Lecture 2

The Thorax
The Thorax

 Axial & Appendicular Skeleton

 Thoracic Wall
 Mammary Glands
 Surface Anatomy
 The Skeleton

 Strong  Bones
 Light  Cartilage
 Weight-bearing  Joints
 Locomotion  Ligaments
 Protection
 Manipulation
Axial/Appendicular
 Axial Appendicular
 Skull  Limb Girdles
– Cranium – Pectoral Girdle
– Facial Bones – Pelvic Girdle
 Vertebrae  Upper Limbs
 Ribs  Lower Limbs
 Sternum
 The Bony Thorax

 The Thoracic Vertebrae

 The Ribs
 The Sternum
 Clavicle
 Scapula
 The Vertebral Column
 26 Bones
– 7 Cervical
– 12 Thoracic
– 5 Lumbar
– Sacrum (5 Fused Sacral
Vertebrae)
– Coccyx (4 Fused
Coccygeal Vertebrae
 Curvature
– Cervical Region =
Concave
– Thoracic Region =
Convex
– Lumbar Region =
Concave
– Sacrum = Convex
Characteristics of Vertebral
Column
 Extends from skull to pelvis
 Support, site of muscle attachment
 Vertebral Canal
– Created by vertebral foramen
– Contains and protects spinal cord
Characteristics of a Typical
Vertebra
 Body
 Vertebral Arch
 Transverse Processes
 Spinous Process
 Vertebral Foramen
 Pedicles
 Laminae
 Articular Processes and
Facets (Superior and
Inferior)
 Intervertebral Foramina
Typical Cervical Vertebra
  TRANSVERSE FORAMINA
   Superior Articular Facets face
superoposteriorly
   Inferior Articular Facets face inferoanteriorly
   Allows wide range of motion (flexion,
extension, lateral flexion, rotation)
    Spinous process fairly short, bifid (except
for C7 --vertrbra prominens-- long and
not bifid)
   Vertebral foramen is triangular
   Body is wider laterally
Typical Cervical Vertebra
Atypical Cervical Vertebrae
 Atlas (C1)
– No Body
– No Spinous Process
– Kidney-shaped Superior Articular Facets

 Axis (C2)
– Odontoid Process = Dens
– Otherwise has features of typical vertebra
Atlas
Axis
 Typical Thoracic Vertebrae
 TRANSVERSE COSTAL FACETS
 DEMIFACETS on VERTEBRAL BODY
 Body is heart-shaped
 Spinous process long/points inferiorly
 Vertebral foramen is circular
 Superior articular facets face posteriorly
 Inferior articular facets face anteriorly
 Rotation
 Lateral flexion limited by ribs
 Flexion/extension prevented
Typical Thoracic Vertebra
 Atypical Thoracic Vertebrae

 T 1 has a full facet for the full rib and a

demifacet for the second fib
 T 11 and T 12 do not have facets on the
transverse processes
 T11 and T 12 have full facets on their
bodies
Lumbar Vertebrae
 Vertebral foramen is triangular
 Spinous processes are short, hatchet-
shaped and project posteriorly
 Superior articular facets face medially
 Inferior articular facets face laterally
 Body is massive/kidney-shaped
 Flexion and extension/some lateral
flexion/rotation prevented
Lumbar Vertebra
 Sacrum
 5 fused sacral vertebrae
 Articulates with
– 5th Lumbar vertebra
   

– Coccyx
– Ilia
 Has body, foramina, alae (wings) and sacral
canal
 Median sacral crest-fused spinous processes
 Lateral sacral crest – transverse processses
The Sacrum
The Coccyx

 Small and triangular

 4 fused coccygeal vertebrae
 Useless except for slight support to
pelvic organs
 Articulates with sacrum
 Point of attachment for some
muscles/ligaments
 Intervertebral Discs
 Act as shock absorbers
 Composed of
– Annulus Fibrosus
• Outer collar of ~12 concentric rings
• Outer rings are ligaments
• Inner rings are fibrocartilage
• Contain the nucleus pulposis, bind successive
vertebrae, resist tension, and absorb
compressive forces
– Nucleus Pulposus
• Gelatinous
• Absorb compressive Stress
 Vertebral Ligaments
 Anterior Longitudinal
Ligament
– Wide and thick
– Attaches to vertebrae and
discs
– Support
– Prevents hyperextension
Vertebral Ligaments (cont.)
 Posterior
Longitudinal
Ligament
– Narrow and
weak
– Attaches only
to the discs
– Limits
Hyperflexion
 Vertebral Ligaments (cont.)

