Download Thoracic Wall

THORACIC WALL
Benish Islam
Lecturer / coordinator Surgical IPMS/KMU
STRUCTURE OF THORACIC WALL
STERNUM
Manubrium
 Body of sternum:
Manibriusternal joint
Xipibhisternal joint

Sternal angle
 Xiphoid process

RIBS
Total 12 pair of ribs
 True ribs: upper 7
 False: 8,9,10th ribs
 Floating ribs: 11,12
ribs
 Typical rib:Costal
Groove,head,neck,
tubercle shaft,angle
 Atypical rib: 1st rib

THORACIC
OUTLET
Opening
at root of
neck.
Oesophagus
, trachea
and blood
vessels pass
through it
•
ENDOTHORACIC
FASCIA
Loose
connective
tissue
Separate
parietal
pleura from
thoracic
wall
INTERCOSTAL MUSCLES (3 TYPES)
External intercostal
muscle:
 Fibers directed
downward and
forward
 From inferior border
of rib above to
superior border of rib
below
 Aponerosis:
Ant.(external)
intercostal membrane
1.
2. INTERNAL INTERCOSTAL MUSCLE
Intermediate layer
 Fibers directed
downward and
backward
 From subcostal groove
of rib above to upper
border of rib below
 Aponeurosis: post.
(internal) intercostal
membrane

3.INNERMOST INTERCOSTAL MUSCLE





Deepest layer
Corresponds to
transversus abdominis
in abdominal wall
Croses more than one
intercostal space
Related to endothoracic
fascia.
Blood vessels,nerves
pass between
intermediate and
deepest layer.
RESPIRATION MECHANISM:
Action
Supply
Inter costal
nerves
 Intercostal
Arteries and
veins:
Post. Intercostal
arteries
Ant. intercostal
veins

DIAPHRAGM
ORIGIN OF DIAPHRAGM
Thin muscular tendinous septum,separate chest
cavity above from abdominal cavity.
 Sternl part:arises from post. Surface of xiphoid
process
 Costal Part:arise from deep surface of lower six
ribs and costal cartilage.
 Verterbral part:arises from vertebral column nd
arcuate ligament.
 Inserted into central tendon
 Rt.dome: upper border of 5th rib
 Lt. dome: lower border of5th rib

DIAPHRAGM
Nerve/Action
Motor nerves:
rt,lt. phrenic nerves C3,4,5
 Sensory nerves:
Phrenic nerve and lower
six intercostal nerves
Action:On contraction,
diaphragm pulls down
central tendon and inc.
vertical diameter of
thorax.

Function
Muscle of Inspiration
 Muscle of Abdominal
Straining
 Weight lifting muscle
 Thoracoabdominal
pump

3 MAJOR OPENING IN DIAPHRAGM
ANTERIOR VIEW OF THORAX
LINES OF ORIENTATION
POSTERIOR CHEST WALL
SURFACE ANATOMY
THANK YOU