Topographical Anatomy of the Thorax

Mediastinum superius

  • cranially: apertura thoracis sup. (T1, first rbs, upper border of sternum)
  • ventrally: manubrium sterni, ribs + muscles
  • dorsally: spine, ribs + muscles
  • laterally: pleura mediastinalis
  • caudally: arbitrary plane between angulus sterni and intervertebral disc of T4-5

    • Structures in 5 layers mentioned deepwards:

    1. thymus, insertions of mm. sternothyroideus and sternohyoideus, vasa thoracica int. + their branches

    2. layer of veins: vv. brachiocephalicae (plexus thyroideus impar, v. intercostalis sup. sin.) connect to form v. cava sup., ductus thoracicus, nn. phrenici

    3. layer of arteries: arcus aortae + its branches

    4. organs: trachea + bifurcatio tracheae (at the level of T4 vertebral body), oesophageus + nn. vagi, rr. cardiaci, n. laryngeus reccurens sin., nodi lymphoidei tracheobronchiales, nodi lymphoidei paratracheales, membrana bronchopericardiaca

    5. truncus sympathicus dx. et sin, nn. cardiaci, nodi lymphoidei juxtaoesophageales, m. longus colli

    		Mediatsinum anterius
  • cranially:arbitrary plane between angulus sterni and intervertebral disc of T4-5
  • ventrally: corpus sterni, ribs + muscles
  • dorsally: pericardium
  • caudally: diaphragma
  • ligg. sternopericardiaca
  • nodi lymphoidei parasternales, prepericardiaci
  • vasa thoracica int. + their branches
  • m. transversus thoracis
    • Mediatsinum medium
  • cranially: arbitrary plane between angulus sterni and intervertebral disc of T4-5
  • ventrally: pericardium
  • dorsally: pericardium
  • caudally: diaphragma
    		•
  • heart in the pericard
  • aorta ascendens, truncus pulmonalis
  • v. cava sup. (+ estuary of v. azygos), v. cava inf.
  • nn. phrenici, vasa percardiacophrenica
  • plexus cardiacus
  • vv. pulmonales
  • nodi lymphoidei pericardiaci laterales
    • Mediatsinum posterius
  • cranially: arbitrary plane between angulus sterni and intervertebral disc of T4-5
  • ventrally: pericardium
  • dorsally: spine, ribs + muscles
  • caudally: diaphragma
    		•
  • esophagus + plexus oesophageus
  • truncus sympathicus + nn. splanchnici (major, minor, imus)
  • nodi lymphoidei prevertebrales, juxtaoesophageales
  • ductus thoracicus
  • v. azygos, hemiazygos et hemiazygos accessoria (+ their tributaries)
  • aorta thoracica + its branches
    		•

    Recessus pleurales

    		 
  • recessus costodiaphragmaticus (the most caudal place of pleural cavity)
  • recessus costomediastinalis
  • recessus phrenicomediastinalis
  • recessus vertebromediastinalis
    		•

    Diaphragma

    pars lumbalis (crus sin.,dx.)

    hiatus aorticus (between crura diaphragmatis, bordered by lig. arcuatum medianum)

    hiatus oesophageus (in crura diaphragmatis)

    foramen venae cavae (in centrum tendineum)

    pars costalis, pars sternalis

    trigonum strenocostale + lumbocostale

    → truncus sympathicus, nn. splanchnici, (v. azygos et hemiazygos)

    → aorta thoracica/abdominalis, ductus thoracicus (v. azygos et hemiazygos)

    → oesophagus, truncus vagalis ant., post. (+ rr. gastrici), rr. oesophageales a. et v. gastricae sin.

    → v. cava inf., rr. phrenicoabdominales n. phrenici dx.

     

     

    Spatium intercostale

  • between two neighbouring ribs
  • mm. intercostales ext (+ membrana intercostalis ext.)
  • mm. intercostales int.(+ membrana intercostalis int.)
  • nerves + vessels  - cranially: v. (cranially) + a. intercostalis ant. et post. (in the middle) + n. (caudally) intercostalis / caudally: r. collateralis a. intercostalis post. + r. collateralis n. intercostalis
  • mm. intercostales intimi
  • mm. subcostales

    •