Human Anatomy

Lec. 10/ Dr. Mortadha Sami

The Thorax
It is the region of the body between the neck and the abdomen. It is flattened in front
and behind but rounded at the sides. The framework of the walls of the thorax is
referred as the thoracic cage which protects the lungs and heart and affords
attachment for the muscles of the thorax, upper extremity, abdomen, and back.

Structure of the Thoracic Walls

The thoracic walls are covered on the outside by skin and by muscles attaching the
shoulder girdle to the trunk, while from inside they are lined with parietal pleura.
The thoracic wall is formed
1. Anteriorly by 12 pairs of ribs with their costal cartilages and the sternum.
2. posteriorly by the thoracic part of the vertebral column (12 thoracic vertebrae
T1–T12) to which the ribs are anchored to them.
3. Laterally by the ribs and intercostal spaces.
4. Superiorly by the suprapleural membrane.
5. Inferiorly by the diaphragm, which separates the thoracic cavity from the
abdominal cavity.
The bones of the thorax split into 3 main groups:
1) the sternum.
2) the ribs.
3) the thoracic spine.
The Sternum
The sternum is a flat bone, which is separated into 3 parts:
1. The Manubrium.
2. The Body.
3. The Xiphoid process.
The function of the sternum is to provide articulations for the ribs and to protect
internal thoracic organs.
The Manubrium
• The manubrium is the most superior portion of the sternum and lies opposite the
3rd and 4th thoracic vertebrae
• The superior aspect of the manubrium is concave, producing a depression known
as the jugular (suprasternal) notch this is visible underneath the skin.
• The manubrium articulates with the clavicles on either side forming the
sternoclavicular joints.
• Also, it articulates with the costal cartilage of the 1st rib and the upper part of
the costal cartilage of the 2nd rib on the lateral edges.
• Inferiorly, the manubrium articulates with the body of the sternum at the
manubriosternal joint, forming the sternal angle (angle of Louis) so called
because the junction between these two components is not flat, but forms a slight
bend.

The body
• The body is flat and elongated and is the largest part of the sternum. It articulates
with the manubrium superiorly (manubriosternal joint) and the xiphoid process
inferiorly (xiphisternal joint).
• The manubrium and body join together at the sternal angle.
• The lateral edges of the body articulates with the costal cartilages of ribs 2-7.

The xiphoid process

• The xiphoid process is the most inferior and smallest part of the sternum.
• It is variable in shape and size, with its tip located at the level of the T10
vertebrae.
• The xiphoid process is largely cartilaginous in structure, and completely ossifies
and fuses with the sternum later in life around the age of 40.
• In some individuals, the xiphoid process articulates with part of the costal
cartilage of the seventh rib.
The Ribs
The ribs are a set of 12 paired curved flattened bones which form the protective
cage of the internal thoracic organs. They also have a role in ventilation; moving
during chest expansion to enable lung inflation. They articulate with the vertebral
column posteriorly (T1–T12 thoracic vertebrae), and attach anteriorly via their
costal cartilages to the sternum.

Rib Structure
There are two classifications of ribs typical and atypical. The typical ribs have a
generalized structure, while the atypical ribs have variations on this structure.
The Typical Ribs
The parts of the typical ribs are:
• The head of the rib is the posterior end of rib. This region articulates primarily
with the costal facet located on the body of the same numbered thoracic vertebra.
• The neck of the rib is the narrowed area lateral to the head.
• Tubercle of the rib is a small bump on the posterior rib surface, which articulates
with the facet located on the transverse process of the same numbered vertebra.
• The shaft of the rib (body) which is a thin and flattened. The inferior border
forms the costal groove, which accommodates the intercostal vessels and nerve.
• The angle of the rib is just lateral to the tubercle, it is the point at which the rib
has its greatest degree of curvature.

Atypical Rib
Ribs 1, 2, 10, 11 and 12 can be described as atypical they have features that are not
common to all the ribs:
• Rib 1 is shorter and wider than the other ribs. It only has one facet on its head for
articulation with its corresponding vertebrae. The superior surface is marked by
two grooves, which make way for the subclavian vessels.
• Rib 2 is thinner and longer than rib 1, and has two articular facets on the head as
normal ribs. It has a roughened area on its upper surface, from which the serratus
anterior muscle originates.
• Rib 10 only has one facet for articulation with its numerically corresponding
vertebrae.
• Ribs 11 and 12 have no neck, and only contain one facet, which is for articulation
with their corresponding vertebrae.

