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Posts Tagged ‘CT’

VASCULAR SUPPLY AND LYMPHATIC DRAINAGE Arteries The arterial supply to the stomach comes predominantly from the coeliac axis although intramural anastomoses exist with vessels of other origins at the two ends of the stomach (Figs 65.9, 65.10, 65.11). The left gastric artery arises directly from the coeliac axis. The splenic artery gives origin to the […]

VASCULAR SUPPLY AND LYMPHATIC DRAINAGE ABDOMINAL AORTA The abdominal aorta begins at the median, aortic hiatus of the diaphragm, anterior to the inferior border of the 12th thoracic vertebra and the thoracolumbar intervertebral disc (Figs 62.6, 62.7). It descends anterior to the lumbar vertebrae to end at the lower border of the fourth lumbar vertebra, […]

PULMONARY FISSURES AND LOBES Right lung The right lung is divided into superior, middle and inferior lobes by an oblique and a horizontal fissure (Fig. 57.3). The upper, oblique fissure separates the inferior from the middle and upper lobes, and corresponds closely to the left oblique fissure, although it is less vertical, and crosses the […]

BRONCHOSCOPY Bronchoscopy allows the direct visualization of the vocal cords, trachea and major airways as far as the first division of the subsegmental airway. Occasionally bronchoscopy can also provide some information about structures adjacent to the airways, for example, significant subcarinal lymphadenopathy may cause splaying or widening of the carina. Bronchoscopy enables the acquisition of […]

CHAPTER 57 – Pleura, lungs, trachea and bronchi The lungs are the essential organs of respiration and are responsible for the uptake of oxygen into the blood and the removal of carbon dioxide. The functional design of the thorax facilitates this complex process. The muscles of respiration and the diaphragm, acting together, increase the intrathoracic volume, creating […]

VASCULAR SUPPLY AND LYMPHATIC DRAINAGE The lungs have two functionally distinct circulatory pathways. The pulmonary vessels convey deoxygenated blood to the alveolar walls and drain oxygenated blood back to the left side of the heart, and the much smaller bronchial vessels, which are derived from the systemic circulation, provide oxygenated blood to lung tissues that […]

CHAPTER 56 – Heart and great vessels PERICARDIUM The pericardium contains the heart and the juxtacardiac parts of its great vessels. It consists of two components, the fibrous and the serosal pericardium. The fibrous pericardium is a sac made of tough connective tissue, completely surrounding the heart without being attached to it. This fibrous sac develops by […]

MEDIASTINAL IMAGING Mediastinal structures may be viewed using X-rays, CT and MRI. NORMAL MEDIASTINAL CONTOURS ON FRONTAL CHEST RADIOGRAPH In a standard posteroanterior chest radiograph the X-ray beam passes from back to the front of the chest. The standing patient breath-holds in full inspiration, and elevates and abducts the arms over the radiographic plate, movements […]

OESOPHAGOSCOPY AND TRANSOESOPHAGEAL ULTRASOUND The oesophagus can be inspected visually by oesophagoscopy. This may be indicated in patients with persistent oesophageal symptoms such as atypical chest pain, dysphagia, odynophagia (painful swallowing) or symptoms of reflux. The procedure is performed with or without sedation. The endoscope is passed orally under direct vision with the patient in […]

THYMUS The thymus (Figs 55.8, 55.9) is one of the two primary lymphoid organs, the other being the bone marrow. It is an encapsulated soft, bilobed organ, the two parts being joined in the midline by connective tissue that merges with the capsule of each lobe. The latter may normally have adhesions to the fibrous […]

DEVELOPMENT The embryology and prenatal development of the thymus are described in Chapter 35. Thymic changes during postnatal life At birth the thymus is most often bilobar. It is 4–6 cm long, 2.5–5 cm wide and 1 cm thick. The thickest part of the gland at birth is not at the thoracic inlet, but immediately […]

THORACIC DUCT In adults, the thoracic duct, including the confluence of lymph trunks (or the cisterna chyli in the small proportion of individuals in whom the latter is saccular), is 38–45 cm in length and extends from the second lumbar vertebra to the base of the neck (Fig. 55.5). Starting from the superior pole of […]

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