amp wall胸壁课件

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1、THORACICCAGEandWALLSURFACELANDMARKSLinesofOrientationRefer:Text:pp91-92(91)Syllabus:p44MidsternallineMidclavicularlineAnterioraxillarylinePosterioraxillarylineLinesofOrientationMidaxillarylineScapularlineSurfaceLandmarksJugularnotchSternalangle:Marksrib2

2、LiesatlevelofT4-5IVdiscApexheartbeat:LeftICspace5;midclavicularlineAorticvalve:RightICspace2SurfaceLandmarksInfrasternalangle:ImportantinCPR.Depressionbetweenistheinfrasternalfossa.XiphisternaljointwithinthefossaisatthelevelofthebodyofT9.SurfaceLandmarksP

3、ulmonaryvalveLeftICspace2TricuspidvalveRightICspace5BicuspidvalveLeftICspace5BifurcationoftracheaVertebrallevelT4-5SurfaceLandmarksPosteriorthorax:scapula:Scapularspineisatlevelof3rdribandT2vertebra.Inferiorscapularangleisatthelevelofthe7thrib,thespineofT

4、7orthebodyofT9.Costalmargin:Superiorpartismarkedbythe7thcartilage.Inferiorpartismarkedbythe10thcartilageCutaneousinnervationClavicularandscapularregions:C3-4Regionofxiphoidprocess:T6Anteriorthorax:T1-T6Upperextremity:C5-T1Lowerthoraxandanteriorabdomen:T7-

5、T12OSTEOLOGYOFTHETHORACICCAGEStructureoftheThoracicCageTwelvethoracicvertebraeTwelvepairsofribsandtheircostalcartilagesSternumIntercostalmusclesSuperiorBoundary(outlet)FirstthoracicvertebraFirstpairofribsandcostalcartilagesManubriumRefertoFig.14,p.53insyl

6、labusInferiorBoundary(outlet)TwelfththoracicvertebraTwelfthpairofribsandcostalcartilagesXiphisternaljointRefertoFig.14,p.53insyllabusBonesoftheThoracicCageManubriumBodyofsternum:FoursternebraeXiphoidprocessManubriosternaljoint:SymphysisSynostosisafterage3

7、0insomeRibsCosta:=Ribbone+itscartilageVertebrosternalribs:1-7Vertebrochondralribs:8-10Vertebralribs(floating):11-12TypicalRibHead:Twoarticularfacetsforarticulationwithcostaldemifacetsonadjacentthoracicvertebrae.Bonycrestbetweenfacetsforattachmenttointerve

8、rtebraldisc.TypicalRibNeck:Narrowportionbetweenheadandtubercle.Tubercle:Articulateswithtransverseprocessofvertebrawithsamenumber.TypicalRibShaftSternalextremityAngleTypicalRibCostalgroove:Containssuperiortoinferior: