STRUCTURE OF THE THORACIC

LECTURE 3 WALL
Thoracic Region
1. Sternum
Thoracic Wall - ANTERIOR TO THE THORACIC WALL
Surface Anatomy - Lies in the midline
o Anatomical landmark – clavicle - Three parts:
o Superior to the clavicle is the neck, inferior is a. Manubrium
thoracic b. Body or Corpus
Thoracic Region: Covering c. Xiphisternum / Xiphoid process
Mammary region – breast thicker superficial fascia
Endothoracic fascia – deep fascia Surface marking: elevation, depression on long bones
Notches – depression
Ridge – lines
Points of articulation – marked by ridge or lines

a. STERNUM : Manubrium
Superior border – suprasternal notch / jugular notch
- Superior margin of the sternum /
Basic Anatomy: Thoracic Region manubrium
 Between the neck and abdomen
 Framework: thoracic cage
a. Vertebral column : thoracic vertebral bone
b. Ribs and intercostal spaces
c. Sternum and costal carilages
Protects:
Clavicular notch – point of articulation – clavicle
a. Lungs
Costal notch – “costal” – ribs
b. Heart
c. Big vessels
d. Other viscera
 Provides attachments for muscles of the thorax,
upper extremities and back
Division of the thoracic cavity:
1. Median partition
- Mediastinum
2. Lateral
- Pleurae and lungs
Inferior border of the mandibrium joins the body : RIBS
manubriosternal joint
b. STERNUM : Body
Anatomical landmark to count the costal notches:
manubriosternal joint / sternal angle / 2nd costal facet
Surface markings along the body of sternum: ridge
(elevated marking)
Sternebrae – segments of the body of the sternum.
- unpaired segmental series of bones forming
the body of sternum.
Xiphisternal joint – connection with the xiphoid process
and the body of the sternum

c. STERNUM : Xiphisternum
- Highly made out of cartilage
- No bone that articulates / attaches in
xiphisternum except to the lower body of the
sternum

STERNAL ANGLE (Angle of Louis)

Spinous process – downward in direction

Costal cartilage - Serves as the link between the ribs and
Xiphisternal joint leads to superior border or margin of the sternum
the body (???) Ways of categorizing / classifying the ribs:
T2 to T9
1. Anterior attachment
Aorta – biggest artery a. True ribs – ribs 1 to 7
- Directly connected to the heart b. False ribs no direct attachment to the
- Landmark in dividing: sternal angle sternum but the attachment is via the 7 th
- Divided into 3 portion: costal cartilage (8 – 10)
1. Ascending aorta c. Floating ribs – 11 – 12
2. Arch of aorta – curves 2. Morphology
3. Descending aorta a. Typical ribs – several ribs that has the same
features/morphology
Sternal plane / Transverse plane – horizontal plane b. Atypical ribs – unique features
- Form superior and inferior part
THORACIC VERTEBRA
a. Superior mediastinum
b. Inferior mediastinum A. Cervical vertebrae (C1 to C7)
B. Thoracic vertebrae (T1 to T12)
Trachea – respiratory organ C. Lumbar (L1 to L5)
Separates into two & will be called as bronchus D. Sacral vertebrae
Vena cava – biggest vein
 TYPICAL RIBS : Components
 Head with two articular facets (demifacet)
THORACIC VERTEBRA ANATOMY
o Superior costal demifacet
o Inferior costal demifacet
 Tubercle
o Articular and nonarticular facet
 Neck
 Shaft
 Costal groove
 Ribs with the same morphology (3rd to 9th)

Borders:
a. Superior border – round and smooth
b. Inferior border – sharp and thin, with costal
groove
Shaft – thin, flattened and twisted

Body is always in the anterior side, the spine is always in

the posterior side

Facets – flat surfaces, points of articulation

“costal” – ribs ; “articular” – vertebral bone

a. Superior & inferior costal facets

b. Transverse costal facets
c. Superior and inferior articular facet

Cervicothoracic Joint

- Articulation between the C7 and the first

thoracic bone (T1)
Costal facet will articulate with the head and the ribs

ATYPICAL RIBS
a. First rib
b. Second rib
c. Tenth rib
d. Eleventh rib
e. Twelfth rib
1st rib
- Anatomical relationship with:
a. Lower nerves of brachial plexus
b. Main vessels: subclavian artery and vein
Serratus anterior – neck muscle
Groove – passage of the vessels
 - Most important muscle of respiration

Costal Cartilage – contribute to the elasticity and

DIAPHRAGM: Origin and insertion
mobility of the thoracic walls

SUPERIOR THORACIC APERTURE

DIAPHRAGM: OPENINGS
3 openings:
1. Aortic Opening
– lies anterior to the body of the 12 th thoracic vertebra
- Transmits aorta, thoracic duct and azygous vein
- Descending aorta
2. Esophageal opening
Aperture – openings - Lies at the level of the 10th thoracic vertebra
Anterior border is made up of suprasternal notch Transmits:
Lateral border – first rib a. Esophagus
b. Right and left vagus nerve
c. Esophageal branches of the left gastric
INFERIOR THORACIC OPENING vessels
Boundaries:
d. Lymphatics from the lower third of the
a. Posteriorly – body of the 12th thoracic vertebra
esophagus
b. Laterally – costal margin
3. Caval opening
c. Anteriorly – xiphisternal joint
– lies at the level of the 8th thoracic vertebra in the
-Closed by the diaphgram
central tendon
– transmits inferior vena cava and terminal branches of
Both openings are covered by:
the right phrenic nerve
SUPRAPLEURAL MEMBRANE
- Example of deep fascia
- Dense fascial layer
- Attached laterally to the medial border of
the first rib and costal cartilage
- Provides additional protection to the apex
Diaphgram
- provides enclosure that separates the two
cavity and closes the inferior thoracic
opening
- Skeletal muscle
- Thin muscular and tendinous septum
- Pierced by the structures that past between
the chest and the abdomen
 4th costal
notch

4th Costal notch will articulate to 4th costal

cartilage

Typical ribs: Ribs 3 – 9

What forms the sternal angle?

Manubriosternal joint

Give the anterior border for superior

thoracic outlet / opening – suprasternal
notch

- Articular part of tubercle of rib 7