Professional Documents
Culture Documents
Handout - Thorax PDF
Handout - Thorax PDF
Thorax
upper part of the trunk
box for vital organs
Boundaries
external upper: 1/ jugular notch
2/ clavicule
3/ acromion of scapula
4/ spine of C7 (vertebra prominens)
internal upper: 1/ superior thoracic aperture (made from jugular notch, 1st pair of ribs,
vertebra Th1)
internal lower: 1/ inferior thoracic aperture (full filed by diaphragm, which extends on
the right side to the 4th intercostal space (ICS), on the left side extends
to the 5th ICS)
1st layer (proper thoracic wall): 1/ osteothorax (ribs, sternum, Th vertebrae + their joints)
2/ proper mm. of thoracic wall (intercostal muscles,
transversus thoracis, subcostalis)
3/ intrinsic mm. of the back (erector spinae m.)
4/ intercostal neuro-vascular bundle (vein, artery, nerve)
5/ endothoracic fascia
6/ parietal pleura
Osteothorax
Thoracic vertebrae (12): 1/ body - costal facets,
2/ arch - vertebral notches – intervertebral foramen,
vertebral foramen
3/ processes – transverse, sup. and inf. articular, spinous
Costovertebral joints: 1/ joints of the heads of the ribs (head of the ribs to the
body of the thoracic vertebrae)
2/ costotransverse joints (costal tubercle and transverse
process)
Sternocostal joints: 1st to7th ribs to sternum
Interchondral joints: costal arch (cartilages of the 7th to 10th rib)
Synostosis: sacrum
2/ central tendon
opening for inferior vena cava (Th8) – inferior vena
cava, phrenocoabdominal br. of right phrenic n.
Internal thoracic vv. , left drains into left brachiocephaic v., right drains into superior vena
cava
Thoracoepigastric vv., they form lateral thoracic v., it drains into axillary v.
Vertebral venous plexus — external and internal
Veins of the thoracic wall form important cavo-caval and porto-caval anastomoses!
Mediastinum
- part of the thoracic cavity between two pleural cavities (right and left)
Borders
ventral: sternum + costal cartilages + transverse thoracis m.
caudal: diaphragm
Division
- horizontal line, which connects sternal angle and intervertebral disc between Th4-5
into:
superior mediastinum
middle mediastinum
posterior mediastinum
Superior mediastinum
- communicates with anterior mediastinum and posterior mediastinum
content: - thymus
- right brachiocephalic vein
- left brachiocephalic vein + its tributaries
- superior vena cava + its tributaries
- right and left phrenic nerve – different passage
- right and left vagus nerve – different course, left recurrent laryngeal n.
- aortic arch – course, branches: brachiocephalic trunk, left common
carotid a., left subclavian artery, bronchial aa.
- trachea (thoracic part)
- oesophagus
- thoracic duct
- superficial cardiac plexus
- sympathetic trunk (covered by endothoracic fascia)
- anterior mediastinal lymph nodes
Anterior mediastinum
- fissure behind the body of sternum and in front of pericardium, it communicates with
superior mediastinum
content: - thymus
- parasternal lymph nodes
- superior et inferior sternopericardiac ligaments
Middle mediastinum
- it is separated by pericardium from other parts of mediastinum (from posterior
mediastinum is also separated by bronchopericardiac membrane)
Posterior mediastinum
inferior - diaphragm