1. The Thoracic Wall Flashcards
Sternal Angle
Posterior: T4/5
Anteriorly: 2nd costal cartilage
Suprasternal notch
Lower border of T2
Xiphisternal joint
T9/10
Central tendon of diaphragm
Nipple
4th IC space/5th rib
2-3cm above right diaphragm
Anterior superficial muscles
Pectorialis major and minor
Serratus anterior
Abdominal wall muscles
Internal muscles
Subcostal muscles (depress ribs) Transversus thoracis (pull costal cartilages inferiorly)
Typical and atypical intercostal nerves
Typical: T3-T6
Atypical: T1-T2, T7-T12
Important dermatomes
C5 - Clavicles C6 - Thumb C6-C8 - Hand C8-T1 - Medial side of arm T4 - Nipple
Posterior IC arteries
Supreme IC artery (1-2/3)
- Subclavian artery
Thoracic aorta
Anterior IC arteries
Internal thoracic
Musculophrenic
Subcostal
General venous drainage
IC space 1: brachiocephalic vein
IC space 2/3: superior IC vein
IC space 4-11: azygos R and hemi-azygos/accessory hemi-azygos L
Right venous system
IC veins 4-11 and superior IC vein enter azygos vein which forms the SVC with the R brachiocephalic vein.
Left venous system
Hemi-azygos and accessory hemi-azygos vein enter azygos vein. L superior IC vein enters L brachiocephalic which joins with the R one.
Posterior mediastinum
Oesophagus Thoracic aorta Thoracic duct Azygos venous system Sympathetic trunk
3 constrictions of the Oesophagus
L primary bronchus
Aortic arch
Diaphragm
Oesophagus in superior mediastinum
Between trachea and vertebral column (T1-T4)
Kept in midline by aortic arch
Thoracic duct on L
Oesophagus in inferior mediastinum
Posterior and R of aortic arch then inclines L and anterior to aorta
Anterior to thoracic duct
Enters oesophageal hiatus at T10
Thoracic duct position
Anterior to T12-T5
Between azygos vein and thoracic aorta
L and posterior of oesophagus
Thoracic duct drainage
Below diaphragm
L upper limb, L thorax, head and neck
Drains in venous angle in L brachiocephalic/subclavian vein
