ATLAS

OF
ANATOMY

THORAX

FAWZI GABALLAH
ZAIZAFON BADAWY
 ATLAS
OF
ANATOMY

THORAX

By

FAWZI GABALLAH ZAIZAFON BADAWY

Professor of Anatomy, Faculty of Professor of Anatomy, Faculty ol
Medicine, Cairo University Medicine, Cairo University

Cairo, Egypt
11

All rights reserved. No part of this

book may be reproduced or transmitted
in any form or by any means without
permission in writing from the authors.

National Library Legal Deposit

4146/1989
 ill

PREFACE

This " ATLAS OF ANATOMY " contains 443 figures on the anatomy

of the thorax including the back. Almost all the anatomical facts

are illustrated in a clear way, and the diagrams are provided

with concise explanatory notes.

The authors hope that this diagrammatic atlas will be helpful

to the medical student as a guide to better understanding of anatomy.

Cairo, 1989 FAWZI GABALLAH

ZAIZAFON BADAWY
IV

OTHER BOOKS BY THE SAME AUTHORS

1. Atlas of Anatomy (other parts). —

2. Atlas of Embryology.
—•

3. Basic Human Anatomy.

4. Basic Embryology.

5. Basic Neurornatomy.

6. A summary ol Anatomy.

7. Oral Questicns in Anatomy.

 CONTENTS
THORACIC CAGE 1

VERTEBRAL COLUMN 5
Cervical vertebrae 8
Thoracic vertebrae 13
Lumbar vertebrae 15
Sacrum and coccyx 16
Joints of the vertebral column 25
Ligaments of the vertebral column 28
Movements of the vertebral column 31

STERNUM 32

RIBS 36

JOINTS AND MOVEMENTS OF THORACIC CAGE 47

Joints of thoracic cage 47
Movements of the ribs 50

MUSCLES OF THORACIC WALL 54

MUSCLES OF THE BACK 59

DIAPHRAGM 64

INTERCOSTAL NERVES 67

ARTERIES OF THE CHEST WALL 71

Internal thoracic artery 71
Posterior intercostal arteries 75

VEINS OF THE CHEST 82

Veins of the chest wall 82
Brachiocephalic veins 86
Superior vena cava 90
Vertebral plexuses of veins 92

THORACIC INLET 93

MEDIASTINUM 96

LUNGS 103
Surfaces and borders 103
Root of the lung 112
Surface anatomy of the lungs 116

BRONCHI AND BRONCHOPULMONARY SEGMENTS 118

PLEURA 124

THORACIC OUTLET 130

TRACHEA 132
VI

PERICARDIUM 140
Position, shape and relations 140
Sinuses of pericardium 146

HEART 149
External features of the heart 149
Right atriuti 156
Right ventricle 159
Left atrium 163
Left ventri;le 165
Conducting system of the heart 172
Blood vesse Ls of the heart 174
Nerve suppl i of the heart 178
Radiography of the chest _ 180
PULMONARY TRUNK 182
Pulmonary arteries 185

AORTA 186
Ascending aorta 187
Arch of the aorta 189
Branches of the arch of the aorta 193
Descending aorta 197

NERVES IN THE CHEST CAVITY 201

Vagus nerve 202
Phrenic neo e , 205
Thoracic pait of sympathetic trunk 209

OESOPHAGUS 213

THORACIC DUCT 219

LYMPH NODES OF THE CHEST 223

 THORACIC CAGE

Fig.(l): BOUNDARIES OF THE THORACIC CAGE

The thoracic cage is conical in shape having an inlet, an outlet and 4 walls
(anterior, posterior and 2 lateral).

(a) inlet: is the narrow upper end, and is continuous with the root of the neck,

(b) outlet: is the broad lower end, and is separated from the abdominal cavity
by the diaphragm.

1. anterior wall: is formed by the sternum, costal cartilages and anterior

parts of the ribs.
2. lateral wall: is formed by the ribs.
3. posterior wall: is longer than the anterior wall and is formed by all
the thoracic vertebrae and the posterior parts of the ribs.
Fig.(2): INLET AND OUTLET OF THE
THOR\CIC CAGE

(a) inlet.

(b) outlet.

1. anterior wall. 3
2. outline of the diaphragm
closing the outlet.
3. posterior wall.

Fig.(3): SLOPE OF THE INLET AND

OUTLET

(a) slope of the inlet: downwards

and forwards from the 1st thoracic
vertebra to the upper border of the
manubrium sterni.

(b) slope of the outlet: downwards

and backwards from the lower end
of the body of the sternum to the
12th thoracic vertebra.
J Fig.(4): BOUNDARIES OF THE INLET

The thoracic inlet is bounded

by the 1st thoracic vertebra (behind),
1st rib (on each side) and upper
border of manubrium sterni (in front).

1. 1st thoracic vertebra.

2. 1st rib.
3. 1st costal cartilage.
4. manubrium sterni.

* Note that the anteroposterior

diameter of the inlet is 1/2 its
transverse diamter.

Fig.(5): CERVICAL RIB

It is an abnormal rib which may be

found in the root of the neck just 4
above the thoracic inlet. It
articulates by its head with the 7th
cervical vertebra and if it is long
enough its anterior end reaches the 1st
rib or the manubrium sterni.

1. 7th cervical vertebra.

2. cervical rib.
3. 1st rib.
4. anterior end of the cervical rib
(replaced by a fibrous cord).

Fig.(6): RELATIONS OF CERVICAL RIB

It may pass below the 3rd part of
subclavian artery and lower trunk of
the brachial plexus.

1. cervical rib.
2. lower trunk of brachial plexus.
3*. 3rd part of subclavian artery.
Fig.(7): BOUNDARIES OF THE
OUTLET

It is bounded by the
cartilages cf the 7th, 8th
9th and 10th ribs of both
sides (in front), by the
12th thoracic vertebra (behind)
and by the 11th and 12th ribs
(on each si,qe).

1. 11th rib.
2. 12th rib.
3. cartilages of 7, 8, 9
and 10 ribs (fused together)
4. 12th thoracic vertebra.

Fig.(8): INFRASTERNAL ANGLE

It is the angle present below the

sternum. It is bounded on each side
by the fused cartilages of 7, 8, 9
and 10 ribs.

1. right bouidary of the infra-

sternal a.igle.
2. arrow in :he infrasternal angle.
3. left boundary of the infrasternal
angle.