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what is the thorax
the area between the neck and abdomen. includes the thoracic cavity and the structures within
what structures does the thorax contain
-the rib cage, thoracic vertebrae and its floor, and the diaphragm
-the primary organs of the respiratory and cardiovascular system
what is the thorax divided into
a central mediastinum, right and left pulmonary cavities
what makes up the thoracic wall
rib cage, skin, breasts, muscles, and fascia covering its anteriolateral aspect, sternum
what are the posterior structures of the thorax called
the back region
what does the rib cage provide
protection of vital organs, resisting of negative internal pressures generated by the recoil of lungs, attachment and support of upper limbs, and attachment for muscles
how many pairs of ribs and costal cartilage
12
how many pairs of thoracic vertabrae
12, and then intervertebral discs (IVD) between them
what are the three types of ribs
true (vertebrocostal)
false (vertebrochondral)
floating (vertebral)
what ribs are true ribs
1-7
what ribs are false ribs
8-10
but also 11 and 12 technically
what ribs are floating ribs
11-12
no anterior attachment
what two classifications of ribs are there
typical and atypical
typical ribs
3-9, includes head, neck, tubercle, and body
atypical ribs
1, 2, 10, 11, 12
why do ribs attach to costal cartilage anteriorly
provide elasticity
what are ribs separated by
intercostal spaces
how are intercostal spaces named
for the rib forming the superior border
what do intercostal spaces contain
muscles, blood vessels, and nerves
what are characteristics of thoracic vertebrae
-bilateral costal facets on bodies, usually superiorly and inferiorly. used for articulation with rib head
-costal facets on transverse process (TVP) for articulation with rib tubercle
-long inferiorly slanting spinous process
-body, attached to pedicles, bilateral TVP, and laminas attached to spinous process
what direction to superior articular facets face
posteriolaterally
what direction to inferior articular facets face
anteriomedially
what are thoracic apertures
the superior and inferior openings of the rib cage
what do thoracic apertures allow communication between
with the neck and arm structures superiorly, and abdominal structures inferiorly
what is the superior thoracic aperture called
thoracic inlet
what is the inferior thoracic aperture
thoracic outlet
what are the accessory muscles of respiration attaching to the rib cage
pectoralis major, pectoralis minor, serratus anterior, and scalenes
what are scalenes
in the neck, attach to manubrium and clavicle to tighten and pull up rib cage during inspiration
what are the true thoracic wall muscles
serratus posterior, levator costarum, intercostals, subcostals, and transverse thoracics
what is the levator costarum
the inner wall of the thoracic cage, used for expiration
what is the diaphragm
primary muscle of inspiration, forms floor of the thoracic cage. separates the thoracic and abdominal viscera
what adjacent structures does fascia invest or attach to
pectoral fascia (bed of breast), clavipectoral fascia (over pectoralis minor), and endothoracic fascia (lines rib cage internally)
what are the nerves of the thoracic wall
intercostal nerves and subcostal nerves
what are intercostal nerves
the anterior primary of the 1st 11 thoracic spinal nerves
where do intercostal nerves run
run between the internal and innermost intercostal muscles. they are lodged in the costal groove on the inferior surface of ribs
what are the intercostal nerves included in
the neurovascular bundle, and the VAN of the intercostal space
what are the subcostal nerves
the anterior primary rami of the 12th thoracic spinal nerve
what is the arterial supply of the vasculature of the thoracic wall
-thoracic aorta through posterior intercostal and subcostal arteries
-subclavian artery through internal thoracic artery and supreme intercostal artery
-axillary artery through superior and lateral thoracic artery
what does the vasculature of the thoracic wall supply
the muscles, skin, and parietal pleura of the thoracic wall, give off branches supplying pectoral muscles and breasts
what do the branches of the posterior intercostal artery supply
spinal cord, vertebral column, and back
what is the venous supply of the vasculature of the thoracic wall
-11 posterior intercostal veins- drain to azygous venous system to the superior vena cava
