Gross Anatomy of Thorax

Lawan Hassan Adamu

L.H. Adamu
04/16/25 1
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 Conceptual overview

• The thorax is an irregularly shaped cylinder

with a narrow opening; superior thoracic
aperture (STA) superiorly and a relatively
large opening; inferior thoracic aperture
(ITA) inferiorly.
• The STA is open, allowing continuity
with the neck;
• The ITA is closed by the diaphragm.
• The musculoskeletal wall of the thorax is
flexible.

L.H. Adamu
04/16/25 2
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 Regions and functions of the thorax
Regions
• The cylindrical thorax consists of:
– a wall
– two pleural cavities
– the lungs
– the mediastinum.
Functions
• The thorax houses the heart and lungs, acts as a conduit for structures passing
between the neck and the abdomen, and plays a principal role in breathing.
• In addition, the thoracic wall protects the heart and lungs and provides support
for the upper limbs.

L.H. Adamu
04/16/25 3
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 Thoracic Wall
• Vertebrae (12 thoracic & IV disc, 2nd – 8th are typical, with one half costal facet
and others are atypical, with one complete costal facet.
• Features: body, foramen , laminae , pedicles, processes, facet.

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 Thoracic Wall
• Ribs (twelve on each side. Attachment wise; I-VII are true ribs, articulate directly with the sternum,
VIII-X are false ribs don’t directly & XI-XII are floating ribs don’t.
• However, structurally, III – IX are typical and I, II, X, XI & XII are atypical.

• Features: head with crest & facets, neck, tubercle with an articular & a non-articular parts, shaft
bend at angle with internal surface somewhat superior and has costal groove at inferior margin.

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 Thoracic Wall

Applied Anatomy
• Cervical rib (1%): its cervical cause of thoracic outlet
syndrome by putting upward stresses on of the brachial
plexus
• Rib fracture: If enough ribs are broken, a loose segment of
chest wall, a flail segment (flail chest), is produced creating
a paradoxically moving segment.

Joint bewteen Vertebrae & ribs

• Costobertebral: head and body
• Costotransverse: tubercle & transverse
process.

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 Thoracic Wall…
Costal cartilage
• At anterior end of each rib is, contributes to the mobility and elasticity of the
wall)
Sternum
• Anteriorly, manubrium, body and xiphoid process).

Joints within and between sternum & costal

• Sternocostal, interchondral, manubriosternal & xiphisternal joints

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Thoracic Wall…
Applied Anatomy
• Collection of sternal bone marrow: for diagnosis of blood diseases such as
leukemia.
• A clinically useful feature of the manubriosternal joint is that it can be palpated
easily.
• Manubrium normally angles posteriorly on the body of sternum, forming a
raised feature referred to as the sternal angle.

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 Thoracic Wall…
Applied Anatomy
The sternal angle.
• This elevation marks :
i. The site of articulation of rib II with the
sternum.
ii. Therefore, rib II is used as a reference for
counting ribs and can be felt immediately
lateral to the sternal angle
iii. The plane between IV disc vertebrae TIV and
TV,
iv. Separates the superior mediastinum from
the inferior mediastinum,
v. Superior border of the pericardium.
vi. End of the ascending aorta
vii. Beginning of the arch of the aorta,
viii. End of the arch of the aorta
ix. Beginning of the thoracic aorta,
x. Bifurcation of the trachea, and just superior
to the pulmonary trunk . 9
 Thoracic Wall…
Intercostals space
• Intercostal spaces (ICS) lie between adjacent ribs and are filled by three layers of
intercostal (IC) muscles (external IC, internal IC, innermost IC, Subcostales and
transversus thoracis ).
• IC nerves and vessels lie in the costal groove (arrange as VAN from superior to inferior)
in the plane between the inner two layers of muscles.
• Endothoracic fascia, loose CT with variable amounts of fat, separate ICS structure from
pleura.

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 Thoracic Wall…
.
Applied Anatomy
Thoracentesis: Insertion of hypodermic needle through an intercostal space into the pleural
cavity.
• Inserting the needle into the 9th intercostal space in the midaxillary line during expiration
will avoid the inferior border of the lung.
• The needle should be angled upward, to avoid penetrating the deep side of the recess.

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 Pleura; types, cavity and recesses
Definition
• The pleura are thin membranes that line the lungs and the inside of
the chest cavity and act to lubricate and facilitate breathing
Types:
• Parietal pleura; associated with the walls of a pleural cavity.
• Visceral pleura, associated with the surface of the lung is which
adheres to.

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 Pleura; types, cavity and recesses
Pleural cavity :
• is the potential space enclosed between the visceral and parietal pleurae, contain
thin layer of serous fluid

Pleural recesses
•spaces where the pleural cavity is not totally filled by the lung parenchyma
•Located in anterior or posterior inferior regions of the pleural cavities .
•Provide additional space for the lungs to expand during forced inspiration

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 Pleura; types, cavity and recesses

Applied Anatomy
• The lungs and pleural sacs may be injured in
wounds to the base of the neck resulting in a
pneumothorax, the presence of air in the
pleural cavity.
• The accumulation of a significant amount of
fluid in the pleural cavity (hydrothorax) may
result from pleural effusion.

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 THANK YOU

Best of Luck ǃ

L.H. Adamu
04/16/25 15
([email protected])