Tiêu đề Excellence Anatomy (Thorax).pdf ✅

Excellence for MRCS OSCE By Dr. Rifat & Dr. Hasnat 1 THORAX TABLE OF CONTENTS S/L TOPICS PAGE NO 01 Sternum 02 02 Thoracic Inlet 03 03 Mediastinum 06 04 Heart 11 05 Lungs 18 06 Sympathetic Trunk 26 07 The Diaphragm 27
Excellence for MRCS OSCE By Dr. Rifat & Dr. Hasnat 2 STERNUM An elongated flat bone that occupies middle portion of anterior thoracic wall. It consists of 3 parts: ê Manubrium /Prosternum ê Body / Mesosternum ê Xiphoid process / Xiphisternum/ Metasternum STERNAL ANGLE (OF LOUIS) Situation: At the level of 2nd costal cartilage anteriorly and the disc between 4th and 5th thoracic vertebrae posteriorly. This level marks the upper border of heart and divides superior mediastinum from inferior mediastinum. CLINICAL IMPORTANCE OF STERNAL ANGLE (Mnemonic RATPLANT) ü Ribs are counted from this level. (2nd costal cartilage) ü Aorta- • Ascending aorta ends • Arch of aorta begins and also ends • Descending thoracic aorta begins at this level. ü Trachea – divides into right and left principal bronchi below this level (Upper T6). ü Pulmonary trunk – divides into right and left pulmonary artery at upper T6. ü Left recurrent laryngeal nerve bends below and behind arch of aorta. ü Azygos vein arches over root of the right lung and terminates into SVC ü Nerve plexus- Cardiac plexus lie at this level ü Thymus gland in some cases. ü Thoracic duct crosses midline from right to left (T5) ü Line of junction between C4 and T2 dermatome. ü Commonest site for sternal fracture. Fig - Vertebral level TIV/V
Excellence for MRCS OSCE By Dr. Rifat & Dr. Hasnat 3 THORACIC INLET Fig – Superior thoracic aperture Fig- Thoracic inlet and mediastinum from front
Excellence for MRCS OSCE By Dr. Rifat & Dr. Hasnat 4 What are the causes of TOS? ê Cervical rib ê Scalene hypertrophy ê Pancoast tumor Origin of subclavian artery? ê Right: Brachiocephalic trunk ê Left: Arch of aorta Which part of brachial plexus crosses the first rib posterior to subclavian artery? Lower trunk of brachial plexus How does bronchial carcinoma cause hoarseness of voice? Compression or invasion of recurrent laryngeal nerve (Pancoast tumor) Identify the upper trunk of brachial plexus? No 35