Review Anatomy notes

Dr amz
(Snell anatomy)

Diaphragm......xiphoid process, lower 6 costal cartilage

L1-L3 vetebrae ( Rt crus)
L1-L2 vetebrae (Lf crus)
Medial arcuate lig (L1-L2)
Lateral arcuate lig (L1-12th rib)
Increases vertical diameter
External intercostal.... Inc AP and transverse diameter
(Down n fwd)
Serratus post superior .... Elevates ribs
Serratus post inferior..... Lowers ribs
Internal intercostal... Down n backward
Neurovascular bundle....( VAN) above downwards...Vein, Artery, Nerve
Needle is inserted in upper border of lower rib

@ inspiration... Diaphragm is at 6th rib

@expiration.... 5th rib
CEA....caval, Esoph, Aortic
(8,10,12)....IP, EV,AAT ....IP = IVC, Rt phrenic nerve.....EV= Esophagus,Rt n
Lf vagus......AAT= aorta,Azygous, thoracic duct
Intercostal nerve... T1-T11
Mediastinum....
Superior mediastium... Sternum to 4th rib
Contents:

Thymus

Brachiocephalic vein n Artery

SVC

Left common carotid

Lft subclavian Artery

Arch of aorta

Phrenic n Vagi

Recurrent laryngeal nerve

Cardiac nerve

Trachea n lymph node

Esoohagus

Thoracic duct

Symp trunk

Anterior mediastinum:

Sternopericardial ligament

Lymph node

Middle mediastinum:

Pericardium

Heart n great vessels

Phrenic nerve

Bifurcation of trachea

Posterior mediastium:

Descending aorta

Esophagus

Thoracic duct

Azygous n hemizygous vein

Vagus

Splanchnic nerve

Sympathetic trunk and lymoh node

Trachea:
C6-cricoid cartilage
Bifurcate @ T4-T5 (sternal angle)
13cm loing (4-6cm in neonates)
2.5cm wide
Parietal pleura: costal side supplied by internal intercostal nerve
Diaphragmatic n mediastinal side.....phrenic nerve
Lung:
Oblique fissure: spinous process of T4, 5th ICS, 6th rib
Horizontal fissure : 5th rib
Contents of inferior pulm lig: inf. Pulm vein,intrapulm lymph node, bronchial
veins
Bronchial veins : azygous n hemizygous vein
Heart:
Transverse sinus:reflection of serous pericardium on aorta
Oblique sinus: reflection of serous pericardium on IVC n SVC n pulm vein
Pericardium supplied by phrenic nerve
Rt Atrium (smooth) n auricle (rough) meet at sulcus terminalis wich contains
crista terminalis (formed by sinus venosus n rt atrium in embryo)
Tricuspid HS: at Rt sternal border
Pulm HS : 2nd Lf ICS
Aortic HS : 2nd Rt ICS
Rt coronary artery: arise from ant aortiv sinus (first branch)
Lf coronary artery: arise from Lf post aortic sinus
Ant cardiac vein: drains directly into Rt atrium
Middle cardiac vein, small cardiac, great cardiac...........drain into coronary sinus
= into Rt atrium
Sympathetic stimulation= inc heart rate, inc foirce of contraction, dilate coronary
artery

Rt ascending lumbar vein, Rt subcostal vein, 8th lower Rt IC vein, Rt superior IC

vein, superior n inferior hemiazygous, mediastinal veins = drain into Azygous
vein
Rt subclavian, Rt internal jugular = drain into Rt brachiocephalic
Rt brachio + Lf brachio = into SVC
Thoracic duct drains into Lf brachiocephalic vein
Rt lymph duct ( drains Rt half of head, neck n thorax) = drains into Rt
brachiocephalic
Phrenic nerve.... C3,C4,C5
Infront of root of lung
Sensory supply to...pericardium,mediastinal perietal pleura, upper n lower
central diaphragm (corners of diaphragm r supplied by IC..intercostal
nerves)
Sympathetic supply..... White n grey rami communicantes only in thoracic region
White = preganglionic
Grey = postganglionic
Espohagus: 25 cm
From pharynx i.e C6 till T10
Constrictions: at beginning, at Lf bronchus, at Diaphragm
Upper esop: Inf thyroid arterty n vein, deep cervical lymphnodes
Middle esop: descending aorta,azygous vein, sup n post mediastinal l.n
Lower esop: left gastric artey n vein, left gastric n celiac l.n
Lf recurrent laryngeal nerve arises from vagus @ sternal angle
Rt recurrent laryn nerve arises in neck, doesnt enter thorax, hooks @ Rt
subclavian artery
Pericardial aspiration: Lf of xiphoid process @ 6th ICS, upward n backward @45
angle
Diaphragm atic surface of Lf ventricle = supplied by Post Interventricular branch
(RCA) n ant IV branch (LCA)
Post wall of Rt atrium,auricle n AV node = supplied by RCA