Heart innervation.
Afferent paths From hearts go in the composition N. Vagus, as well as in middle and lower cervical and chest heartless nurses. At the same time, in sympathetic nerves, a feeling of pain is carried out, and on parasympathetic - all other afferent impulses.
Efferent parasympathetic innervation. Preggangionary fibers begin in the dorsal vegetative core wandering nerve and go in the latter, its heart branches (Rami Cardiaci n. Vagi) and cardiac plexuses internal nodes Hearts, as well as nodes of the shallower fields. Postgangle fibers come from these nodes to the heart muscle.
Function: braking and oppression of heart activities; The narrowing of the coronary arteries.
Preggangionary fibers begin from side horns spinal cord 4 - 5 upper breast segments, out of respective RAMI Communicantes Albi and pass through a sympathetic barrel to five top chest and three cervical nodes. In these nodes begin postganglyonary fibers, which are as part of heart nerves, Nn. Cardiaci Cervicales Superior, Medius Et Inferior and Nn. Cardiaci Thoracici, reaches the heart muscle. Break is carried out only in Ganglion Stellatum. Cardiac nerves contain in its composition preggling fibers, which switched to postganglyonary in heart plexus cells.
Function: Strengthening the work of the heart (this was established by I. P. Pavlov in 1888, calling the sympathetic nerve reinforcing) and the acceleration of the rhythm (for the first time I installed I. F. Zion in 1866), expanding the coronary vessels.
Afferent paths from visceral pleura are pulmonary branches breast Department Sympathetic trunk, from parietal pleura - nn. INTERCOSTALES and N. Phrenicus, from bronchi - n. Vagus.
Efferent parasympathetic innervation. Preggangional fibers begin in the dorsal vegetative kernel of the wandering nerve and go in the last and its pulmonary branches to the Plexus Pulmonalis nodes, as well as nodes located along the trachea, bronchi and inside the lungs. Postgangngling fibers are sent from these nodes to muscles and iron bronchial wood.
Function: The narrowing of the lumen of the bronchi and bronchiole and the separation of mucus.
Efferent sympathetic innervation. Preggangonary fibers come out of the side horns of the spinal cord of the upper chest segments (THII - THVI) and pass through the corresponding Rami Communicantes Albi and a sympathetic barrel to star and upper chest nodes. The last postganglyonary fibers begin in the composition of pulmonary plexus to bronchial muscles and blood vessels.
Function: expansion of the lumen of bronchi; narrowing.
Burrying of pulmonary fabricexcept Alveol, is carried out by bronchial arteries, AA. Bronchiales, departing from the chest aorta. In lung, they follow the transition of the bronchi (from 1 to 4, more often 2-3).
Pulmonary arteries and veins Perform the function of blood oxygenation, providing power only the final alveoli.
Venous blood from lung fabric, bronchi and large vessels are subject to bronchial veins falling through v. Azygos or v. Hemiazygos in the system of the upper hollow vein, and also partially into pulmonary veins.
Lymphotok from light
Lymphottok from light and pulmonary pleura It goes on superficial and deep lymphatic vessels. Disclosures lymphatic vessels From the surface network is sent to regional NODI BRONCHOPULMONALES. Deep discrepancing lymphatic vessels, heading along the bronchi and vessels to regional lymph nodes, are interrupted into NODI Intrapulmonales lying on the bronchi forkliving, and then in Nodi Bronchopulmonales located at the lung gates. Next, the lymph flows into the upper and lower tracheobronchial and oilyrachemical lymph nodes.
Innervation of the lungs
Innervation of the lungs It is carried out by branches of wandering, sympathetic, spinal and diaphragmal nerves forming the front and rear pulmonary plexus, Plexus Pulmonalis. Branches from both plexuses are sent to the tissue of light by vessels and brutalies of the bronchi. In the walls of the pulmonary arteries and veins there are places of the greatest accumulation of nerve endings (reflexogenic zones). These are the mouths of the pulmonary vein and the initial part of the pulmonary trunk, the surface of its contact with the aorta and the bifurcation area.
