GENERAL ANATOMY
THORAX – THORACIC WALL TYPICAL THORACIC VERTEBRA
• segmental in design and composed of skeletal elements and
muscles. It extends between:
superior thoracic aperture
bordered by: vertebra T1, rib 1, and the manubrium of the
sternum
inferior thoracic aperture
bordered by: vertebra T12, rib 12, end of rib 11, costal
margin and the xyphoid process of sternum
• Skeletal framework
consists of: the thoracic vertebrae, intervertebral discs, ribs
and sternum
• Thoracic vertebrae
12 thoracic vertebrae, each of which is characterized by
articulations with ribs.
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GENERAL ANATOMY
- Vertebral body: heart shaped - The superior costal facet: articulates with part of the head of
- Dimensions: roughly equal in the transverse and its own rib
anteroposterior directions. - The inferior costal facet: articulates with part of the head of
- Spinous process: Long the rib below.
- Vertebral foramen: circular Oval facet (transverse costal facet)- the end of the
- Laminae: Broad transverse process articulates with the tubercle of its own rib.
- Superior articular process: Flat with articular surface facing
posteriorly
- Inferior articular process: project from the laminae and their
articular facets face anteriorly
- Transverse process: club shaped and project posterolaterally
THORAX – THORACIC WALL
• A typical thoracic vertebra has (3) sites on each side for
articulation with ribs.
(2) Demifacets are located on the superior and inferior
aspects of the body
tubercle of its own rib.
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GENERAL ANATOMY
RIBS
• There are twelve pairs of ribs, each terminating anteriorly in
a costal cartilage
Ribs 1-7: true ribs
Ribs 8-10: false ribs
Ribs 11-12: floating ribs
• A typical rib consists of: a curved shaft with anterior and
posterior ends.
Anterior end: continuous with its costal cartilages
Posterior end: articulates with the vertebral column and is
characterized by a head, neck, and tubercle.
Articular part- is medial and has an oval facet
• The head is somewhat expanded and typically presents two Non articular part- is roughened by ligament attachments
articular surfaces separated by a crest • The shaft is generally thin and flat with internal and external
• The neck is a short flat region of bone that separates the surfaces.
head from the tubercle. • The superior margin is smooth and rounded, whereas the
• The tubercle projects posteriorly from the junction of the inferior margin is sharp. The shaft bends forward just laterally
neck with the shaft and consists of two regions, an articular to the tubercle at a site termed the angle. The inferior margin
part and a nonarticular part: of the internal surface is marked by a distinct costal groove.
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GENERAL ANATOMY
DISTINCT FEATURES OF UPPER AND LOWER RIBS STRENUM
• Rib 1 is flat in the horizontal plane and has broad superior • The adult sternum consists of three major elements:
and inferior surfaces. The superior surface of the rib is Manubrium, body, xiphoid.
characterized by a distinct tubercle, the scalene tubercle, • Manubrium- manubrium of the sternum forms part of the
which separates two smooth grooves that cross the rib bony framework of the neck and the thorax.
approximately midway along the shaft. The superior surface of the manubrium is expanded laterally
• Rib 2 is flat but twice as long and bears a distinct and palpable notch, the jugular notch
• Rib 10 has a single flat facet (suprasternal notch), in the midline.
• Ribs 11 and 12 articulate only with the bodies of their own • Xiphoid process is the smallest part of the sternum.
vertebrae and have no tubercles or necks. Both ribs are
short, have little curve, and are pointed anteriorly.
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GENERAL ANATOMY
JOINTS COSTROTRANSVERSE JOINT
• A typical rib articulates with: • Costotransverse joints are synovial joints between the
the bodies of adjacent vertebrae, forming a joint with the tubercle of a rib and the transverse process of the related
head of the rib; and vertebra
the transverse process of its related vertebra, forming a • The joint is stabilized by two strong extracapsular ligaments
costotransverse joint that span the space between the transverse process and the
rib on the medial and lateral sides of the joint
The costotransverse ligament is medial to the joint and
attaches the neck of the rib to the transverse process.