 Ligamentum Flavum
– Strong and elastic
– Connect vertebrae to those immediately
superior and inferior
– Stretches with flexion, recoils with return to
erect posture
The Bony Thorax
 The Ribs
 12 Pairs
– All attach to thoracic vertebrae and run
anteroinferiorly
– Superior 7 pairs are true ribs
• Attach to sternum directly by costal cartilages
• Vertebrosternal
– Inferior 5 pairs are false ribs
• Attach to sternum indirectly or not at all
• Vertebochondral
• Pairs 11 and 12 are floating ribs
– No anterior attachments
Typical Ribs
 Ribs 2-9 (10)
 Head
 Neck
 Tubercle
 Angle
 Shaft
 Subcostal
Groove
– Intercostal vein
– Intercostal artery
– Intercostal nerve
Typical Posterior Rib Articulation
•Head of rib
attaches to superior
demifacet of its
vertebra, inferior
demifacet of
vertebra above, and
intervertebral disc
•Tubercle of rib
attaches to
transverse costal
facet
 Atypical Ribs

 Ribs 1, 11, and 12

 Rib 1
– articulates only with T1 (remember there is
a full facet on the body of T1)
– Flattened and broad
– Supports the subclavian vein and artery
which supply the arm
 Atypical Ribs

 Ribs 11 and 12
– Articulate with only one vertebral body
– Do not articulate with a vertebral
transverse process
– Do not have a ventral attachment – floating
ribs
Blood Vessels of the Thoracic Wall
 Internal
Thoracic
Artery
– aka int.
mammary
– Branch of
subclavian
– Anterior
intercostals
 Posterior
Intercostals
– Run in sub-
costal groove
 Muscles

 Origin
– The attachment of a muscle that remains
relatively fixed during contraction
 Insertion
– The attachment of a muscle that is more
moveable during contraction
 The Intercostal Muscles
 External Intercostals
– Superficial
– 11 pairs lie between
ribs
– Fibers run obliquely
downward and
anteriorly
– Origin is inferior
border of rib above
– Insertion is superior
border of rib below
– Lift ribcage, aiding in
inspiration
The Intercostal Muscles
(cont.)
 Internal Intercostal
muscles
– Lie deep to external
intercostals
– 11 pairs lie between ribs
– Fibers run downward and
posteriorly
– Origin is superior border
of rib below
– Insertion is inferior border
of rib above (subcostal
groove)
– Draw ribs together, aiding
in forced expiration
 Intercostal Muscles (Cont.)

 Innermost Intercostals
• Attach to innermost surfaces of ribs
• Fibers run anteroposteriorly (i.e. horizontally)
• Thought to function like internal intercostals

 VAN
• the intercostal neurovacular bundle runs between
the interior intercostals and the innermost interior
intercostals
The Bony Thorax
 The Sternum
 Lies in anterior midline
 Formed from multiple fused sternebrae
 3 Sections
– Manubrium
• Articulates with ribs 1 and 2
• Articulates with clavicle at clavicular notches
• Has jugular notch
• Joins body at sternal angle which is a fibrocartilage joint
– Body (Gladiolus)
• 4 separate bones that fuse after puberty
• Articulates with costal cartilages of ribs 2-7
– Xiphoid Process
The Clavicle
The Scapula
 The Mammary Glands

 Present in both sexes

 Function only in lactating females
 Modified sweat glands (exocrine
glands)
 Location
 Female  Male
– Base of breast – Nipple in located
• 2nd rib in the 4th
superiorly intercostal space
• 6th rib inferiorly in the
• Sternum midclavicular line
medially
• Midaxillary line
laterally
 Underlying Muscle
– Pectoralis major and
minor
– Part of serratus anterior,
external oblique
 Arteries
– Lateral thoracic artery,
branches of internal
thoracic artery, posterior
intercostals
 Veins
– Intercostal, internal
thoracic, axillary veins
 Nerves
– Branches of intercostal
nerve
 Structure
 Breast made of 15-25 lobes (each lobe is a compound
alveolar gland opening to nipple)
 Lobes separated by adipose and strips of connective
tissue which form the suspensory ligaments of the
breasts
 Each lobe consists of lobules (clusters of acini/alveoli)
 Walls of alveoli lined w/milk-secreting simple cuboidal
epithelial cells; milk passes through progressively
larger ducts, finally reaching the lactiferous ducts
 Lactiferous ducts of lobes open at nipple
 Areola’s sebaceous glands produce sebum during
nursing
Surface Anatomy
Anterior Thorax
Posterior Thorax
Surface innervation
 Pleura (C4)

Heart (T3 i
diaphragma C4 T4)
Oesophagus
T4 i T5
Gaster T8

liver + gall bladder Pancreas +

T8 – T11 small
intestine T 10
kidney and testicles
Colon T11 (ovaria)
T10 – L1
Heart diagram
Auscultation points
 tricuspidal valve

bicuspidal valve
Ostium tr. pulmonalis

Ostium aortae
Ant. border and fissures of the lung

A. ant. border B. inferior border 1- horizontal fissure 2 –

oblique fissure