1. Thorax, Pleural Cavity

2. Bones sternum - all landmarks
12 ribs, costal cartilages - all landmarks
12 thoracic vertebrae - all landmarks

7. Borders
1. superior thoracic aperture ( thoracic inlet) - opening to neck,
superior borders of: manubrium, 1st pair ribs, costal cartilages, 1st thoracic vertebrae
2. inferior thoracic aperture / thoracic outlet - opening to abdomen
inferior borders of: T12 vertebra; ribs 12, 11; costal cartilages #10, 9, 8, 7, xiphoid

8. Diaphragm
muscle + fibrous connective tissue - separates thoracic & abdominal cavities
domed in center

10. Pleural sacs
a continuous serous membrane folded back on itself to form a double layer
1. visceral pleura - inner layer - forms external surface covering of lung 
2. parietal pleura - outer layer - forms inner lining of thoracic wall 
3. both layers meet at root

13. Pleural sacs
Pleural cavities: potential space - contains thin serous fluid layer, slight negative pressure
Regions of parietal pleura are named by surrounding structures:
cervical/apical, costal, diaphragmatic, mediastinal
Recesses: narrow clefts at edges of pleura, where lungs don't extend
costodiaphragmatic - most inferior, between costal & peripheral border of diaphragm, first place to find fluid accumulation in X-ray
costomediastinal - most anterior, medial, in front of mediastinum

15. Thoracocentesis

16. Mediastinum
central structures between two pleural sacs, sternum & vertebral bodies
Heart: pericardium, chambers, blood supply, pulmonary vessels, ligamentum arteriosum vagus nerve, recurrent laryngeal nerve
Trachea
Esophagus
Phrenic nerve: in mediastinal pleura -- to pericardium

18. Blood Vessels
Intercostal arteries - anterior & posterior, + subcostal (12th)
1st and 2nd posterior intercostal artery - branch off supreme (superior) intercostal artery, which branches off costocervical trunk of subclavian artery
3d - 11th posterior intercostal, & subcostal artery - are branches of thoracic aorta

21. Blood Vessels
1st- 5th (or 6th) anterior intercostal artery: = branches of internal thoracic artery
6th (or 7th) - 9th anterior intercostal arteries - are branches of musculophrenic artery - anterior & posterior intercostal arteries terminate by anastomosing with each other
There are no anterior intercostal arteries in the most inferior two intercostal spaces. These areas are provided by posterior intecostal arteries only.

22. Blood Vessels
internal thoracic artery (branch of subclavian): divides behind #6 costal cartilage:
a. superior epigastric artery
b. musculophrenic artery

23. Nerves Intercostal nerves = ventral rami of thoracic nerves 1-11
to intercostal muscle, skin
travel in costal grooves, between internal & innermost intercostal muscle.

25. Herpes Zoster Shingles Viral infection of Chicken pox virus
Affect along intercostal nerve

28. Muscles External intercostalis Internal intercostalis
Innermost intercostalis
Subcostalis
Transversus thoracis

29. External intercostalis
ORIGIN Inferior border of ribs as far back as posterior angles
INSERTION Superior border of ribs below, passing obliquely downwards and backward
ACTION Fix intercostal spaces during respiration. Aids forced inspiration by elevating ribs
NERVE Muscular collateral branches of intercostal nerves

30. Internal intercostalis
ORIGIN Inferior border of ribs as far back as posterior angles
INSERTION Superior border of ribs below , passing obliquely downwards and backwards
ACTION Fix intercostal spaces during espiration. Aids forced inspiration by elevating ribs
NERVE Muscular collateral branches of intercostal nerves

31. Innermost intercostalis
ORIGIN Internal aspect of ribs above and below
INSERTION Internal aspect of ribs above and below
ACTION Fix intercostal spaces during respiration
NERVE Muscular collateral branches of intercostal nerves

33. Subcostalis ORIGIN Internal posterior aspects of lower six ribs
INSERTION Internal aspects of ribs two to three levels below
ACTION Depresses lower ribs
NERVE Muscular collateral branches of intercostal nerves

35. Transversus thoracis
ORIGIN Lower third of inner aspect of sternum and lower three costosternal junctions
INSERTION Second to sixth costal cartilages
ACTION Depresses upper ribs
NERVE Muscular collateral branches of intercostal nerves