The lateral costotransverse ligament is lateral to the joint
and attaches the tip of the transverse process to the
roughened nonarticular part of the tubercle of the rib.
A third ligament, the superior costotransverse ligament,
attaches the superior surface of the neck of the rib to the
transverse process of the vertebra above.
Slight gliding movements occur at the costotransverse joints.
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GENERAL ANATOMY
• Sternocostal joints - The sternocostal joints are joints
between the upper seven costal cartilages and the sternum
• Interchondral joints - occur between the costal cartilages of
adjacent ribs (Fig. 3.25), mainly between the costal
cartilages of ribs VII to X, but may also involve the costal
cartilages of ribs V and VI.
• Manubriosternal and xiphisternal joints- The joints
between the manubrium and the body of the sternum and
between the body of the sternum and the xiphoid process
are usually symphyses
• Intercostal spaces lie between adjacent ribs and are filled
by intercostal muscles
• Intercostal nerves and associated major arteries and veins
lie in the costal groove along the inferior margin of the
superior rib and pass in the plane between the inner two
layers of muscles.
• In each space, the vein is the most superior structure and is
therefore highest in the costal groove. Therefore, the nerve is
the structure most at risk when objects perforate the upper
aspect of an intercostal space.
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GENERAL ANATOMY
• Endothoracic fascia- a layer of loose connective tissue, COSTROTRANSVERSE JOINT
deep to the intercostal spaces and ribs, and separating these
• The muscles of the thoracic wall, together with muscles
structures from the underlying pleura
between the vertebrae and ribs posteriorly (i.e., the
levatores costarum and serratus posterior superior and
serratus posterior inferior muscles) alter the position of the
ribs and sternum and so change the thoracic volume during
breathing. They also reinforce the thoracic wall.
• Intercostal muscles- are three flat muscles found in each
intercostal space that pass between adjacent ribs. Individual
muscles in this group are named according to their positions
The external intercostal muscles are the most superficial.
The internal intercostal muscles are sandwiched between the
external and innermost muscles.
The innermost intercostal muscles are the deepest of the
three muscles.
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GENERAL ANATOMY
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GENERAL ANATOMY
• Arterial Supply- Vessels that supply the thoracic wall
consist mainly of posterior and anterior intercostal arteries
• Posterior intercostal arteries- The upper two posterior
intercostal arteries on each side are derived from the
supreme intercostal artery
• Costocervical trunk- is a posterior branch of the subclavian
artery.
• Anterior intercostal arteries- The anterior intercostal
arteries originate directly or indirectly as lateral branches
from the internal thoracic arteries .
• Each internal thoracic artery arises as a major branch of
the subclavian artery in the neck.
• At approximately the level of the 6th intercostal space, it
divides into two terminal branches:
•
the superior epigastric artery, which continues inferiorly into the
anterior abdominal wall; and
the musculophrenic artery, which passes along the costal margin,
goes through the diaphragm, and ends near the last intercostal
space.
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GENERAL ANATOMY
VENOUS DRAINAGE
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GENERAL ANATOMY
LYMPHATIC DRAINAGE INNERVATION
• Lymphatic vessels of the thoracic wall drain mainly into: • Intercostal nerves- Innervation of the thoracic wall is mainly
Internal thoracic arteries(parasternal nodes) by the intercostal nerves
Intercostal nodes • In the thorax, the intercostal nerves carry:
Diaphragmatic nodes • ■ somatic motor innervation to the muscles of the thoracic
• Parasternal nodes drain into bronchomediastinal trunks wall (intercostal, subcostal, and transversus thoracis
• Intercostal nodes(upper thorax) drain into muscles),
bronchomediastinal trunks • ■ somatic sensory innervation from the skin and parietal
• Intercostal nodes(lower thorax) drain into the thoracic duct pleura, and
• ■ postganglionic sympathetic fibers to the periphery.
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