Circulation in the lungs. In connection with the function of gas exchange lights get
not only arterial, but also venous blood. The latter flows through the branches
pulmonary artery, each of which enters the gate of the corresponding lung and
it is then divided according to the branch of the bronchi. The smallest branches of the pulmonary
the arteries form a network of capillaries, powered by alveoli (respiratory
capillaries). Venous blood flowing to pulmonary capillaries through branches
pulmonary artery, enters into osmotic metabolism (gas exchange) with contained in
alveole air: it highlights its carbon dioxide and gets in return
oxygen. From the capillaries there are veins carrying blood enriched
oxygen (arterial), and then forming larger venous trunks.
The latter merge further in VV. Pulmonales.
Arterial blood is brought into the lungs on RR. Bronchiales (from Aorta, AA.
intercostales Posteriores and a. Subclavia). They nourish the wall of the bronchi and the pulmonary
fabric from the capillary network, which is formed by the ramifications of these arteries,
there are VV. Bronchiales, blowing in part in VV. Azygos Et Hemiazygos, and
partly in VV. Pulmonales. Thus, the systems of pulmonary and bronchial veins
anastomed among themselves.
The lungs distinguish surface lymphatic vessels laid in
deep layer of pleura, and deep, intra-light. Root deep
lymphatic vessels are lymphatic capillaries forming networks
around respiratory I. terminal bronchiole, in monozhaqinous and interdolkovoy
partitions. These networks continue in the plexus of lymphatic vessels around
light artery branches, veins and bronchi.
The distinguished lymphatic vessels go to the root of the lung and lying here
lymph nodes, Nodi Lymphatici Bronchopulmonales et tracheobronchiales.
Tar as the endowing vessels of tracheobronchial nodes go to the right
venous corner, then a significant part of the lymph of the left lung, leaking from
his lower lobe enters the right lymphatic duct.
The nerves of the lungs occur from Plexus Pulmonalis, which is formed by branches
n. Vagus et truncus symphaticus.
Coming out of the named plexus, pulmonary nerves spread in shares
segments and loss of lung in the course of the bronchi and blood vessels,
components of vascular bronchial beams. In these beams, the nerves form
plexus in which microscopic intraganic nervous
nodules where the pregganese parasympathetic fibers switches on
postgangngling.
Three nervous plexuses are distinguished in bronchi: in Adventization, in muscle
layer and under the epithelium. Subpitheral plexus reaches Alveol. Besides
efferent sympathetic and parasympathetic innervation, light supplied
afferent innervation, which is carried out from the bronchi for wandering
nerve, and from visceral pleura - as part of the sympathetic nerves passing
through a cervical node.
Segmental lung structure. In the lungs there are 6 tubular systems: bronchi,
pulmonary arteries and veins, bronchial arteries and veins, lymphatic vessels.
Most of the branches of these systems are in parallel each other,
forming vascular bronchial beams that make up the basis of internal
light topography. Respectively, the vascular-bronchial beam each share
the lung consists of individual sections called bronchopulmonary segments.
Ticket number 44 (lech. Faculty)
Muscles and fascia breasts, structure, functions, blood supply, innervation.
Surface.
1.m. Pectoralismajor (big breast muscle)
Start: MedialN. floors. Clavicle, handle and sodium body, cartilage II-VII ribs, the front wall of the vagina's direct abdominal muscle.
Attachment: Comb Big Budrock Shoulder Bone.
Function: leads shoulder to the torso, lowers the raised shoulder. With fixed upper limbs Rims the ribs by participating in the act of breath. Inn: N.N.pectReles Medialis et Lateralis (CV-TH I).
Blood supply: AA. ThoracoCromialis Thoracica Lateralis, Thoracica Superior, RR. Intercostales anteriores.
2.m.pectoralisminor (small breast muscle).
Start: III-IV ribs. Attachment: Cravoid extension blades (pr.coracoideus). Function: pulls the blade ahead and down, with a strengthened shoulder belt raises the ribs. Inn: NN.pectRales Medialis et Lateralis (C VII- TH i). Snapshots: aa.thoracoacromialis, Intercostales Anterioris, Thoracica Superior.
3.m.subeclavius \u200b\u200b(plug-in).
Start: cartilage I edge. Attachment: acromial end of the clavicle. Function: pulls the clavicle medial and down. Inn: N.Subclavius \u200b\u200b(CV). Blood supply: A.Thoracicasuperior, A.ThoraCoachromialis.
4.M.Serratus Anterior (advanced).