-anterior intercostal veins- tributaries of internal thoracic veins
-internal thoracic veins
-subcostal veins
what do veins do in relation to their arteries
-generally accompany the same named arteries
-drain the same areas that their corresponding arteries supply
what are breasts
the most prominent superficial structure in the anterior thoracic wall
breast location in relation to pectoral fascia
breasts are anterior to pectoral fascia
what are the breast structures
mammary glands (and their structures), nipple, areola
what are the mammary glands
accessory to reproduction in females, rudimentary in males. they are surrounded by fat. they have an axillary process (tail), lobules, and modified sweat glands
what do lobules produce
parenchyma (functional substance)
where does the parenchyma drain
into the lactiferous ducts leading to a lactiferous sinus where milk accumulates prior to exiting the nipple
what type of control are the modified sweat glands under in the breast
hormonal control
what does the areola surround
the nipple
where is the arterial supply from of the breast
-medial mammary branches and intercostal branches of internal thoracic artery from the subclavian artery
-lateral thoracic and thoracoacromial arteries from the axillary artery
-posterior intercostal arteries from the thoracic aorta
what is the venous drainage of the breast
into the axillary vein by tributaries that accompany the supplying arteries
why is lymphatic drainage of the breast important
due to the metastasis of cancer
how does lymphatic drainage of the breast work
by subareolar lymphatic plexus. 75% drains to pectoral and axillary lymph nodes and the rest drains into parasternal lymph nodes. the lymph eventually enters the right lymphatic duct of the thoracic duct on the left, then enters the R&L venous angles
how many compartments are in the thoracic cavity
3
what are the three compartments of the thoracic cavity? what do they contain?
-R&L pulmonary cavities- contain the lungs and pleurae
-Central Mediastinum- contains the heart, great vessels, thymus, part of the trachea, esophagus, and the lymph nodes
what are the two types of pleurae in the thoracic cavity
visceral (pulmonary) pleura and parietal pleura
what is visceral (pulmonary) pleura
pleura that lines the lung surface
what is the parietal pleura
plerua that lines the pulmonary cavities
what is the parietal pleura specifically named for
named for the parts it touches. ie- ribs, diaphragm, mediastinum
what is pleural cavity
the potential space between the visceral and parietal pleuras
what is the pleural sac
combination of the pleurae, pleural cavity, and pleural sac
what is the essential function of the lungs
respiration and to oxygenate blood
what do the base of the lungs rest on
the diaphragm
when do the lungs descend and ascend
descend- inspiration, ascend- expiration
where is the apex of the lungs
the superior end at the root of the neck
where is the base of the lungs
inferior surface
what are the three surfaces of the lungs
costal, mediastinal, diaphragmatic
what does the anterior border of the left lung have
a deep cardiac notch that shapes the lowest anteroinferior part of the superior lobe into the lingula
how many lobes does the right lung have
3- superior, middle, and inferior
how many lobes does the left lung have
2-superior and inferior
what are the fissures on the right lungs
-right oblique fissure (between the superior and inferior lobes and the middle and inferior lobe)
-horizontal (between middle and superior lobes)
what are the fissures on the left lung
the left oblique fissure
what do the roots of the lung do
attach the lung to the mediastinum
what do the roots of the lung contain
pulmonary artery, superior and inferior pulmonary vein, main bronchus, nerves, and vessels
what is the hilum
area on the mediastinal surface where root structures enter and exit
what is the tracheobronchial tree
the sub-laryngeal airway to the lungs
what is the cartilagenous trunk that splits at the sternal angle
the trachea
what does the trachea split into
the right and left main bronchus, which enter the hilus of each lung respectively
what do the main bronchus (primary) divide into
Lobar Bronchi (3 on right, 2 on left) to supply each lobe
what to lobar bronchi (secondary) divide into
several segmental bronchi (tertiary)
what do segmental bronchi (tertiary) divide into
bronchopulmonary segments
what is the largest subdivision of a lobe
bronchopulmonary segments