Anatomy Thorax

Thorax Esophageal Pathway Notes

noreply@blogger.com (Anonymous) — Thu, 07 Mar 2013 16:24:00 +0000

Esophagus Pathway

Blood Supply

Aorta  Aortic arch 

Left subclavian or brachiocephalic to right subclavian  thyrocervical  esophageal branches
Aorta  bronchial arteries  esophageal branches
Thoracic aorta  aortic esophageal arteries
Descending aorta  celiac trunk  left gastric  esophageal branches

Blood Drainage

Esophageal venous plexus

Upper esophagus

Inferior thyroid  brachiocephalic  SVC
Right side

Highest intercostal  azygous  SVC
Azygous  SVC

Left side

Highest intercostal  brachiocephalic  SVC
Accessory hemiazygos 

Highest intercostal  brachiocephalic  SVC
Azygous  SVC

Hemiazygos  azygous  SVC

Lower esophagus

Esophageal branches  left gastric  hepatic portal  liver  central veins  hepatic veins  IVC

Nerve Supply

Afferent

Somatic

N/A

Autonomic

Parasympathetic

Stretch and pain receptors  vagal fibers  ascend parallel to efferent parasympathetic fibers  jugular foramen  medulla

Sympathetic

N/A

Efferent

Somatic

N/A

Autonomic

Parasympathetic

Medulla  jugular foramen 

Recurrent laryngeal  upper esophagus plexus for swallowing
Anterior posterior vagal trunks  lower esophagus plexus

Sympathetic

IML  ventral root  thoracic spinal nerves  white rami  sympathetic ganglion 

Cervical ganglia (upper esophagus)  Ach synapse  esophageal plexus
Thoracic ganglia  Ach synapse  esophageal plexus
Greater thoracic splanchnic nerve  ach synapse  esophageal plexus

Thorax Posterior Heart Pathways Notes

noreply@blogger.com (Anonymous) — Thu, 07 Mar 2013 16:23:00 +0000

Posterior Heart Pathways

Blood Supply

Left ventricle  aortic valve  right or left coronary arteries

Right coronary artery  posterior descending artery
Left coronary artery  posterior left ventricle

Blood Drainage

`Middle cardiac vein  coronary sinus  RA
Posterior vein of left ventricle  coronary sinus  RA

Nerve Supply

Afferent

Somatic

N/A

Autonomic

Parasympathetic

Chemoreceptors and baroreceptors in great vessels  ascending fibers of vagus  jugular foramen  CV and respiratory centers of medulla

Sympathetic

Pain receptors in myocardium  ascending fibers through sympathetic cardiac nerves  sympathetic trunk ganglion  white rami  thoracic spinal nerves  dorsal root of spinal cord  anterolateral paths

Efferent

Somatic

N/A

Autonomic

Parasympathetic

Medulla  vagus  jugular foramen  thoracic vagal cardiac nerves  cardiac plexus  syn to postganglionic fiber  SA node, AV node, coronary arteries

Sympathetic

IML  ventral root  thoracic spinal nerves  white rami  sympathetic ganglion  ach synapse  postganglionic fiber  SA node, AV node, coronary artery, myocardium

Thorax Anterior Heart Pathway Notes

noreply@blogger.com (Anonymous) — Thu, 07 Mar 2013 16:22:00 +0000

Anterior Heart Pathways

Blood Supply

Left ventricle  aortic valve  right and left coronary arteries

Right coronary  marginal branches
Left coronary  left anterior descending

Blood Drainage

Anterior cardiac vein  small cardiac vein  right AV sulcus  coronary sinus  RA
Great cardiac vein  left AV sulcus  coronary sinus  RA

Nerves

Same as posterior heart

Thorax Diaphragm Pathway Notes

noreply@blogger.com (Anonymous) — Thu, 07 Mar 2013 16:20:00 +0000

Diaphragm Pathways

Blood Supply

Aorta  aortic arch  left subclavian or brachiocephalic to right subclavian  internal thoracic  pericardiophrenic  superior surface of diaphragm
Descending aorta  inferior phrenic

Blood Drainage

Inferior diaphragm  inferior phrenic  IVC
Superior diaphragm  pericardiophrenic  brachiocephalic  SVC

Nerves

Efferent

Somatic

Respiratory center in medulla  spinal cord  C345  cervical plexus  phrenic nerve

Autonomic

N/A

Afferent

Somatic

Upper and lower surface of diaphragm  upward through phrenic nerve C345 dorsal roots  spinal cord  medulla
Lower diaphragm  intercostal nerve  dorsal root T spinal nerves

Thorax Pleural Pathways

noreply@blogger.com (Anonymous) — Thu, 07 Mar 2013 16:18:00 +0000

Parietal Pleura Pathway

Blood Supply

Aorta  aortic arch 

Descending aorta  posterior intercostal  costal pleura
Left subclavian or brachiocephalic to right subclavian  internal thoracic  anterior costal pleura

Mediastinal pleura
Pericardiophrenic  diaphragmatic pleura

Blood Drainage

Diaphragmatic pleura  pericardiophrenic  brachiocephalic  SVC
Mediastinal pleura  internal thoracic  brachiocephalic  SVC
Costal pleura  internal thoracic  brachiocephalic  SVC
Costal pleura  intercostal vein 

Right azygous  SVC
Left hemiazygos  highest intercostal  brachiocephalic  SVC
Left hemiazygos  azygous  SVC

Nerves

Afferent

Pain

Costal pleura  intercostal nerve  dorsal root  anterolateral
Diaphragmatic and mediastinal pleura  phrenic  cervical plexus  C345  anterolateral paths