Identify the lines used in anatomical surface descriptions of the thorax. median line mid-axillary line mid-clavicular line

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1 L 14 A B O R A T O R Y Thorax THORACIC WALL Identify the lines used in anatomical surface descriptions of the thorax. median line mid-axillary line mid-clavicular line Identify the surface landmarks of the thorax jugular notch sternal angle xiphoid process infrasternal angle Identify muscles associated with thoracic wall and review specifics. Latissimus dorsi Serratus Posterior Sup/Inf. Serratus Anterior Pectoralis Major/Minor Erector Spinae scalenes Identify the intercostal muscles of the thoracic wall deepest layers are deep to intercostal vessels and nerves. Identify the attachment points, actions, and innervation source for these muscles. Identify the primary vascular source for the muscles of the thoracic wall. internal thoracic artery anterior intercostal arteries thoracic aorta posterior intercostal arteries Describe the venous drainage of the anterior thoracic wall. anterior intercostal veins internal thoracic veins posterior intercostal veins azygous vein (right) hemiazygous vein (left)

2 108 Laboratory 14 Thorax Thoracic Wall Muscle Origin Insertion Innervation Blood Supply Action External intercostal (1 ) Internal intercostal (1 ) Innermost intercostal (lateral) (1.5 ) Subcostalis (posterior) (2 ) Transverse thoracis (anterior) (3.5 ) Inferior border of superior Rib Superior border of inferior Rib of inferior Rib of posterior inferior Ribs near angle Posteroinferior Sternum Superior border of inferior Rib Inferior border of superior Rib of superior Rib of inferior Ribs 7-12 of Costal Cartilage 2-6 (T2-T10) (T2-T10) (T2-T10) (T7-T10) (T2-T6) Internal Thoracic A (elevate) (depress) (depress) (depress) (depress) BREAST AND LYMPHATIC TISSUE Describe the following anatomical structures associated with female breast tissue: nipple areola suspensory (Cooper s) ligaments axillary tail retromammary space Identify the primary vascular sources for breast tissue. anterior intercostal arteries lateral thoracic artery internal thoracic artery pectoral arteries (thoracoacromial trunk) Trace the lymphatic drainage pathway of the breast. areolar plexus areolar plexus parasternal nodes axillary nodes supra / infraclavicular nodes subclavian nodes thoracic/lymphatic duct brachiocephalic vein

3 Laboratory 14 Thorax 109 LUNGS AND PLEURAE Distinguish between the parietal and visceral pleurae. Describe the regions of the parietal pleurae. costal diaphragmatic mediastinal cervical Identify the fissures, lobes, and names of the bronchi of the lungs. lingula cardiac notch horizontal fissure oblique fissure tracheal bifurcation (carina) primary bronchi secondary (lobar) bronchi DIAPHRAGM Identify the central tendon of the diaphragm. Describe the apertures of the diaphragm and the structures that pass through them. Caval opening (T8-T9) inferior vena cava Esophageal hiatus (T10) esophagus, vagal trunks Aortic hiatus (T12) abdominal aorta, thoracic duct, splanchnic nerves Identify the primary vascular sources of the diaphragm. (superior phrenic) inferior phrenic pericardiophrenic musculophrenic Identify the phrenic nerve (C3-C5) and note its primary innervation target.

4 110 Laboratory 14 Thorax MEDIASTINUM Describe the three layers of pericardium. fiberous parietal visceral Describe the pericardial cavity and fluid. Describe the vascular supply to the pericardium. Describe the innervation of the pericardium. Identify the great vessels of the heart. superior vena cava inferior vena cava ascending aorta aortic arch pulmonary trunk pulmonary arteries Locate the following nerves: left/right vagus nerves ant/post vagal trunks phrenic nerve recurrent laryngeal nerve Identify the following structures associated with the mediastinum: trachea carina thymus esophagus aortic arch thoracic aorta brachiocephalic trunk common carotid artery subclavian artery brachiocephalic veins azygous vein hemiazygous vein superior vena cava sympathetic chain thoracic splanchnic nerves thoracic duct

5 Laboratory 14 Thorax 111 HEART Identify the 4 chambers of the heart. Identify the following atrial structures: superior vena cava inferior vena cava coronary sinus pectinate muscles tricuspid atrioventricular valve bicuspid/mitral atrioventricular valve interatrial septum fossa ovalis Identify the following internal structures/regions of the ventricles: trabeculae carneae papillary muscles chordae tendinae interventricular septum pulmonary semilunar valve aortic semilunar valve ligamentum arteriosum Identify the coronary arteries and their major branches Identify the major drainage of the heart Identify where the coronary sinus drains into the right atrium Arteries Veins Right Coronary posterior interventricular marginal Middle Cardiac Small Cardiac Coronary Sinus Left Coronary anterior interventricular circumflex marginal Great Cardiac

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