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Benish Islam Lecturer / coordinator Surgical IPMS/KMU

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Presentation on theme: "Benish Islam Lecturer / coordinator Surgical IPMS/KMU"— Presentation transcript:


2 Benish Islam Lecturer / coordinator Surgical IPMS/KMU
Thoracic Wall Benish Islam Lecturer / coordinator Surgical IPMS/KMU

3 Structure Of thoracic Wall

4 Sternum Manubrium Body of sternum: Manibriusternal joint
Xipibhisternal joint Sternal angle Xiphoid process

5 Ribs Total 12 pair of ribs True ribs: upper 7 False: 8,9,10th ribs
Floating ribs: 11,12 ribs Typical rib:Costal Groove,head,neck, tubercle shaft,angle Atypical rib: 1st rib

6 Thoracic outlet Opening at root of neck.
Oesophagus , trachea and blood vessels pass through it Thoracic outlet

7 Endothoracic fascia Loose connective tissue
Separate parietal pleura from thoracic wall Endothoracic fascia

8 Intercostal muscles (3 types)
External intercostal muscle: Fibers directed downward and forward From inferior border of rib above to superior border of rib below Aponerosis: Ant.(external) intercostal membrane

9 2. Internal intercostal muscle
Intermediate layer Fibers directed downward and backward From subcostal groove of rib above to upper border of rib below Aponeurosis: post. (internal) intercostal membrane

10 3.Innermost Intercostal muscle
Deepest layer Corresponds to transversus abdominis in abdominal wall Croses more than one intercostal space Related to endothoracic fascia. Blood vessels,nerves pass between intermediate and deepest layer.

11 Respiration mechanism:
Action Supply Inter costal nerves Intercostal Arteries and veins: Post. Intercostal arteries Ant. intercostal veins

12 Diaphragm

13 Origin of diaphragm Thin muscular tendinous septum,separate chest cavity above from abdominal cavity. Sternl part:arises from post. Surface of xiphoid process Costal Part:arise from deep surface of lower six ribs and costal cartilage. Verterbral part:arises from vertebral column nd arcuate ligament. Inserted into central tendon Rt.dome: upper border of 5th rib Lt. dome: lower border of5th rib


15 Diaphragm Muscle of Inspiration Muscle of Abdominal Straining
Nerve/Action Function Motor nerves: rt,lt. phrenic nerves C3,4,5 Sensory nerves: Phrenic nerve and lower six intercostal nerves Action:On contraction, diaphragm pulls down central tendon and inc. vertical diameter of thorax. Muscle of Inspiration Muscle of Abdominal Straining Weight lifting muscle Thoracoabdominal pump

16 3 major opening in diaphragm


18 Anterior view of thorax

19 Lines of orientation

20 Posterior chest wall

21 Surface Anatomy

22 Thank you

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