THORACIC CAVITY B.

Thoracic wall
1. Breast
Diaphragm – separates the thoracic cavity from the a. Modified sweat gland
abdominal cavity b. In women, breast overlies the
PECTORALIS MUSCLE at the levels of
A. Thoracic skeleton ribs 2-6
1. Sternum c. 15 to 20 lobules of glandular tissue
a. Manubrium d. Nipple is surrounded by areola
i. Midline jugular or suprasternal containing areolar glands
notch –palpated at the base of e. Suspensory ligaments of Cooper
anterior neck f. Arterial blood supplied by mammary
ii. Lateral notches – attach to branches of AXILLARY ARTERY,
clavicles INTERNAL THORACIC ARTERY,
iii. Lateral borders – articulate w/ INTERCOSTAL ARTERIES
costal cartilages of the first ribs g. May be divided into quadrants: 2
b. Body lateral- drain to superior nodes of the
i. Joins the manubrium at the axilla; 2 medial – drain to axillary nodes,
STERNAL ANGLE anterior chest wall, interior abdominal
c. Xiphoid process wall; Malignancies may spread along
2. Ribs lymphatic routes
a. Head 2. Skeletal landmarks
b. Neck a. SUPRASTERNAL / JUGULAR NOTCH – at
c. Tubercle –articulates w/ the transverse the base of the neck; impt in locating
process of a thoracic vertebra the trachea
d. Shaft b. XIPHOID PROCESS – for external
e. Angle compressions during CPR
f. Subcostal groove c. STERNAL ANGLE – marks the position of
3. Ribs – Types 2nd RIB; From this location, ribs can be
a. TRUE RIBS – 1 to 7; attach directly to counted externally bec 1st rib cannot be
the sternum via costal cartilages palpated
b. FALSE RIBS – 8, 9, 10 ; not directly 3. Muscles of the thorax
attached a. DIAPHRAGM – most important muscle
c. FLOATING RIBS – 11, 12; do not have of respiration; when it CONTRACTS, it
anterior attachment INCREASES the size of the thorax by
4. Thoracic vertebrae pulling the CENTRAL TENDON inferiorly;
a. Heart-shaped body <3 supplied by the R and L PHRENIC
b. Long slender spinous processes NERVES, anterior primary rami of C3, C4
c. Ribs 1, 10, 11, 12 articulate with only a and C5
single vertebra b. EXTRINSIC THORACIC MUSCLES
5. Joints – allow for movement during inspiration i. Upper limb muscles: pectoralis
a. COSTOVERTEBRAL JOINTS – synovial major,pectoralis minor, serratus
joints between the heads of the ribs anterior, latissimus dorsi,
and vertebral bodies and between the rhomboid major, rhomboid
tubercles of the ribs and transverse minor, levator scapulae,
processes; elevation and depression of trapezius
the ribs ii. Abdominal wall muscles: rectus
b. STERNOCOSTAL JOINTS – synovial joints abdominis, external oblique,
between the costal cartilages of true internal oblique, transversus
ribs (except 1st rib) abdominis
c. COSTOCHONDRAL JOINTS – iii. Posterior muscles: erector
synchondroses between distal ends of spinae and muscles of the back
ribs and their corresponding costal
cartilages
 c. Accessory extrinsic muscles of
respiration- elevate the sternum and
ribs during FORCED INSPIRATION
i. SCM
ii. Scalenus anterior
iii. Scalenus medius
iv. Scalenus posterior
d. Intercostal muscles of the thorax
i. External intercostal muscle –
elevate ribs during inspiration
ii. Internal intercostal – depresses
ribs during expiration
iii. Subcostals, Transversus thoracis
– depress ribs during expiration
e. Levator costarum –back muscles that
participate in respiration; C7 to T11;
ELEVATE ribs during INSPIRATION;
innervated by posterior primary rami of
thoracic spinal nerves
f. Serratus posterior
i. Superior muscle- elevates ribs
during inspiration
ii. Inferior muscle – depresses or
stabilizes the lower ribs
4. Intercostal blood vessels and nerves
C. Pleural Cavities – contain the lungs; lined w/ pleura, a
serous membrane
1. PARIETAL PLEURA – lines the pleural cavity itself
a. Costal Pleura – inner aspect of rib cage
b. Diaphragmatic pleura – superior aspect
of diaphragm
c. Mediastinal pleura – mediastinum
d. Cervical pleura (cupola) – extends into
the neck
2. VISCERAL PLEURA – lines the lungs
3. PLEURAL RECESSES –areas of space between
reflected areas of pleura
a. COSTODIAPHRAGMATIC RECESS –
laterally and inferiorly
b. COSTOMEDIASTINAL RECESS –medially
and anteriorly
D. Lungs – functional site: ALVEOLI where the exchange
of oxygen and carbon dioxide take place, supported by
elastic tissue that tends to collapse and shrink the lung
during expiration
1. Surfaces of the Lung
a. Superior apex –bulges up through the
thoracic inlet
b. Mediastinal surface
c. Convex costal surface
d. Concave base or diaphragmatic surface
2. Borders of the Lung
a. Anterior border- separates the costal
surface from the mediastinal surface
b. Posterior border
c. Lower circumferential border-
separates the diaphragmatical surface
from the costal and mediastinal
surfaces
3. Fissures and lobes of the lung
a. R lung- 3 lobes
L lung – 2 lobes
Both lungs have an oblique fissure but
the R lung has a second horizontal
fissure
b. Cardiac notch on the L lobe
4. Hilum of the lung – entrance and exit for the air
tubes and BVs
a. PULMONARY ARTERY – carries
UNOXYGENATED blood from the RV to
the lungs and the PULMONARY VEIN
carries OXYGENATED blood from the
lungs
b. BRONCHI arises from the midline
trachea; carry air to and from the lung
c. BRONCHIAL ARTERY arises from the
THORACIC DESCENDING AORTA and
travels to the hilum to supply the lung
d. AUTONOMIC NERVES enter the lungs
through the hilum
e. LYMPHATIC VESSELS
E. Bronchi
The trachea is composed of cartilaginous rings
connected w/ fibroelastic tissue. The rings are
incomplete; fibrous tissue and involuntary muscle