From Big Medical Encyclopedia

CHEST CAVITY [cavum thoracis (PNA, BNA, JNA); synonym cavum pectoris] — the space located in a thorax and limited by an intrathoracic fascia.

Fig. 1. The diagrammatic representation of a horizontal cut of a trunk at the level of VI of a chest vertebra. Serous spaces of a chest cavity are visible: 1 — cavum pleurae; 2 — vertebra thoracica; 3 — musculi dorsi; 4 — fascia endothoracica; 5 — costa; 6 — pleura costalis; 7 — pleura mediastinalis; 8 — recessus costomediastinalis; 9 — pericardium; 10 — cavum pericardii, 11 — mediastinum post.

The form G. of the item does not match a shape of a thorax (see) since items press in G. from below a diaphragm, and behind a body of chest vertebrae. Of the item includes two serous pleural bags and the mediastinum located between them (fig. 1). In a lower part mediastinums (see) there is a third serous cavity limited pericardium (see). In the pleural bags formed by a pleura are located lungs (see). Between parietal and visceral pleura (see) there is a slit-like space filled with serous liquid — a pleural cavity (cavum pleurae) playing important fiziol, a role in the mechanism breath (see). In a pleural cavity at inflammatory diseases and damages of bodies of G. of the item air, serous liquid, pus, blood can collect.

Fig. 2. Diagrammatic representation of horizontal cuts of an embryo. Four consecutive stages of development of a chest cavity (according to Patten), and — the first: 1 — mesocardium dorsale; 2 — coelom; 3 — mesocardium ventrale; 4 — endocardium primitivum; 5 — epimyocardium primitivum; 6 — pharynx primitiva. — the second: 1 — esophagus; 2 — v. cardinalis communis; 3 — cavum pericardiale; 4 — cor; 5 — plica pleuropericardialis; 6 — cavum pleurale; 7 — rudiments of lungs (pulmonary kidneys), in — the third: 1 — esophagus; 2 — cavum pleurale; 3 — pulmones; 4 — plica pleuropericardialis; 5 — cor; 6 — cavum pericardiale; 7 — n. phrenicus. — the fourth: 1 — n. phrenicus; 2 — cavum pericardiale; 3 — cor; 4 — plica pleuropericardialis; 5 — pulmo; 6 — cavum pleurale; 7 — esophagus.

Mediastinum (mediastinum) — the space located between leaves of a mediastinal pleura, an intrathoracic fascia (in front and behind) and a phrenic fascia (from below), in Krom there are various vitals, large vessels and nerves (heart, a thymus, a gullet, an aorta, etc.). Each body of a mediastinum is covered with the fascial capsule; between bodies there is a friable connecting fabric, edges can promote distribution of purulent processes to a mediastinum and on a neck.

Development of a chest cavity it is connected with transformations of a secondary perigastrium of an embryo — tseloma (see), forming owing to division of lateral mesoderms (see) on somatic [mesoderma somaticum (parietale)] and splankhnichesky [mesoderma splanchnicum (viscerale)]. Because in a cranial part of a body of an embryo of a dorsal mesentery it is not formed and the intestinal tube is located directly on a back body wall, laying of heart is ahead of future throat (fig. 2) and the splankhnichesky mesoderm passes from it to heart. As a result between a somatic and splankhnichesky mesoderm the pericardiac cavity (cavum pericardii), by the connecting peritoneal and pericardiac channel (canalis pericardioperitoneal] of s) with a peritoneal cavity (cavum peritonei) is formed. On 4 — 5th week of development there is a formation of a cross partition (septum transversum), edges partially isolates a chest part of a tselom from belly. In the next weeks development (6th and 7th) departs from dorsolateral walls and two plevroperikardialny folds (plicae pleuropericardiales) separating a pericardiac cavity from side narrow coelomic spaces — pleural cavities grow in the cranial and medial directions. At the same time there is a growth of the second couple of folds — pleuroperitoneal (plicae pleuroperitoneales) which, connecting to a cross partition, separate pleural and pericardiac cavities from peritoneal. Rudiments of lungs grow into narrow pleural cavities and in process of development increase them. Ateliosis of pleuroperitoneal folds is followed by inborn defect of a diaphragm (more often at the left) and possibility of phrenic hernia (see. Diaphragm ).

Blood supply bodies of a chest cavity it is carried out from various sources: from ascending (the coronal arteries supplying heart) and a chest aorta (the esophageal, mediastinal, bronchial, pericardiac branches going to the bodies of the same name). The Pristenochny pleura receives branches from intercostal and upper phrenic arteries, and also branches of a subclavial artery. Outflow of a venous blood comes in the numerous veins (esophageal, bronchial, pericardiac, mediastinal, etc.) falling in unpaired and semi-unpaired veins, and from bodies of an upper mediastinum — in subclavial veins. Limf, vessels of bodies of G. of the item take away a lymph in regional nodes of a mediastinum.

Innervation bodies of a chest cavity comes from vegetative textures: superficial and deep noncardiac, front and back pulmonary, esophageal and aortal, the wandering and recurrent nerves forming at the expense of branches, a sympathetic trunk, branches of a phrenic nerve. The listed textures are connected among themselves by multiple bonds owing to what it is possible to speak about uniform cervicothoracic vegetative neuroplex.

Pathology bodies of a chest cavity — see. Aorta , Thorax , Grudnoy Canal , Breast , Lungs , Gullet , Pleura , Heart , Mediastinum etc., and also the separate articles devoted to diseases of these bodies, e.g. Myocarditis , Pneumonia etc.

Bibliography: Elizarovsky S. I. and Kondratyev G. I. Atlas «Surgical anatomy of a mediastinum», M., 1961; Isakov Yu. F. and Stepanov E. A. Tumors and cysts of a chest cavity at children, M., 1975, bibliogr.; Nadj D. Surgical anatomy, the Thorax, the lane with Wenger., Budapest, 1959, bibliogr.; Surgical anatomy of a breast, under the editorship of A. N. Maksimenkov, L., 1955, bibliogr.; Blechschmidt E. Die pranatalen Organsysteme des Menschen untersucht un-ter funktionellen Gesichtspunkten, Stuttgart, 1973; Tondury G. Angewandte und topographisehei Anatomie, Stuttgart * 1970, Bibliogr.

S. S. Mikhaylov.