Thoracic Wall Anatomy PDF

Thoracic Wall LEARNING OBJECTIVES After this lecture, you should be able to: Define the boundaries, spaces, and contents of the thorax Describe the osteology of the thoracic wall Describe the intercostal muscles of the chest wall Understand the blood supply to the chest wall...

Thoracic Wall LEARNING OBJECTIVES After this lecture, you should be able to: Define the boundaries, spaces, and contents of the thorax Describe the osteology of the thoracic wall Describe the intercostal muscles of the chest wall Understand the blood supply to the chest wall Understand the intercostal neurovascular structures ANATOMY OF THE THORAX THORAX (CHEST) Boundaries chest wall (bony structures) superior/inferior outlets Spaces R & L pleural cavities mediastinum Contents heart lungs others DEFINITION OF THE THORAX thoracic inlet superior border bounded by T1 vertebra, rib 1, and manubrium midaxillary line lateral border thoracic diaphragm and costal margin inferior border © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. ANATOMY OF THE THORAX – Thoracic Inlet THORACIC INLET SUPERIOR THORACIC APERTURE © 2019 Elsevier, Inc. All Rights Reserved. Modified from Gray’s Anatomy for Students. ANATOMY OF THE THORAX – Inferior Thoracic Aperture MUSCULAR DIAPHRAGM T8 - inferior vena cava T10 - esophagus T12 - aorta © 2019 Elsevier, Inc. All Rights Reserved. Modified from Gray’s Anatomy for Students THORAX/ABDOMEN RELATIONSHIP NIPPLES Level of 4th rib Diaphragm elevation upon full expiration (4th intercostal space) © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. OSTEOLOGY OF THE THORAX 1. Thoracic vertebrae (12) 2. Ribs (12 pairs) 3. Sternum © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. OSTEOLOGY OF THE THORAX jugular notch thoracic inlet bounded by T1 vertebra, rib 1, and manubrium sternal angle (of Louis) sternum manubrium body xiphoid process © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. OSTEOLOGY OF THE THORAX ribs (12) true (7) costal cartilages costal margin false (3) floating (2) © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. OSTEOLOGY OF THE THORAX - Ribs © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. MUSCLES OF THE ANTERIOR THORACIC WALL intermediate deep lateral pectoral nerve deltoid cephalic vein medial pectoral nerve pectoralis major pectoralis minor © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. SUPEFICIAL THORAX: THE BREAST breast nipple areola © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. SUPERFICIAL THORAX: THE BREAST suspensory ligaments (Cooper’s) gland lobule lactiferous duct axillary tail (of Spence) fat © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. INTERCOSTAL MUSCLES V A N © 2020 Elsevier, Inc. All Rights Reserved. Modified from Gray’s Anatomy for Students. LAYER OF THE THORACIC WALL skin superficial and deep fasciae external intercostal muscle internal intercostal muscle intercostal nerve innermost intercostal muscle or transversus thoracis muscle endothoracic fascia pleura (not seen) © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy. BLOOD SUPPLY TO THE THORACIC WALL posterior intercostal artery aorta internal thoracic (mammary) artery site of anastomosis allows collateral flow anterior intercostal artery © 2019 Elsevier, Inc. All Rights Reserved. Modified from Atlas of Human Anatomy.