LABORATORY EXERCISES:

THORAX I: THORACIC WALL

EXERCISES

1. Illustrate and label the bones that comprise the thoracic wall. (Typical thoracic vertebra,
typical rib, manubrium, body of sternum and xiphoid)

2. What are the joints found within the bones that make up the thoracic wall. Describe each
according to articulations, movement or action and type of joint.

Joints Type of Joint Articulations Movement/Action

Intervertebral Symphysis Adjacent vertebral flexion, extension,
(of vertebrae (secondary bodies bound and a twisting
T1-T12) cartilaginous) together by IV movement that's a
disc combination of
rotation and lateral
flexion
Costovertebral Synovial plane Head of each rib small degree of
joint with superior demi gliding and rotation
or costal facet of of the rib head;
 vertebral body of enable lifting of the
same number and ribs upwards and
inferior demi- or outwards during
costal facet of breathing.
vertebral body
superior to it and
IV disc between
them
Tubercle of rib
with transverse
process of vertebra
of same number

Costochondral Primary Lateral end of No

(hyaline) costal cartilage action/movements
cartilaginous with sternal end of
joint rib
Interchondral Synovial plane Between costal forwards and
joint cartilages of 6th backwards
and 7th, 7th and
8th, and 8th and
9th ribs

Sternocostal 1st: primary Articulation of 1st slight bending and

cartilaginous costal cartilages twisting actions
joint with manubrium
(synchondrosis) of sternum

2nd-7th: Articulation of the

synovial plane 2nd- 7th pairs of
joint costal cartilages
with sternum
Sternoclavicular Saddle type of Sternal end of Elevation
synovial joint clavicle with depression
manubrium of Protraction
sternum and 1st retraction
costal cartilage Axial rotation
Manubriosternal Secondary Articulation Angulation,
cartilaginous between anteroposterior
joint manubrium and displacement
(symphysis) body of sternum
3. Illustrate and label the intercostal muscles.

4. Describe the intercostal muscles.

The spaces between the ribs contain three muscles of respiration: the external intercostal, the
internal intercostal, and the innermost intercostal muscle. The innermost intercostal muscle is
lined internally by the endothoracic fascia, which is lined internally by the parietal pleura. The
intercostal nerves and blood vessels run between the intermediate and deepest layers of muscles.
They are arranged in the following order from above downward: intercostal vein, intercostal
artery, and intercostal nerve.

Name of Muscle Origin Insertion Nerve supply Action

External Inferior border Superior border Intercostal With 1st rib
intercostal of rib of nerves fixed, they raise
muscle (11) rib below ribs
(fibers pass during
downward and inspiration and
forward) thus
increase
anteroposterior
and
 transverse
diameters of
thorax
Internal Inferior border Superior border Intercostal With last rib
intercostal of rib of nerves fixed by
muscle (11) rib below abdominal
(fibers muscles, they
pass downward lower ribs during
and expiration
backward)
Innermost Adjacent ribs Adjacent ribs Intercostal Assists external
intercostal nerves and internal
muscle intercostal
(incomplete muscles
layer)

5. Describe the other muscles of the thorax

Name of Muscle Origin Insertion Nerve supply Action
Diaphragm Xiphoid process; Central tendon Phrenic nerve Very important
lower six costal muscle of
cartilages, first inspiration;
three lumbar increases
vertical
vertebrae diameter of
thorax by pulling
central tendon
downward;
assists in raising
lower ribs
Also used in
abdominal
straining

and weight
lifting
Levatores Tip of transverse Rib below Posterior rami of Raises ribs and
costarum (12) process of C7 thoracic spinal therefore
and
nerves inspiratory
T1–11 vertebrae muscles
Serratus Lower cervical Upper ribs Intercostal Raises ribs and
posterior and nerves therefore
superior upper thoracic
inspiratory
spines muscles
 Serratus Upper lumbar Lower ribs Intercostal Depresses ribs
posterior inferior and nerves and therefore
lower thoracic
expiratory
spines muscles

6. Describe the internal thoracic artery based on its origin, course in the thorax and its terminal
branches.

Internal Thoracic Artery

Origin: near the origin of the subclavian artery
Course in the thorax: It travels downward on the inside of the ribcage, approximately a
centimeter from the sides of the sternum, and thus medial to the nipple. It is accompanied by
the internal thoracic vein. It runs deep to the external oblique, but superficial to the vagus nerve
It continues downward until it divides into the superficial intercostal artery and the inferior
epigastric artery around the sixth costal cartilage. After passing the sixth intercostal space which
are the mediastinal branches, thymic branches, pericardiacophrenic artery, which travels with
the phrenic nerve then to the sternal branches, to the perforating branches and twelve anterior
intercostal branches, the internal thoracic artery splits into the following two terminal branches:
terminal branches: in the sixth intercostal space by dividing into the superior epigastric and
musculophrenic arteries.
Terminal branches:

• Superior epigastric artery-which enters the rectus sheath of the anterior abdominal wall
and supplies the rectus muscle as far as the umbilicus
• Musculophrenic artery-which runs around the costal margin of the diaphragm and
supplies the lower intercostal spaces and the diaphragm

7. Describe the thoracic inlet and outlet.

Thoracic inlet-superior

Thoracic outlet- inferior

8. Describe the diaphragm

The diaphragm is an unpaired, dome shaped skeletal muscle that is located in the trunk. It
separates the thoracic and abdominal cavities from each other by closing the inferior thoracic
aperture. The diaphragm is the primary muscle that is active in inspiration.

9. What are the 3 openings in the diaphragm? Describe each.

caval opening (vena caval foramen), esophageal hiatus, and aortic hiatus.
 Openings of the Diaphragm Structures passing through
Caval opening (vena caval foramen) Inferior vena cava
Branches of the right phrenic nerve
Esophageal hiatus Anterior and posterior vagal trunks,
esophagus
Aortic hiatus Descending aorta
Azygos vein
Thoracic duct

10. Describe the posterior chest wall.

It contains the spinous processes, scapula, superior angle, spine of the scapula and inferior angle.

• Suprascapular- the region superior to the spine of scapula.

• Scapular- the part corresponding to the scapula.
• Infrascapular-which is just inferior to the inferior angle of the scapula.
• Interscapular- which spans the part of the thorax between the medial borders of the left
and right scapulae. It lies within the bodies of the first and eight thoracic vertebrae.

11. What are the lines of orientation or imaginary lines on the chest wall? Describe each.
• Midsternal line: Lies in the median plane over the sternum
• Midclavicular line: Runs vertically downward from the midpoint of the clavicle
• Anterior axillary line: Runs vertically downward from the anterior axillary fold
• Posterior axillary line: Runs vertically downward from the posterior axillary fold
• Midaxillary line: Runs vertically downward from a point situated midway between the
anterior and posterior axillary folds
• Scapular line: Runs vertically downward on the posterior wall of the thorax passing
through the inferior angle of the scapula (arms at the sides).