Thorax CHAPTER 1
(, thorax). (chest) (thorax),. (chest) (pectoral),, () ( ), ( )., (breast). (, thoracic cavity).. ( ) (thoracic cage, rib cage), (, sternum) (, thoracic vertebrae) (, rib) (, costal cartilage) (horizontal bar) ( 1 1). (thoracic diaphragm). (, liver). (thorax), (chest). (thorax). (mediastinum) (, lung). (pulmonary cavity).,... (mammary gland) (reproductive organ), (, breast).,, (, rib). (back). (, breast)., ( ) ( 6 ).. ( ).
..,,,.,. (,,, ) (),.,. ( ). (thoracic skeleton) (thoracic cage) ( 1 1),. 12 (, rib) (costal cartilage), 12 (thoracic vertebrae) (intervertebral disc), (, sternum).,. ( 1 1, 1 2).. (bone marrow, ),., 1. true (vertebrocostal) rib ( ). 2. false (vertebrochondral) rib (, ),. 3. floating (vertebral, free) rib (, ).. () (head) (crest of head) ( 1 2, 1 3). (neck). (tubercle) ( 1 8B). (shaft), (costal angle). ( 4 4 6 ). (costal groove). (,, ) ( 1 3) ( ), 7. T1.
.,, T1, T2. (, tuberosity for serratus anterior)... (costal cartilages).. 7. (, costal margin) ( 1 1A, 1 13).,., ( 1 5). (intercostal space) ( 1 1A)... 11 11. (, ). (, subcostal space) T12., (inspiration),. (thoracic vertebrae) ( 1 4, 1 5). (, costal facet),. (, costal facet of transverse process).,. (superior and inferior costal facet) (demifacet), (T2 T9).,. 1 ( T6 ). (whole costal facet) T1 C7, T1. T1. T10 1,. T11, T12 1. ( T6, T7) () (, spinous process), ( 1 4D, 1 5). (, lamina) (vertebral canal). (superior articular process) (superior articular facet), (inferior articular process) (inferior articular facet). ( 1 4A C).., sternum sternon() ( 1 6).,. (, manubrium), (, body of sternum) ( xiphoid process).
(, synchondroses)., manubrium handle( ),.. (, jugular notch, suprasternal notch). ( ) ( ),, sternoclavicular (SC) joint ( clavicular notch) (). (syndondrosis of the first rib)( 1 1A, 1 6A). (, manubriosternal joint), sternal angle (of Louis) ( 1 6A, B)., T5 T9 ( 1 6A C). (, costal notch)., (sternebrae, primordial segments of sternum). (, sternal synchondroses). 25. (transverse ridges) ( 1 6A),. (xiphoid process). T10.,,,. 40.. (xiphisternal joint). (, infrasternal angle, subcostal angle) ( 1 1A)..
,.. (, diaphragm),. / (). (thoracic inlet) (superior thoracic aperture) ( 1 7) T1. 1.. (trachea), (esophagus),,. 6.5cm, 11cm. 2 4 inch.. (thoracic outlet) (, inferior thoracic aperture) T12... (, xiphisternal joint)...,. ( ) ()., ( ) ( ).,,, ( 1 1A, B).,.,., (, ).. 1 8. 1 1. (intervertebral joint) (intervertebral disc). 4. (, sternoclavicular joint) 6. ( 1 5).
(joints of heads of ribs). ( ),, ( 1 4, 1 8A). T6 T5,. (, crest of head of rib) (, intra-articular ligament of head of rib), 2 (synovial cavity). (fibrous layer of joint capsule) (, radiate ligament of head of rib), ( 1 8A, B). ( )., ( ). (, costotransverse joints). (, vertebral arch). (, costotransverse ligament) (, lateral costotransverse ligament). (, superior costotransverse ligament) (, crest of neck of rib).... 6 ( 1 9)., ( 1 8A, B). (, 1 10A, C). ( 1 9), (, 1 10B, C). (, manubrium) (synchondrosis of 1st rib).., (radiate sternocostal ligaments).,.
(, inspiration) ( 1 10D, F). ( ),,,, ( )., (intrathoracic pressure) ( 1 10E, C)., (intra-abdominal pressure).. (, vertical dimension) ( 1 10F)..,. (AP dimension). ( ) ( 1 10A, C).,,. (transverse dimension) ( ) ( 1 10B, C).,, ( 1 10C, F). (, chest pain), (Swartz, 2005).,.. (heart attack) (substernal pain).. ( ). (, brachial plexus) (, subclavian vessel).. (rib fracture)., ( ) (). (lower rib fracture), (diaphragmatic hernia) ( 2 ).,,... (flail chest),.. /. (thoracotomy) ( B1 1). (anterior thoracotomy) H ( 1 13). (posterior thoracotomy). ( B1 1).,..
H,. (, pneumonectomy)., (periosteal sheath).,. 12, ( 4 ). (0.5~2%). (superior thoracic aperture). (supernumerary rib). ( ).,.,. 40 (ossified xiphoid process). (epigastric fossa).. (sternal fracture).,.. (comminuted fracture)., (deep fascia,, 1 6A),. (, sternal angle), (, manubriosternal joint)..
(,, ) ( ). 25 45%. (Rosen, 2005). (, coronary artery bypass grafting),. (, median sternotomy). ( ).. (bone marrow needle biopsy). (, cortical bone) (, spongy bone). (blood dyscrasia). () (, sternal band bar) ( ).. (, ectopia cordis) (, complete sternal cleft). ( ) ( ) V U, (direct apposition). (sternal plate) (, sternal foramen).. (pectus excavatum, funnel chest) (pectus cavinatum, pigeon chest).,.,. (, thoracic inlet). (, thoracic outlet), T1 (). (thoracic outlet syndrome) (Rowland, 2005)., (roof of the neck) ( 6, 8 ). (rib dislocation, slipping rib syndrome), (dislocation of sternocostal joint)..,. (displacement of interchondral joint)... (rib separation)., (tearing).,. (, phrenic nerve). (paralysis of the diaphragm). (, inspiration) ( B1 2A),, ( B1 2B).
(, expiration).. (axioappendicular muscle) ( ) (, )., ( 1 11). ( 6 ). (pectoralis major) (pectoralis minor) (serratus anterior) ( 100m ). (, scalene muscle),.. (true muscle) (, serratus posterior), (, levatores costarum), (, intercostal), (, subcostal), (, transversus thoracis). 1 12A, B, 1 2. (serratus posterior muscle)
. (, serratus posterior superior). (, serratus posterior inferior). (Vilensky et al., 2001).. (myofacial pain syndrome). (, levatores costarum muscle).. (, intercostal muscles) ( 1 11~1 14, 1 2). (, external intercostal m), (, internal intercostal)., (, innermost intercostals) (11, external intercostal muscles) ( 1 11~1 13, 1 15). (, external intercostal membrane) ( 1 15A).. ( 1 15C). (, external abdominal oblique muscles).. (11,, internal intercostal muscles) ( 1 12B, 1 14, 1 15C).., ( 1 16). (, internal intercostal membrane) ( 1 15A). (, internal abdominal oblique muscle).