Thoracic cage

Surface Anatomy

Anterior Surface of Thorax

Palpate
Sternum (3 parts) Jugular notch Sternal Angle (= 2nd rib) Clavicle Costal margin Infrasternal angle Xiphosternal joint

Midclavicular Line Midaxillary Line

Posterior Surface of Thorax

Palpate
Spinous Process of C7 Scapula (ribs 2-7)

Scapular spine Acromion Process Inferior Angle of Spine Inferior Border

Locating Internal Structures

Heart deep to xiphosternal angle Pleural Cavities
Inferior margin = adjacent to T12 in Posterior Midline To Rib 10 at Midaxillary line To Rib 8 at Midclavicular line To Xiphosternal joint medially

Lungs posterior border is 2 ribs superior to pleural cavity (rib 8)

The Vertebral Column

Composed of 26 bones, including 24 individual vertebrae and the fused vertebrae that form both the sacrum and the coccyx
The vertebral column has several functions: providing vertical support for the body supporting the weight of the head helping to maintain upright body position helping to transfer axial skeletal weight to the appendicular skeleton of the lower limbs housing and protecting the delicate spinal cord and providing a passageway for spinal nerves connecting to the spinal cord

The Chest Wall

Rib cage Soft tissues Muscles The chest wall is lined by the parietal pleura. The parietal pleura also covers the mediastinum. The visceral and parietal pleurae are attached by a thin film of liquid. There is normally no pleural space.

Thoracic Wall Dimensional Changes During Respiration

Lateral dimensional changes occur with rib movements. Elevation of the ribs increases the lateral dimensions of the thoracic cavity, while depression of the ribs decreases the lateral dimensions of the thoracic cavity.

Muscles that Move the Ribs

The scalenes help increase thoracic cavity dimensions by elevating the first and second ribs during forced inhalation. The ribs elevate upon contraction of the external intercostals, thereby increasing the transverse dimensions of the thoracic cavity during inhalation. Contraction of the internal intercostals depresses the ribs, but this only occurs during forced exhalation. Normal exhalation requires no active muscular effort.
A small transversus thoracis extends across the inner surface of the thoracic cage and attaches to ribs 26. It helps depress the ribs.

Two posterior thorax muscles also assist with respiration. These muscles are located deep to the trapezius and latissimus dorsi, but superficial to the erector spinae muscles. The serratus posterior superior elevates ribs 25 during inhalation, and the serratus posterior inferior depresses ribs 812 during exhalation. In addition, some accessory muscles assist with respiratory activities. The pectoralis minor, serratus anterior, and sternocleidomastoid help with forced inhalation, while the abdominal muscles (external and internal obliques, transversus abdominis, and rectus abdominis) assist in active exhalation.

Boyles Law

The pressure of a gas decreases if the volume of the container increases, and vice versa. When the volume of the thoracic cavity increases even slightly during inhalation, the intrapulmonary pressure decreases slightly, and air flows into the lungs through the conducting airways. Air flows into the lungs from a region of higher pressure (the atmosphere) into a region of lower pressure (the intrapulmonary region). When the volume of the thoracic cavity decreases during exhalation, the intrapulmonary pressure increases and forces air out of the lungs into the atmosphere.

Parts and regions of the thorax

Boundaries Superiorjugular notch, sternoclavicular joint, superior border of clavicle, acromion, spinous processes of C7 Inferiorxiphoid process, costal arch, 12th and 11th ribs, vertebra T12 Regions Thoracic wall Thoracic cavity

Landmarks
Jugular notch corresponds with
The 2th thoracic vertebra in male, the 3th thoracic vertebra in female

Sternal angle connects 2nd costal cartilage laterally corresponds with

The lower border of 4th thoracic vertebra The bifurcation of trachea in the adult The beginning of aortic arch which ends posteriorly at the same level The esophagus is crossed by the left main bronchus

 Xiphoid process phisternal junction lies opposite the body of the 9th thoracic vertebra Clavicle
Inferior fossa of clavicle Coracoid process

Ribs and intercostal spaces Costal arch

Infrasternal angle Xiphocostal angle

Papillae

Thoracic wall
Skin Superficial fascia
Thoracoepigastric v. Supraclavicular n. Anterior and lateral cutaneous branches of intercostal n.

Deep fascia

Intercostal space
Posterior intercostal v. Posterior intercostal a. Intercostal n.

Internal thoracic vessels Internal thoracic a.&v Parasternal ln Endothoracic fascia

Location: Female Superior border: 2nd rib Inferior border: 6th rib Medial border: Sternum Lateral border: Midaxillary line Male Fourth Intercostal Space, Midclavicular line Underlying muscle Pectoralis major and minor Part of serratus anterior, external obliques Arterial blood supply Internal thoracic artery Lateral thoracic artery Posterior intercostals Thoracoacromial artery Venous blood supply Axillary vein Internal thoracic vein Intercostal veins Innervations Intercostal nerves

Anatomy of the Breast

Mammary Glands
Modified sweat glands Role to provide nourishment and passive immunity to the neonate 15 to 25 lobes Lobes made of lobules
Function only in lactating females

Lactiferous ducts open to the nipple

Compound alveolar gland

Alveoli Alveoli lined by epithelial cells Secrete milk

Mammary Glands

Mammary Glands
Suspensory ligament
Lobes surrounded by adipose and connective tissue

Areola
Pigmented skin that surrounds the nipple