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Flashcards in Chapter 1 - Introduction Deck (14)
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Boundaries of thoracic cage

Anteriorly: Sternum
Posteriorly: Thoracic vertebrae
Each side: 12 ribs


Describe the thoracic cage in children

-In children, the chest wall is highly elastic.
-Fractures are therefore rare.
-Fractures occur mostly due to violence.
-Weakest point is at the angle.
-Upper two ribs are protected by clavicle and floating ribs are least commonly injured.



-Due to spasmodic contractions of diaphragm accompanied by closed glottis.
-Stimulated by gastric irritation.
-May also be due to phrenic nerve irritation, uraemia or hysteria.


Boundaries of inlet of thorax

Anteriorly: Manubrium sterni
Posteriorly: Body of T1
Each side: 1st rib

The plane of the inlet is directed forwards and downwards at an angle of 45.


Sibson's fascia

1.suprapleural membrane
2.Partially separates thorax from neck
4.Apex: transverse process of C7
5.Base: inner border of 1st rib.
6.Flattened tendon of scalenus minimus
7.Inferior surface: Fused to cervical pleura
8.Superior surface: related to subclavian vessels
9.Provides rigidity to thoracic inlet so that root of neck is not puffed during respiration.


Structures passing through thoracic inlet

1. Oesophagus
2. Trachea
3. Brachiocephalic A
4. Left common carotid and left subclavian A
5. RL brachiocephalic V
6. Internal thoracic A
7. Superior intercoastal A
8. Posterior intercoastal V
9. Inferior thyroid V
10. Phrenic N
11. Vagus N
12. Sympathetic trunk
!3. Sternothyroid, Sternohyoid, Longus colli


Boundaries of outlet of thorax

Anteriorly: Infrasternal angle between coastal margins
Posteriorly: T12
Sides: Cartilages of 7th-12th ribs


3 large openings in diaphragm

1. Vena caval
2. Oesophageal
3. Aortic


Vena caval opening

1. Inferior vena cava
2. Right phrenic nerve
3. Lymphatic of liver


Oesophageal opening

1. Oesophagus
2. Vagal trunks
3. Left gastric vessels


Aortic opening

1. Aorta
2. Thoracic duct
3. Azygos vein


Small openings of diaphragm

1. Superior gastric A through space of Larrey
2. Musculophrenic A
3. Greater and lesser splanchnic N
4. Left phrenic N pierces left cupola


space of Larrey

Between slip of xiphoid process and 7th coastal cartilage slip of diaphragm


Thoracic inlet syndrome

-Subclavian artery and 1st thoracic N pass over first rib
-They may be pulled or pressed by cervical rib or by scalenus anterior
-Vascular/Neural symptoms or both