Rib Classifications
The bony ribs do not extend anteriorly completely around to the sternum. Instead,
each rib ends in a costal cartilage. These cartilages are hyaline cartilages. Most ribs
are then attached, either directly or indirectly, to the sternum via their costal
cartilage.
The ribs are classified into three groups based on their relationship to the
sternum:
1. True ribs: The upper 7 pairs are attached anteriorly to the sternum by their costal
cartilages.
2. False ribs: The 8th, 9th, and 10th pairs of ribs are attached anteriorly to each other
and to the 7th rib by means of their costal cartilages.
3. Floating ribs: The 11th and 12th pairs. These are short ribs that do not attach to
the sternum at all. Instead, their small costal cartilages terminate within the
musculature of the lateral abdominal wall.
The costal cartilages contribute significantly to the elasticity and mobility of the
thoracic walls. In old age, the costal cartilages tend to lose some of their flexibility
as the result of superficial calcification.
Joints of the Chest Wall
Joints of the Sternum:
1. The manubriosternal joint: is a cartilaginous joint between the manubrium and
the body of the sternum. A small amount of angular movement is possible during
respiration.
2. The xiphisternal joint: is a cartilaginous joint between the xiphoid process and
the body of the sternum.

Joints of the Ribs:

1. Joints of the Heads of the Ribs The 1st rib and the three lowest ribs have a
single synovial joint with their corresponding vertebral body. For the 2nd to 9th
ribs, the head articulates by means of a synovial joint with the corresponding
vertebral body and that of the vertebra above it. There is a strong intraarticular
ligament that connects the head to the intervertebral disc.
2. Joints of the Tubercles of the Ribs The tubercle of a rib articulates by means of
a synovial joint with the transverse process of the corresponding vertebra. (This
joint is absent on the 11th and 12th ribs.).
3. Joints of the Ribs and Costal Cartilages These joints are cartilaginous joints.
No movement is possible.
4. Joints of the Costal Cartilages with the Sternum The 1st costal cartilages
articulate with the manubrium, by cartilaginous joints that permit no movement.
The 2nd to 7th costal cartilages articulate with the lateral border of the sternum by
synovial joints. The cartilages of the 11th and 12th ribs are embedded in the
abdominal musculature.
Suprapleural Membrane
Superiorly, the thorax opens into the root of the neck by a narrow aperture, the
thoracic outlet. The outlet transmits structures that pass between the thorax and the
neck (esophagus, trachea, blood vessels, etc.). On either side of these structures, the
outlet is closed by a dense fascial layer called the suprapleural membrane.

Diaphragm
The diaphragm is a double-domed musculotendinous sheet, located at the inferior
most aspect of the rib cage and acts as the floor of the thoracic cavity and the roof
of the abdominal cavity. It serves two main functions:
• Separates the thoracic cavity from the abdominal cavity.
• Undergoes contraction and relaxation, altering the volume of the thoracic cavity
and the lungs producing inspiration and expiration.
The right dome lies at a higher level, because of the large size of the right lobe of
the liver.

Attachments of diaphragm
The attachments can be divided into:
• Lumbar vertebrae.
• Costal cartilages of lower four ribs 7-10 while it attaches directly to ribs 11-12.
• Xiphoid process of the sternum.

Shape of the Diaphragm

• From front, the diaphragm curves up into right and left domes, or cupulae.
• The right dome reaches as high as the upper border of the 5th rib (because of the
large size of the right lobe of the liver), while the left dome may reach the lower
border of the 5th rib.
• The central tendon lies at the level of the xiphisternal joint .
• The domes support the right and left lungs, whereas the central tendon supports
the heart.
Action of the Diaphragm
On contraction, the diaphragm pulls down its central tendon and increases the
vertical diameter of the thorax.

Openings in the Diaphragm

The diaphragm has three main openings:
➢ Esophageal opening: The esophagus and vagus nerve, pass through this
opening.
➢ Aortic opening: The aorta, the body’s main artery that transports blood from the
heart, passes through the aortic opening. The thoracic duct, a main vessel of the
lymphatic system, also passes through this opening.
➢ Caval opening: The inferior vena cava, a large vein that transports blood to the
heart, passes through this opening.