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Thoracic cavity ( Mediastinum, Pleura)
Mrs. Benish Islam Coordinator Lecturer Surgical(IPMS) KMU
MEDIASTINUM
Superior:Thoracic outletRoot of neck Inferior:Diaphragm Anterior:Sternum Posterior:Vertebral column It Contains:Thymus,trachea,oesophagus,Thoracicduct,heart,large vessels
Tough thick movable partition.
Inferior mediastinum (3 parts)
Contents of superior mediastinum Thymus Large vein Large arteries Trachea Esophagus Thoracic duct Sympathetic trunk Anterior:Sternum Posterior4 thoracic vertebra
Contents of inferior mediastinumthymusHeart with pericardiumPhrenic nervesEsophagusThoracic ductDescending
aortaSympathetic
trunk
Pleura
Pulmonary ligament
Pleural Space
Parts of pleura
Divisions according to regionsCervical pleura: extends upto neck,
lining undersurface supra pleural membrane, reaches 1-1.5 inch above one third of clavicle.
Costal pleura: linesribs, intercostal cartilage, intercostal space, back of sternum.
Diaphragmatic pleura: covers thoracic surface of pleura.
Mediastinal pleura: covers and forms later boundry of mediastinum.
Nerve Supply:(parietal pleura)Sensitive to pain, pressure,
temperature touch and supplied by:
Costal pleura: intercostal nerves
Mediastinal pleura: phrenic nerves
Diaphragmatic pleura: phrenic nerves and six intercostal nerves
Visceral pleura: Autonomic supply, pulmonary plexus
Pneumothorax
Air+Serous fluid=hydropneumothorax
Air+pus=pyopneumothoraxAir+blood=hemopneumhoraxA collection of pus (no
air)=empyemaSerous fluid= pleural effusion
Needle thoracostomy/Tube thoracostomy
Think pair and shareA patient presented with pain in
chest, there was dullness on percussion and dull breath sounds heard on stethoscope. Pleural effusion is suspected.
Patient is feeling pain in Parietal or Visceral pleura?
Thank you Learn Your lesson