Start: I-IX ribs. Attachment: medial edge and lower corner of the blade. Function: pulls the shovel lateral and down. TIN: N.THORACICUSLONGUS (CV-CVII). Blood supply: aa.thoracicodorsalis, thoracicalateralis, intercostales.
Deep.
1.mm.intercostalesexterni (outer intercostal muscle).
Start: Lower edge overlying ribs. Attachment: upper edge of the underlying ribs. Function: lifting up. Inn: NN.Intercostales (THI I- XI XI). Snapshots: Aa.intercostales Posteriores, Thoracica Interna, Musculophrenica.
2.mm.intercostales Interni (Internal Mix).
Start: upper edge of the underlying ribs. Attachment: Lower edge overlying ribs. Function: lowering ribs. Inn. And the blood supply is the same as the outer.
3.mm.subcostales (hypothematics).
Start: X-XII ribs, near their corners. Attachment: the inner surface of the overlying ribs. Function: lowering. Inn: NN.Intercostales (TH I - TH XI). Square: AA.Intercostales Posteriores.
4.M.TransVersus thoracis (cross-shifts).
Start: Movie-shaped process and edge of the bottom of the sternum body. Attachment: II-VI edges in bone connection places with cartilage. Function: lowering ribs. Inn: nn.intercostales (thii- thvi). Blood supply: A.Thoracicainterna.
5.mm.levatores Constarum (Rib).
Start: transverse process. Attachment: The angle of the nearest rib. Function: Subscribe. ribs. Inn: NN.Spinales, NN.Intercostales (CVIII, TH I - TH XI). Accessibility: A.Intercostales Posteriores.
Fascia
fascia Pectoralis (breast). Lamina SuperjucialISTWNABLIFTHEsShigsArticleSustoysuscissea, medial - hardened. Lateral and upwards continues in deltoid, lower - in the axillary fascia. Laminaprofunda lies at the back of a big breast muscle continues upwards. In FasciaClavipectoralis. Laterally and the Book of Chat. From the surface. Plast. This fascia. Actual and thoracic - Fasciathoracica, covers outside intercostal muscles and intracure ribs. Fascia EndothoracicAlifies the chest cavity from the inside, arrives from the inside to the inner intercostal muscles, the transverse muscle of the chest and the inner surface of the ribs.
Chest areas: Regiopectoralis is limited to the lower edge of the big breast muscle, at the top - Fossainfraclavicularis. Regiosternalis from the front median line to the ocolid line; REGIOAXILLARIS (axillary) in its composition includes an axillary fossaaxillaris. REGIOINFRAMAMMARIA (breeded) borders at the bottom of СRIOHYPOCHONDRIACA (hypotherapy). It is the bottom of the chest.
Arterial blood for powering the lung fabric and the walls of the bronchi enters the lungs through the bronchial branches from the thoracic part of the aorta. Blood from the walls of the bronchial over the bronchial veins is subject to the inflows of pulmonary veins, as well as in the unpaired and semi-park veins.
On the left and right pulmonary arteries in the lungs deoxygenated bloodwhich as a result of gas exchange is enriched with oxygen, gives carbon dioxide and becomes arterial.
Arterial blood from the lungs on the pulmonary veins is subject to the left atrium.
Light lymph vessels fall into bronchopal, lower and upper tracheobronchial lymph nodes.
The innervation of the lungs is carried out of the vagus nerve and from the sympathetic barrel, the branches of which in the field of the root of the lung form pulmonary plexusplexus. pulmonalis. The branches of this plexus on bronchoms and blood vessels penetrate the lung. In the walls of large bronchi there are plexuses of nerve fibers in Adventization, muscle and mucosa.
The paths of the outflow of lymphs from the right and left lungs, their regional lymphatic nodes.
On the path of lymphatic vessels The lungs are bronchopile lymph nodes. Intraghane bronchopal nodes are located in each light in the places of branching of the main bronchi to the equity and equity on segmental, and the extraorganas (root) are grouped around the main bronchi, near pulmonary artery and veins. The standing lymphatic vessels of the right and left bronchopullenses are directed to the lower and upper tracheobronchial lymph nodes. Sometimes they fall directly in breastbank, as well as in prejudicial nodes (right) and distortionocarotide (left).
