OSTEOLOGY OF THORAX
 Curved to form an angle which increase from above downwards
STERNUM
 Consists of: manubrium – sternal body – xiphoid process
 Cancellous bone – source of hemopoietic stem cells
Manubrium
 It forms the anterior wall of superior mediastinum
 Upper margin is concave – forms jugular notch – where
interclavicular lig. lies
o Both angles at upper margin – articulates with respective
clavicle forming SC joint
o Below these angles – small articulation with 1st costal
cartilage (primary cartilaginous joint – synchondrosis)
 Lower margin – articulates with sterna body (secondary
cartilaginous joint – symphysis)
o Both angles at lower margin – articulates with upper part of
2nd costal cartilage
 Between articulations of 1st and 2nd, intercostals muscle is
attached at the lateral border
 Anterior surface – received attachment of pect. major & tendon
of SCM
 Posterior surface – attachment of sternohyoid & sternothyroid
 Both anterior & posterior surface is covered with two investing
layer of deep cervical fascia
Body of sternum
 Along its lateral border – articular facets for lower part of 2nd,
and 3rd until 7th costal cartilage – synovial joint  because of
their attachment to the sternum, they are called as ‘true ribs’
 Between the costal facets, anterior intercostals membrane &
internal intercostals muscle attached
 Pect. major widely attached at its anterior surface
 Transversus thoracis arise from its posterior surface
Xiphisternum
 Projects downward for attachment of linea alba
 It articulates with sternal body by secondary cartilaginous joint
(symphysis) which usually ossified later.
Surface markings
 Sternal angle – 2nd costal cartilage  useful to count the ribs
 Jugular noth – upper border of T3
 Sternal angle – lower border of T4
 Lower end of sternum – lower border of T8
RIBS
Typical rib
 Has: head, neck, shaft , tubercle
Head
 Has two articular facets – the vertical facet for own vertebra, and
upper facet for vertebra above
Neck
 Flattened, with sharp crest forming its upper border  for
attachment of superior costotransverse ligament
Tubercle
 Has two facets:
o Medial facet – smooth, for articulation with transverse
process of own vertebrae
o Lateral facet – rough, for attachment of lateral
costotransverse ligament
Shaft
 Upper border:
o Blunt
o Attachment for external & internal intercostals muscles
 Lower border:
o Sharp, forming costal groove on inner surface
o From the sharp border – external intercostals arises
o From the costal groove – internal intercostals is attached
o From the inner surface – transverse thoracic attached
o Neurovascular bundle lies between in the costal groove,
between internal intercostals & transverse thoracic muscles
 Its anterior end – articulate with costal cartilage in primary
cartilaginous joint
Atypical rib (1st, 11th, 12th)
1st rib
 STRONGEST, BROADEST, FLATTEST, MOST CURVED
 Superior surface – a part of root of the neck
 Inferior surface – a part of roof of the thoracic cavity
Head
 Has single facet for upper part of T1 vertebra body
 Structures that pass anterior to it (from medial to lateral most):
o Cervicothoracic ganglion of sympathetic trunk
o 1st posterior intercostal vein
o Superior intercostals artery VAN
o 1st thoracic nerve
* Cervical dome of the pleura + apex of the lungs – separate these
structures against the bony part of the rib
Tubercle
 Bony prominence that project between its short neck & shaft
 It is the most posterior part of the rib
 Medially, it has facet to articulate with 1 st transverse process (of
T1 thoracic vertebra)
 Laterally, it receives attachment of lateral costotransverse
ligament
Shaft
 Its undersurface (inferior):
o Crossed obliquely by small 1st intercostal vessels & nerve
o External & internal intercostals muscles attached to its outer
rim of the surface
 Its outer border:
o Blunt
o Gives attachment of 1st digitation of serratus anterior
 Its internal border:
o Gives attachment to suprapleural membrane in front of
subclavian groove
 Its upper surface:
o Has grooved for subclavian artery, with lower trunk of
brachial plexus behind it
o Posterior to the groove, between the groove and the
tubercle, it is a quadrangular area where scalene medius
attached
o Anterior to the groove, small bony prominent arises called
scalene tubercle – for attachment of scalene anterior
o Anterior to this, another groove presence in which
o
subclavian lies
At the anterior end of upper surface, subclavius arises
o Therefore, the structures on its upper surface are (from
posterior to anterior):
 Scalene medius attachment (in the quadrangular area)
 Lower trunk of brachial plexus (in the groove for
subclavian a.)
 Subclavian a. (in the same groove)
 Scalene anterior (on the scalene tubercle)
 Subclavian vein (in another groove of its own)
 Subclavius (at anterior end)
 Its anterior end expands to articulate with 1st costal cartilage
How to know right or left 1 st rib?

 Laid it on a table
 In normal orientation, both ends (anterior & posterior) should
both touch the surface  by this, we can distinguish the upper
and lower surface
 Then, we identified which one is anterior or posterior end. How?
 The head is the posterior end  has single articular facet
 So, now, we able to identify right or left rib

11th rib

 Has head with single facet for T11 vertebra

 Short neck
 No tubercle
 Very slight angle
 Shallow costal groove

12th rib

 Has head with single facet for T12 vertebra

 Very short neck
 No tubercle
 No angle
 No costal groove