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Thoracic Part of Sympathetic Chain
(Page 128)Dr.Sherif Fahmy
Course & Relations
Dr.Sherif Fahmy
Thoracic part of Sympathetic chain
Cervical part of sympathetic chain
Medial arcuate lig. of diaphragm
Abdominal part of sympathetic chain
Neck of 1st rib
Dr.Sherif Fahmy
Sympathetic chain
Medial arcuate ligament
Dr.Sherif Fahmy
Structure
Dr.Sherif Fahmy
Sympathetic ganglion
Dr.Sherif Fahmy
Branches- Rami communicants to
corresponding intercostal nerves.- To autonomic plexuses in thorax.- To aorta.- To abdominal organs through
splanchnic nerves.Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Greater splanchnic nerve
Dr.Sherif Fahmy
Applied Anatomy1- Spinal anesthesia at high level may lead to temporary drop of blood pressure.2- In case of essential hypertension, cutting of sympathetic chain between T2 & T5 will lead to drop of blood pressure.
Dr.Sherif Fahmy
Autonomic Plexes(Page 136)
1- Pulmonary Plexuses.2-Oesophageal plexuses.3- Cardiac plexuses (superficial and deep).
Dr.Sherif Fahmy
1- Pulmonary Plexus (Posterior & Anterior)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
2- Oesophageal Plexus(Anterior & Posterior)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
3- Cardiac Plexus (Superficial & Deep)
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Lymphatic Drainage
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Thoracic Lymph Drainage
A- From Chest wall.B- From thoracic contents.
Dr.Sherif Fahmy
A- From Chest Wall1- Superficial lymph vessels:- From front of chest to pectoral lymph nodes, parasternal or lower deep cervical lymph nodes.- From back of chest to subscapular nodes. Dr.Sherif
Fahmy
2- Deep lymph vessels:A- From anterior chest wall to parasternal nodes.B- Posterior part of chest wall to intercostal lymph nodes (opposite neck of ribs).C- Four diaphragmatic nodes (anterior, posterior and 2 lateral) which drain diaphragm and liver.Dr.Sherif
Fahmy
B- from Thoracic Contents
1- Anterior mediastinal nodes.2- Posterior mediastinal nodes.3- Nodes of lungs, bronchi and trachea.
Dr.Sherif Fahmy
•Lymph vessels from: -Anterior mediastinal nodes.-Tracheal lymph nodes.-Parasternal lymph nodes.Will unit together to form broncho-
medistinal lymph vessels which joins thoracic duct on left side and right lymphatic duct in right side.
Dr.Sherif Fahmy
Deep lymph nodes of chest wall
Dr.Sherif Fahmy
Anterior mediastinal nodes
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Thoracic Duct(Page 121)Dr.Sherif Fahmy
Dr.Sherif Fahmy
Cisterna chyli
Aortic opening of diaphragme
Left brachio-cephalic vein
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Tributaries of Thoracic Duct1- Lymph from intestine, abdominal wall and lower limb through cisterna chyli.2- Left broncho-mediastinal lymph vessels.3- Left subclavian lymph vessels.4- left jugular lymph vessels.5- posterior mediatinal lymph nodes.
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Esophagus(Page 117)Dr.Sherif Fahmy
Parts & Course
Dr.Sherif Fahmy
Level of C6 vertebra
Diaphragm
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Shape, Size and Curves
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Relations
Dr.Sherif Fahmy
Posterior
Dr.Sherif Fahmy
Anterior
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Left & Right
Dr.Sherif Fahmy
Constrictions
Dr.Sherif Fahmy
Beginning
Esophageal openning of diaphragme
At level of left bronchus
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Nerve Supply
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Dr.Sherif Fahmy
Blood Supply
Dr.Sherif Fahmy
Left & Right
Dr.Sherif Fahmy
Applied Anatomy1- Impaction of food.2- Barium swallow to determine enlargement of left atrium.3- Esophageal varices.
Dr.Sherif Fahmy
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