Lower tracheobronchial(bifurcation) lymphaticknots, nodi. lymphatici. tracheobronchiales. inferiores., lie under the bifurcation of the trachea, and top tracheobronchial (right and left) lymph nodes,nodi. lymphatici. tracheobronchiales. superiores. dextri. et. sinistri.are located on the side surface of the trachea and in the tracheoobronchial corner formed by the lateral surface of the trachea and the upper semicircle of the main bronchus of the corresponding side. These lymph nodes are sent to the bronchopile assemblies, as well as other visceral and parietal nodes. breast cavity. The reduced lymphatic vessels of the right upper tracheobronchial nodes are involved in the formation of the right bronchostered trunk. There are also the paths of the outflow of lymphs from the right upper tracheobronchial lymph nodes in the direction of the left venous angle. The luminous lymphatic vessels of the left upper tracheosobronchial lymph nodes fall into the chest duct.
Vessels and nerves of the lungs.Arterial blood for powering the lung fabric and the walls of the bronchi enters the lungs through the bronchial branches from the thoracic part of the aorta. Blood from the walls of the bronchial over the bronchial veins is subject to the inflows of pulmonary veins, as well as in the unpaired and semi-park veins. On the left and right pulmonary arteries, venous blood is entered, which, as a result of gas exchange, is enriched with oxygen, gives carbon dioxide and becomes arterial. Arterial blood from the lungs on the pulmonary veins is subject to the left atrium. Light lymph vessels fall into bronchopal, lower and upper tracheobronchial lymph nodes.
The innervation of the lungs is carried out of the vagus nerve and from the sympathetic barrel, the branches of which in the field of the root of the lung form pulmonary plexusplexus. pulmonalis. The branches of this plexus on bronchoms and blood vessels penetrate the lung. In the walls of large bronchi there are plexuses of nerve fibers in Adventization, muscle and mucosa.
68. Plevra; her departments, borders; The cavity of the pleura, the sinuses of the pleura.
Pleura, pleura., the serous lung shell is divided into visceral (pulmonary) and parietal (client). Each light is covered with pleural (pulmonary), which over the surface of the root goes into parietal pleura, lining the adjacent to the light wall of the chest cavity and the degrating light of the mediastinum. Visceral (pulmonary) pleura,pleura. viscerdlis. (pulmondlis), it grips tightly with the body of the organ and, covering it from all sides, enters the slots between the lobes. Book from the root of lung visceral pleura, descending from the front and rear surfaces Lung root, forms vertically located ligament,lLG.. pulmonale, lying in the front plane between the copper of the surface of the lung and medium pleutra and lowered down almost to the diaphragm.
Parietal (cloth) pleura,pleura. parietdlls., it is a solid leaflet that grows with the inner surface of the chest wall and in each half of the chest cavity forms a closed bag containing the right or left light, covered with visceral plesera (Fig. 242). Based on the position of parts of the parietal pleura, it is highlighted with rib, mediastinal and diaphragmal pleura. Ribratra [part], pleura. [ pars.] costdlis, covers the inner surface of the ribs and intercostal gaps and lies directly on the intrathless fascia. In front of the sternum and behind the spinal pillar, the rebellious pleura goes into a mediastinal. Mediastinal pleura [part], pleura. [ pars.] mediaStindLLs., it takes from the lateral side to the mediastinum organs, is located in the anterorable direction, stretching from the inner surface of the sternum to the side surface of the spinal column. Mediastinal pleurra on the right and the left side with pericardium; On the right, it also borders with the upper hollow and the unpaired veins, with the esophagus, on the left - with breast aorta. In the area of \u200b\u200bthe root of the lung, the mediastile pleura covers it and goes into visceral. At the top at the level of the top aperture of the chest, the rib and mediastinal pleurra switch to each other and form dome pleuralcupula. pleurae., limited with the lateral side by the staircase muscles. Rear from the dome of the pleural is the head I head and the long muscle of the neck, covered with the presidoy plate of the cervical fascia, to which the dome of the pleura is fixed. In front and media to the dome of the pleura will be adjusted by subclavian artery and vein. Above the dome of the pleura is the shoulder plexus. Below, the root and mediastinal pleurra goes into a diaphragmal pleura [part], ple uRA [ pars.] diafragmdtica., which covers the muscular and tendon parts of the diaphragm, with the exception of its central departments; where pericardi fucked with a diaphragm. Between Parietal and Visceral Pleverra there is a sliding closed space - pleural cavitycdvitas. pleurdlis. In the cavity there is a small amount of serous fluid, which wets in contact with smooth coated meso-telia wheels of pleura, eliminates the friction of them about each other. With dy-ha *, increasing and decreasing the volume of lungs, a moisturized visceral pleura freely slides along the inner surface of the parietal pleura.
