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Anatomy Atlases: Atlas of Human Anatomy in Cross Section: Section 3. Middle Thorax (Heart and Lungs)

Atlas of Human Anatomy in Cross Section: Section 3. Middle Thorax (Heart and Lungs)

Plate 3.5

Ronald A. Bergman, Ph.D., Adel K. Afifi, M.D., Jean J. Jew, M.D., and Paul C. Reimann, B.S.
Peer Review Status: Externally Peer Reviewed

Plate 3.5

Upper Left Quadrant

Lower Left Quadrant

Lower Right Quadrant

Upper Right Quadrant

1. Costomediastinal recess
2. Right coronary a. and v. in coronary sulcus
3. Costosternal articulation, synovial joint
4. Internal thoracic a. and v.
5. Pleural cavity
6. Rib 4
7. Pectoralis major m.
8. Right atrium
9. Pectoralis minor m
10. Septum membranaceum (atrioventricular part)
11. Ribs
12. Phrenic nerve
13. Lung, right upper lobe, anterior segment
14. Superior vena cava
15. Foramen ovale
16. Rib 6
17. Pericardium and left atrium
18. Pulmonary v., right inflow tract

19. Intercostal neurovascular bundle
20. Lung, right lower lobe, superior segment
21. Long thoracic nerve and lateral thoracic a. and v.
22. Rib 7
23. Thoracodorsal nerve and thoracodorsal a. and v.
24. Latissimus dorsi m.
25. Intercostal neurovascular bundle in costal groove
26. Right vagus and esophageal plexus
27. Esophagus
28. Esophageal blood vessels
29. Greater splanchnic nerve, azygos v., and thoracic duct
30. Intercostal a. and v.
31. Longissimus dorsi m.
32. Vertebral body, T8 (middle)
33. Spinal cord, ventral columns, and spinal nerve in vertebral notch
34. Spinal cord, dorsal columns
35. Vertebral spinous process of T7

36. Semispinalis dorsi and multifidus mm.
37. Trapezius m.
38. Vertebral transverse process (T8)
39. Spinal nerve ganglion
40. Hemiazygos v.
41. Rib 8 and latissimus dorsi m.
42. Left pulmonary v. br.
43. Teres major m.
44. Lung, left lower lobe
45. Serratus anterior m.
46. Thoracodorsal nerve, a., and v. and latissimus dorsi m.
47. Lung, left lower lobe, anterior medial basal segment and thoracic aorta
48. Bronchus
49. Left vagus nerve and left pulmonary ligament

50. Lung, left upper lobe, lower division (lingular) inferior segment, and left pulmonary v.
51. Coronary sinus, pulmonary interlobar (oblique) fissure
52. Left coronary a., circumflex br.
53. Left ventricular myocardium, cardiac fossa
54. Lung, left lower lobe, superior segment, and parietal pleura
55. Mitral valve, ostium
56. Epicardium (visceral pericardium)
57. Pericardial fat, pericardial and pleural cavities
58. Intercostal mm.
59. Left ventricle, papillary m.
60. Parietal and fibrous pericardium and parietal and visceral pleura
61. Aortic cardiac outlet
62. Left coronary a., anterior descending a. br.
63. Interventricular septum
64. Transversus thoracis m.
65. Lung, left upper lobe, upper division, anterior segment, and right ventricle
66. Rib 4, costal cartilage
67. Sternum, body and anterior mediastinum

This section passes through the middle of the eighth thoracic vertebra (32), grazing the inferior vertebral notch (33) and transverse processes (38). The tip of the spinous process of T7 (35) is also seen. Ventrally, the section includes the body of the sternum (67) and its articulation (3) with the fourth rib (66) cartilage. The section cuts ribs 4 (6, 66), 5 (11), 6 (16), 7 (22), and 8 (41).

In the middle mediastinum, the right atrium (8) is seen at the entrance of the superior vena cave (14). The right inferior pulmonary vein (18) and the left inferior pulmonary vein (50) are joined to the left atrium (17). The foramen ovale (15) is seen but was found to be functionally closed (typical of about 25~ of hearts). The origin of the aorta (61) is seen

at this level, which is just inferior to the aortic (semilunar) valve.

A well defined transversus thoracis muscle (64) is seen. Teres major (43) and pectoralis major (7) and minor (9) make their last appearance at this level.

The upper and lower lobes of the left lung and the upper and lower lobes of the right lung and some bronchopulmonary segments (13, 20, 54, 65) are identified in this cut.

The nerve supply to latissimus dorsi (24, 46), the thoracodorsal nerve (23, 46); the nerve to serratus anterior (45), the long thoracic nerve (21); and the nerve supply to the intercostal muscles, the intercostal neurovascular bundle (19, 25), are seen.

The thoracic duct (29) is located slightly ventral and medial to the azygos vein (29).

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