Introduction to thorax

It is bony cage, which encloses heart and lungs 37 bones form it Boundaries of thorax Anteriorly - sternum& costal cartilage Posteriorly thoracic vertebrae & intervertebral disc On either side ribs & intercostal space Superior - inlet of thorax formed by first rib, upper border of sternum, 1st thoracic vertebra Inferior diaphragm Ribs there are 12 pairs of ribs divided in to three categories

Vertebrosternal (true) 1st to 7th ribs which articulate with sternum through costal cartilage Vertebrochondral (false)- 8,9,10th ribs costal cartilages of these ribs articulate with costal cartilages of ribs superior to them

Vertebral ribs 11th and 12th which are Anteriorly free

Ribs are also divided in to typical and atypical Typical ribs has Head has two articular Demifacet one for corresponding vertebra and other for vertebra immediately above Tubercle is divided in to articular and non-articular parts articular facet for transverse process of TV It shows angle 5cm lateral to tubercle where it is twisted It has well defined costal grove It has outer and inner surface Typical ribs are 3rd to 9th Atypical ribs - these ribs do not have the characteristics of typical ribs these are 1st, 2nd, 10th, and 11th, 12th. First rib it is atypical because Its angle corresponds to the tubercle

 Has only one facet It has superior and inferior surfaces No costal groove No twist Side determination - when rib is place on horizontal surface superior surface with shallow groove facing upwards anterior and posterior ends touches the ground if placed wrongly head of ribs remain raised above Structures related to first ribs Neck related to Sympathetic trunk Superior intercostal artery

1st posterior intercostal vein 1st thoracic nerve

Upper surface related with Origin of subclavius Costoclavicular ligament Subclavian vein

 Scalenus anterior muscle inserted into tubercle Subclavian artery Lower trunk of brachial plexus Scalenus medias insertion Lower surface related with costal pleura and serratus anterior muscle Second rib

Length is double of 1st

No twist both ends touches the ground Scalene tubercle origin to Scalenus anterior Shaft has external and internal surfaces Tenth ribs Single facet on its head Other features are same like typical Eleventh rib Single facet No tubercle No neck

 Shallow costal groove Slight angle Twelfth ribSingle facet No neck No tubercle No angle No costal groove Shorter then 11th

Sternum - it has three parts

Manubrium Body Xiphoid process Manubrium has free concave upper margin called suprasternal notch Inferiorly articulates with body to form Manubriosternal joint Superiorly articulate with clavicle to form sternoclavicular joint

Anterior surface gives origin to sternocleidomastoid and pectoralis major Posterior surface sternothyroid and sternohyoid Sternal angle Body of sternum It is made up of 4 sternebrae upper end articulates with Manubrium lower end with Xiphoid process

2nd to 7th costal cartilages are attached to its lateral surface

Anteriorly related with skin and superficial fascia Posteriorly gives origin to sternocostalis

Body lies at the level of T6,7,8th vertebrae

Xiphoid process It is pointed lower end lies at T9 Anteriorly it Gives attachment of rectus abdominis Posteriorly to sternocostalis

 Linea alba attached to lower end Clinical anatomy - since it is easy to access the sternum is common site for bone marrow biopsy

Thoracic vertebrae
Identify the parts of vertebrae Body Spine Pedicle Lamina Transverse process Superior articular process Inferior articular process Inferior and superior vertebral notches Vertebrae are of three types Cervical have foramina transversarium in the transverse process Thoracic have no foramina transversarium have but articular facet

on the side of body near the pedicle for head of ribs Lumbar no foramina transversarium no articular facet but larger body There are 12 thoracic Vertebrae Each thoracic Vertebrae has superior and inferior articular process at the junction of pedicle with lamina They are divided in to typical and atypical thoracic Vertebrae Typical thoracic Vertebrae T2,3,4,5,6,7,8. Two Demifacet one at the upper end of posterior part of body and another at lower end of posterior part of body There is an articular facet on the transverse process Superior vertebral notch is not deep Inferior vertebral notch is deep Atypical thoracic Vertebrae T1,9,10,11,12. First thoracic Vertebrae

 Complete facet at its upper end

Demifacet at the lower end for head of 2nd rib & a facet over transverse process for tubercle of 1st rib

Spine is horizontal like cervical Ninth thoracic Vertebrae

Only one demi facet at upper end for head of 9th rib

No demi facet for lower end

There is a facet on the transverse process for tubercle of 9th rib

Tenth thoracic Vertebrae Complete facet on the side of upper end Body has no articular facet Facet over the transverse process for the tubercle of T-10 Eleventh thoracic vertebra Complete facet on the side of upper end No facet on transverse process Twelfth thoracic vertebra

 It is similar to lumbar vertebra Complete facet on the side of upper end No facet on transverse process