THORAX

Surface anatomy
Truncated cone
Flattened anteroposteriorly
Contains the important organs of circulation, respiration and digestion
Shortens in front
Consists of the f
1. Anterior wall
a. Sternum
i. Manubrium
ii. Body
iii. Xyphoid
b. Anterior parts of the ribs and corresponding costal cartilages
2. Lateral wall
a. Ribs that obliquely courses downward and forward
3. Posterior wall
a. Thoracic vertebra (t1 to t12)
i. Characterized by their articular facets and heart shaped body
of the vertebra
b. Posterior part of the rib and their angles
4. Superior aperture (thoracic inlet)
a. Located at the base of the neck
b. Bounded by
i. Suprasternal notch
ii. 1st rib and costal cartilage
iii. 1st thoracic vertebra
c. At this area, the intercostals muscles are replaced by
i. Scalene muscles
d. Has a diaphragm
i. Consists of Sibsons fascia
1. Pyramidal extends from the transverse process of C7
inserting into the inner surface of the 1st rin
e. Flattened therefore measures 2x4 inches
f. In adults - oval (kidney shaped) ; in children round (barrel shaped)
5. Thoracic outlet (inferior aperture)
a. Courses inferiorly and backwards in the front
b. 8.5 inches in diameter
c. Covered by muscular movable diaphragm
d. Separetes the thoracic from abdominal cavity
e. Transmits the inferior vena cava, aorta and esophagus
SURFACE LANDMARKS (Bony features of the thorax)
Clavicle and associated muscles
Sternum
o Suprasternal notch between T2 and T3
Sternoclavicular joint
Costosternal joint
Xyphisternal joint
o At the level of T9
Sternal angle of Louis
o Between T4 and T5

Where the 2nd rib articulates with the lower border of manubrium
and upper border of sternum
o Important landmark for counting the ribs and intercostals spaces
Ribs and corresponding cartilages
Scapula
o In the level of 2nd to 7th rib
o Medial border when protacted is at the level of the 6 th rib
Thoracic vertebra from T9 to T12
Inferior sternocostal angle
o Angle formed by the lowest costal cartilage with the xyphoid
process
Nipple
o Males: 4th intercostal space mammary line
o Females: variable
o

ARBITRARY LINES (used for descriptive orientation of the structures of the thorax)
- Vertical lines or longitudinal lines
Midsternal line
o Bisects the sternum to right and left equal halves
o Corresponds to the midline at the back
Mammary line
o From the medial aspect of the clavicle along the nipple downward
Parasternal line
o Opposite the lateral edges of the sternum midway between
midsternal line and mammary line
Midclavicular line
o Middle of the clavicle downward to the middle of the inguinal region
Anterior axillary line
o From the anterior axillary folds downward
Posterior axillary line
o From the posterior axillay fold downwards
Midaxillay line
o From the middle of the axilla downwards
o In between anterior and posterior axillary line
Midscapular line
o Bisects the inferior angle of the scapula
Paravertebral line
o Opposite the transverse processes of the vertebra downwards