Thorax: Heart, Lungs, Mediastinum, and Pleura

This thoracic tissues chapter deals mainly with the heart, lungs, and great vessels, as well as the chest wall. The dissection guide in this chapter should allow complex airway and vascular anatomy to be sequentially analysed, which in turn allows the confident identification of disease processes. Given that the majority of adult deaths have some degree of cardiac or pulmonary disease, the chapter is necessarily large, with many images of the techniques of the dissection of the thoracic tissues and of the pathological processes that are commonly found. The chapter starts by considering the thoracic tissues en bloc and describes how to separate the tissue elements without damaging or losing evidence. The lung tissues are shown in progressively dissected format, and then grouped diseases are presented. Common pathologies of sepsis and neoplasia are shown alongside degenerative conditions such as fibrosis and chronic obstructive pulmonary disease. The normal anatomy of the heart tissues is likewise demonstrated, in the manner of blood passing through the heart. The sequential dissection protocol deals with the coronary arteries and ischaemic heart disease. In addition, the therapeutic maneuvers to combat ischaemic heart disease—stent placement, coronary bypass surgery, and thrombolytic therapies—are seen, and the chapter also looks at cardiomyopathies, valvular and inflammatory heart disease, vascular disease, and, to a small extent, congenital heart disease.