Skeleton of the Thorax

Dr Othman Manasor
21 August 2005
Yr 1 Medical and Dental Students
 The Thoracic Cage
The skeleton of the thorax is an
osseocartilaginous framework within which
are the principal organs of respiration and
circulation.
It is conical in shape ,narrow above &
broad below,flattened from front
backwards,longer behind than in front.
It is a bellowlike structure , which moves
during respiration.
Skeleton of Thorax
 BOUNDARIES
Posteriorly-the bodies of 12 Thoracic vertebrae
and their intervening discs,
and the posterior parts of the ribs.
Anteriorly- the sternum,the anterior ends of the
ribs and their costal cartilages.
Laterally- the thorax is convex,and is formed by
the ribs and their cartilages.
The ribs are separated from each other by
intercostal spaces, which contain the intercostal
muscles and membranes, neurovascular
bundles & lymphatics
 FUNCTIONS
Contains and protects the Heart and
Lungs,
Sub diaphragmatic organs e.g. liver,
stomach, spleen are sheltered beneath the
costal margins.
It alters the diameters of thorax in different
phases of respiration by the movements of
the ribs and the diaphragm.
Attachment of certain muscles
 Bones of the ThoraX
12 thoracic vertebrae
12 intervertebral discs
12 Ribs
12 costal cartilages
Sternum-manubrium, body, xiphoid
process
 Thoracic Vertebrae
Facet on the body-articulate with head of
rib
Facet on transverse process-articulate
with tubercle of rib(except lower 2-3 ribs)
Long spinous process

On neck flexion-spine of C7/T1prominent.

 True and False Ribs
True ribs = Vertebrocostal-
upper 7, articulate with vertebra and sternum

False Ribs =Vertebrochondral

8-12th ribs
=Articulate with vertebra and attached to
sternum thru costal cartilages of other ribs, or
no attachments at all
(8,9,10-thru 7th c.cartilage, 11,12= floating ribs)
 Typical and Atypical Ribs
3-10 th ribs are TYPICAL Ribs
Has head, neck , tubercle, body
Head- has 2 articular facets
Tubercle- articulates with transverse
process
Body- thin, flat, curved,
has internal and external surfaces
has superior and inferior borders

ATYPICAL Ribs: 1,2 11,12

 First Rib
Broadest, most curved, shortest among true
ribs
Flattened-has scalene tubercle
Subclavian vein crosses anterior to scalene
tubercle
Subclavian artery and inferior trunk of brachial
plexus pass posterior to s.tubercle
facet articulates with T1 body
Tubercle articulates with T1 transverse process
Help form superior inlet of thorax.
 2nd Rib 11,12 Ribs

Small, less curved, Short

2x longer than rib1 One facet on the
Broad,rough head
eminence for No neck or tubercle
serratus anterior
muscle
 Costal Cartilage
Hyaline cartilage
Contributes to elasticity and mobility of ribs
Upper 7 attch. to sternum.
8-10 cartilages -artic. with inferior border
of the cartilage above.
7-10 cartilages-meet and the inferior
border forms the Costal margin
Subcostal/infrasternal angle- inferior to
xiphisternum joint
 The Sternum
MANUBRIUM

Triangular in shape , has jugular or

suprasternal notch

Clavicular notch on either side

1st costal cartilage attch to it inferior to

clavicular notch.

Angle of Louis- 5cm inf. to jugular notch,

where manubrium meets body of sternum
 The Sternum
BODY
Longer, thin, smaller
Concave anterior and posterior surfaces
Shorter in female

XIPHOID PROCESS
Thin, sword shaped
Ossified and fused to sternal body at age 40.
 Intercostal arteries
Posterior intercostal arteries
11 pairs
1st & 2nd pairs are the branches
costocervical trunk
Lower 9 pairs come from desc.thoracic
aorta
Anterior intercostal arteries
1-6 spaces from internal thoracic artery
7-9 spaces- from musculophrenic artery
 Intercostal arteries
Posterior intercostal arteries
11 pairs
1st & 2nd pairs are the branches of
costocervical trunk
Lower 9 pairs come from desc.thoracic
Aorta
Anterior intercostal arteries
1-6 spaces from internal thoracic artery
7-9 spaces- from musculophrenic artery
 Rib, Applied anatomy
Chest wall of the children is highly elastic, so
rib fracture is rare in children
In adults, ribs may be fractured by direct
violence
Cervical rib ( 0.5%) is attached to the
transverse process of 7th cervical vertebra and
with 1st rib. It may press the lowest trunk of the
brachial plexus and subclavian artery.
Costal cartilages undergo progressive
ossification in old age.
 Sternum, applied anatomy
Sternal puncture to harvest bone
marrow
Sternal angle- helps in counting
intercostal spaces.
Split of sternum- in operation of
retrosternal goitre, cardiac surgery.
Fracture can occur at sternal angle.
 Intercostal Space, applied
Fluid draining from pleural cavity

Intercostal nerve block

Pus from the region of the vertebral column

tends to track around the thorax along the
course of the neurovascular bundle, and to
point three sites of exit of cutaneous branches
of the intercostal nerve-
Lateral to erector spinae
In the mid axillary line
Just lateral to the sternum
DIAMETERS OF THE
THORAX and
MOVEMENTS of the
walls.
1-Transverse Diameter
(Bucket Handle movement)

2-Anteroposterior Diameter
(Pump handle movement)

3-Vertical Diameter
(Diaphragm)
Thank you

Othman Mansor