Chest cavity, vertebral column and back

muscles.
Respiratory muscles.
Sándor Katz M.D., Ph.D.
Chest cavity - bony structures
Chest cavity- bony structures
Sternum
Ribs

True ribs: first seven pairs connect

to the sternum directly by costal
cartilages.

False ribs: remaining five pairs

connect to the sternum indirectly,
forming costal arch.
Last two pairs: floating ribs.
Ribs
Ribs
Vertebral column
General vertebral features
First cervical vertebra - Atlas

1: anterior tubercle
2: anterior arch
3: fovea dentis
4: transverse process
5: transverse foramen
6: superior articular facet
7: posterior arch
8: posterior tubercle
9: vertebral foramen
Second cervical vertebra - Axis

1: dens axis
2: superior articular process
3: vertebral body
4: lamina
5: vertebral arch
6: inferior articular process
7: transverse process
8: spinous process
 Atlas and Axis

1: dens axis
2: transverse foramen
3: spinous process
4: anterior arch
5: posterior arch
6: transverse process
7: superior articular facet
Cervical vertebrae
Thoracic vertebrae
Costovertebral attachments
Lumbar vertebrae
Sacrum
Intervertebral discs (Synchondroses)
(A type of the continuous bony connections.)
Atlanto-occipital joint

Ellipsoid (condylar) joint.

Ligaments:
posterior and
anterior atlanto-occipital
membrane.

Permitted movements:
flexion-extension,
slight lateral flexion
Atlanto-axial joint
PIVOT PART:
Anterior median atlanto-axial joint:
Between the dens axis (ant. articular
facet) and fovea dentis of the atlas.

Posterior median atlanto-axial joint:

Between the dens axis (post. articular
facet) and transverse ligament of atlas.

PLANE PART:
Lateral atlanto-axial joint:
Between the articular processes.

MOVEMENTS:
50% of the cervical rotation (50°)
comes from the atlanto-axial joint.
Flexion: 10°. Extension is really limited.
Zygapophysial (facet) joint

Cevical region:
All movements are possible such
as flexion, extension, lateral
flexion and rotation.

Thoracic region:
Lateral flexion and rotation.
No flexion/extension.

Lumbar reion:
Flexion and extension.
Covering structures
Covering structures
Spinal curvatures
 Scoliosis
(S-shaped deformity of the spine)
Superficial back muscles - spinohumeral muscles

Trapezius: acromial third of

clavicle, acromion, spine of scapula

Levator scapulae: superior angle of

scapula

Rhomboid minor, major: medial

border of scapula

Latissimus dorsi: crest of lesser

tubercle

Function:
Move the upper limb.
Deep (axial) muscles

Erector spinae muscle (longissimus+iliocostal

Spinalis muscles

Functions:

Unilateral innervation: lateral flexion.

Bilateral innervation: extension.

Transversospinal muscles
(from transverse processes to spinous processes)

Semispinalis muscles:
Cover 5-6 vertebrae.

Multifidi muscles:
Cover 3-4 vertebrae.

Rotatores muscles:
Cover 1-2 vertebrae.

Functions:

Unilateral innervation: lateral flexion.

Bilateral innervation: extension.

 Respiratory muscles

• Intercostalis muscles

• Diaphragm

• Accessory muscles
Intercostalis muscles
External intercostal muscles:

Arise from the lower border of the

ribs and insert on the upper border
of the ribs below.

Function:
Elevation of the ribs, they reinforce the
intercostal space during the deep
inspiration.

Internal intercostal muscles:

Arise from the ridge of the inner

surface of ribs and insert on the
inferior border of the ribs above.

Function:
Depression of the ribs, they reinforce the
intercostal space during the deep expiration.
Diaphragm
(inspiration)

CENTRAL TENDON
Caval hiatus for the inferior vena cava - T8

MUSCULAR PART:
• Sternal part
Superior epigastric artery.

• Costal part

• Lumbar part:
Left and right crus and both have medial
and lateral parts.
Esophageal hiatus for the esophagus - T12
Aortic hiatus for the aorta and thoracic duct - L1
No hiatus for the azygos and hemiazygos veins and
greater and lesser splanchnic nerves - L2
Movements of the thoracic wall during
breathing

A: Pump handle movement of ribs

and sternum.

B: Bucket handle movement of ribs.

Accessory respiratory muscles

Inspiration: scalene muscles

and sternocleidomastoid.

Expiration: abdominal muscles.

 Thank you for your attention.

Reference: Gray’s Anatomy for Student

Thieme Atlas of Anatomy