In the places of transition, the edge pleura in the diaphragmal and mediastinal are formed by a greater or less deepening value - pleural sinesrecessus. pleurdles.. These sinuses are reserve spaces of the right and left pleural cavities, as well as spacing, in which the pleural (serous) liquid can accumulate in violation of its formation or suction processes, as well as blood pus during damage or lung diseases, pleura. Between rib and diaphragmal pleutra there is a well-visible deep rib-diaphragmal sinus,recessus. costodiaphragma.- ticus., reaching the greatest size at the level of the middle axillary line (here it is its depth of about 9 cm). At the transition site of mediastinal pleura in the diaphragmal is not very deep, oriented sagittral diatragm-dialatinal sinus,recessus. phrenicomediastinalis.. Less than pronounced sinus (deepening) is available at the journey of the edge pleura (in the front of it) to the mediastinal. Here is formed rib mediastinal sinus,recessus. costomediastinalis.
The dome of the pleura on the right and the left reaches the cervix I of the rib, which corresponds to the level of an ostic process of the VII cervical vertebra (rear). From the front of the dome of the pleural rises by 3-4 cm above the rear (1-2 cm above the clavicle). The front boundary of the right and left edge pleura passes unequal (Fig. 243). On the right, the front border from the dome of the pleura is descended behind the right breast-clearable joint, then heading behind the handle to the middle of its connections with the body and from here drops behind the bodies of the sternum, located left from the middle line, to the VI rib, where it goes to the right and goes into the lower limit pleura. The lower boundary of the pleura on the right corresponds to the line of transition of the edge pleura in the diaphragmal. From the level of the cigarette cigarette ribs with the sternum, the lower boundary of the pleura is directed laterally and down, on the mid-crocerant line crosses the VII edge, along the anterior axillary line - the VIII edge, along the middle line - IX edge, on the rear axillary line - x edge The blade line is the XI edge and comes to the spinal column at the neck of the XII rib, where the lower border goes into the rear border of the pleura on the left front limit of the parietal pleura from the dome goes, as well as on the right, behind the breast-clearing joint (left). Then goes behind the handle and the bodies of the sternum down, to the level of cartilage IV ribs, located closer to the left edge of the sternum; Here, rejecting laterally and down, crosses the left edge of the sternum and descends close to the cartilage of VI ribs (it goes almost parallel to the left edge of the sternum), where it goes into the lower border of the pleura. The lower boundary of the edge pleura on the left is somewhat lower than on right side. Rear, as well as on the right, at the level of the XII rib, it goes into the back limb. The border of the pleura is rear (corresponds to the rear line of the transition of the edge pleura in the mediastinal) sinks from the dome of the pleura down along the spinal column to the head of the XII rib, where it goes into the lower limit (Fig. 245). The front boundaries of the edible pleura on the right and the left are not the same: throughout the II to the IV rib, they go behind the sternum parallel to each other, and at the top and bottom diverge, forming two triangular spaces free from the pleura, the top and lower intergeneral fields. Upper intergeneral field,the reversed by the top of the book is located behind the handle of the sternum. In the region of the upper space in children there is a forkry gland, and in adults - the remnants of this gland and fatty fiber. Lower intergeneral fieldlocated upwards, located behind the lower half of the body of the sternum and the front sections of the fourth and fifth left intercostal intervals. Here, the necroser bag is directly in contact with breast wall. The boundaries of the lung and pleural bag (both on the right and left) mainly correspond to each other. However, even with the maximum breath, the lung does not fill the pleural bag completely, as it has large sizes than the organ located in it. The boundaries of the dome of the pleura correspond to the boundaries of the top of the lung. The rear boundary of the lungs and pleura, as well as the front of their border on the right coincide. The front boundary of the parietal pleura on the left, as well as the lower boundary of the parietal pleura on the right and the left differ significantly from these borders at the right and left lungs.
