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Thoracic Cage and Joints of Thorax

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29 views39 pages

Thoracic Cage and Joints of Thorax

Uploaded by

jiyariya779
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Thoracic Cage and Joints of

thorax
Dr Kuntal Vashishtha
Assistant Professor
Thorax
• Upper part of trunk separated
from abdomen by diaphragm
• Contains main organs of
respiration (pair of lungs) &
circulation( Heart) –Thoracic
Cavity
• Supported by
oseo-cartilaginous elastic
framework ( Thoracic cage)
• Designed for increasing &
decreasing intra-thoracic
pressure
In coronal section
THORACIC •Truncated cone ,
CAGE narrow above
In transverse section
(Thoracic inlet) &
• Bean or kidney shaped wider below
Transverse Dia > A.P. (Thoracic outlet)
diameter
• Reverse in quadrupeds

Circular in children
( below 2 yrs.)
Thoracic Cage - Formation
Sternum
Parts
• Manubrium Sterni
• Body
• Xiphoid process

Other features
• Suprasternal notch (jugular)
Interclavicular notch
• Facet for clavicle
• Sternal angle (angle of Louis)
• Facet for costal cartilages
Thoracic Vertebra(12)
• Body - anteriorly
• 7 processes
Feature for identification
Costal facets on body
2-8 – typical
1st & last 4 are atypical
Ribs
• 12 pair , Bony arches placed
obliquely & arranged one
below the other
• Gaps in b/w called
intercostal spaces (11)
Ribs
• First seven connected
anteriorly to lateral side of
sternum through their
costal cartilages called
true (vertebrosternal) ribs
• Rest 5 are false ribs of
which 8th , 9th & 10th
Joined to each other
(vertebrochondral ) ribs
Ribs
• Anterior end of 11th & 12th
are free (Floating ) ribs

• First two & last 3 has


special features (Atypical)
rest 3 – 9 (Typical ribs)
Ribs

Parts of Rib
Two Ends –
Ant.(sternal) & Post(vertebral)
Head with two facets (upper small &
Lower large
Neck
Tubercle
Shaft with costal groove
Joints between ribs and vertebrae
Thoracic inlet
Boundaries
• Anterior – upper border of
Manubrium sterni (T3 – Upper)
• Posterior – Superior surface of
body of T1(Upper)
• On each side – first rib with its
cartilage
Dimensions
• Transverse dia – 4-5 inches
• Anteropost. dia – 2-2.5 inches
THORACIC INLET

• Slope – ant. Part 1.5 cm below than post. Part


ant. Part lies at T3(U)
• Obliquity approx 45 degree
Structures passing through
Thoracic Inlet
In median plane
• Sternohyoid , sternothyroid , remains of Thymus, inferior thyroid veins , trachea ,
oesophagus , left recurrent laryngeal nerve, ant. Longitudinal. Ligment of
vertebral column, longus coli muscle
On right side
• Right internal thoracic artery , rt. Phrenic nerve , rt. Brachiocephalic vein ,
brachiocephalic artery , rt. Vagus , rt. Sympathetic chian , rt first post intercostal
vein , rt. Superior intercostal artery , rt. First thoracic nerve , rt. Pleura , apex of rt.
Lung
On left side
• Left internal thoracic artery , lt. Phrenic nerve , lt. Brachiocephalic vein , lt. Vagus
nerve , lt. Common cartotid artery , lt. Subclavian artery ,thoracic duct , lt.
Sympathetic chain , lt. First post. Intercostal vein , lt.superior intercostal artery ,lt.
First thoracic nerve , lt. Pleura ,apex of lt. lung
Structures passing through
Thoracic Inlet
Supra Pleural Membrane or
Sibson’s Fascia
• Triangular in shape
• Apex attached to tip of tr.
Process of C7
• Base to inner border of the
first rib & its cartilage
• Functionally provides
rigidity to thoracic cage
• Inferior surface is fused to
cervical pleura
• Superior surface is related
to subclavian vessels &
other structures of root of
neck
Thoracic Inlet Syndrome
Cause:

• Streching of subclavian artery and lower trunk


of brachial plexus due to:

– Hypertrophied scalenus anterior

– Cervical Rib is present in .5% person which is


attached to c7 vertebra
Thoracic Inlet Syndrome
CLINICAL PICTURE

1.Numbness and tingling along medial border of


forearm and hand due to involvement of lower
trunk of brachial plexus

2.Ischemic symptoms in the upper limb due to


compression of subclavian artery
Inferior aperture (outlet)
• Broad lower end of thorax surrounding upper part
of abdominal cavity & is separated by diaphragm
Boundaries
• Anterior – infrasternal angle between two costal
margins
• Posterior – inferior surface of body of T12
• On each side – costal margins formed by
cartilages of 7th , 8th ,9th & 10th ribs & 11th,12th ribs
Diaphragm

3 Large openings
•Aortic – T12
•Oesophageal –T10
– in muscular part
•Venacaval – T8 –
in central tendon
Joints of thorax

Dr. Kuntal Vashishtha


Joints of sternum
• Manubriosternal

• Xiphisternal joint

• Sternoclavicular joint

• 7 Sternochondral joints
Sterno clavicular joint

1st sterno chondral joint

}
Manubrio sternal joint (primary cartilagenous)

Sterno chondral joint


(2nd – 7th plain synovial )
Xiphisternal joint
Manubriosternal joints
• Articulations:
– Lower border of manubrium
– Upper border of body of sternum

• Type:
– Secondary cartilaginous (symphysis)
STERNOCHONDRAL JOINTS
• Articulations:
1st sternochondral joint is primary
cartilaginous
2nd to 7th are plane synovial joints
STERNOCLAVICULAR JOINT
ARTICULATIONS
Medial end of clavicle and clavicular notch
of manubrium

TYPE
Saddle joint
Joints of vertebral column
1)Costovertebral

2)Costotransverse

3)Intervertebral
Joints Between Ribs And Vertebra
Joints Between Ribs And Vertebra
Costotransverse Joint
•Between tubercle of rib
and transverse process

•Plane synovial joint

•Capsule is strengthened
by these ligaments:
•1)Superior costotransverse
•2)Inferior costotransverse
•3)Lateral costotransverse
THANK YOU
STAY SAFE
N
STAY HAPPY

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