
⑤ aortic arch;
⑥ brachiocephalic trunk;
⑦ left common carotid A.
⑧ cardiac plexus and lymph nodes.

21. The Posterior Mediastinum
Main organs:
① principal bronchi;
② thoracic part of esophagus;
③ thoracic aorta;
④ thoracic duct;
⑤ azygos and hemiazygos V.;
⑥ vagus nerves;
⑦ sympathetic trunk and lymph nodes.

23. The Posterior Mediastinum
The thoracic part of esophagus
Relation
• Anteriorly:
• Posteiorly:
• Left side:
• Right side:.

24. The thoracic part of esophagus
2) Blood supply
Arteries:
• Superior part
• Inferior part
Veins:
→ azygos vein, hemiazygos vein,accessory hemiazygos vein → Superior vena cava

25. The thoracic part of esophagus
3) Lymphatic drainage
• Superior part
• Middle part
• Inferior part
• Part of it
4) Nerves

26. The Sympathetic Trunk • 10-20 ganglia and interganglionic fibers.
• upper 4th-5th ganglions→esophageal, cardic, pulmonary plexuses.
• 5th-9th ganglions→greater splanchnic N. →celial ganglion
• 10th-12th ganglions→lesser splanchnic N. →aorticorenal ganglion

27. Thoracic aorta 1）position and passage 2）branches
Parietal branches and visceral branches
3）relation
anteriorly：
posteriorly：
right：
left：

28. What are they in the posterior mediastinum?
Question ?
What are they in the posterior mediastinum?

29. Summary The thoracic wall Breast Intercostal spaces Mediastinum
Superior mediastinum
Posterior mediastinum

30. Thank You!