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The pleural cupula and its ligamentous connections – patterns/drawings in

literature compared with fresh cadavers

Conference Paper · September 2015

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4 authors:

Romed Hoermann Erich Brenner

Medizinische Universität Innsbruck Medizinische Universität Innsbruck
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Bernhard Moriggl Karl-Heinz Kuenzel

Medizinische Universität Innsbruck Medizinische Universität Innsbruck
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 The pleural cupula and its
ligamentous connections -
patterns/drawings in literature
Sektion für compared with fresh cadavers
klinisch-funktionelle
Anatomie R. Hörmann1, E. Brenner1,
B. Moriggl1, K.H. Künzel1
Paturet G. (1958) Traitè d‘Anatomie
ie
Humaine, Tome III, Fasc. II, Masson & C ,
Paris, p 1166
Background: Current concepts in manual therapy
aim at treating the “pleural cupula ligaments” in
distinct pathologies. This structures are described
only in antiquated anatomical literature.
Aim: Since new studies are missing that investi-
gate the morphological and functional aspects, we
depicted the ligamentous structures in question
and their relation to the pleura and neurovascular
bundle.

Methods: On seven fresh cadavers we dissected the

distinct cervical fasciae, the costopleural, transverso-
pleural and vertebropleural ligaments. Peculiar photo
and video recordings of the different steps were made.
Abbreviations:
arrows: vertebropleural ligament
asterisk: costopleural ligament
as: anterior scalene muscle, deflected
1.r: 1st rib
bp: brachial plexus
ca: carotid artery
ita: internal thoracic artery
sa: subclavian artery
tb: brachiocephalic trunc
va: vertebral artery
vc: vertebral column
vn: vagal nerve, deflected

st
Results: The ligaments are connected to the pleural cupula and the 1 rib
as an anterior and posterior bundle that encase the subclavian artery.
Further connections to the trunci of the brachial plexus exist.
Conclusion: We believe that during head, neck and shoulder movements
the illustrated ligaments stabilize the pleural cupula, providing at the same
time a slide bearing for the subclavian artery and the adjacent nerve
bundles. Therefore we conclude that manual mobilization and
manipulation techniques provide a viable option in pathologies of the
cervical region.

1
Division of Clinical and Functional Anatomy, Medical University of Innsbruck, AT

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