Scalenus
medius
brachial
plexus
C7
scalenus
anterior
cervical
rib
lower trunk of plexus
subclavian
artery
cervical rib
fibrous
band
FIGURE 27 Thoracic outlet as seen from above. Note the
presence of the cervical ribs (black) on both sides. On the
right side of the thorax, the rib is almost complete and
articulates anteriorly with the 1st rib. On the left side of the
thorax, the rib is rudimentary but is continued forward as a
fibrous band that is attached to the first costal cartilace. Note
that the cervical rib may exert pressure on the lOwer trunk of
the brachial plexus and may kink the subclavian artery.
Joints of the Ribs and Costal Cartilages
These joints are cartilaginous joints. No movement is
possible.
Joints of the Costal Cartilages with the Sternum
ercostal
artery. GURE
us the
abdomen, ratration.
2nd
2.9
lumborum If, to
the y, the
conversel
Cross
Cutaneous
branch
section
lateral
lst
to
nuscle
branches tomuscular
parietal
pleura
branch
the the
llth and 12th
ribs the rib
intercostal
nerve
of
the
cutaneous
anterior
branch
thorax
shoWing
oblique
wil
befixed
spinal
nerve
membrane
intercostal
posterior
distribution
posterior
ramus
lowered
muscles by
the
byof
the the
intercostal
anterior
membrane
typical
parietal
pleura
of
a
intercostal
nerves.interThe
intercostal
thoracic
aorta
perforating
branch
thoracic
internal
artery
anterior
artery
nerve intercostal
intercostal
posterior
and
posterior
a
is
innermost
intercostal
cutaneous
lateral
intercostal
internal
intercostal
external
artery
branch
and
an
anterio
W
11 Th
In
THORAX
216
Sternal part
Superior epigastric Nesses
7th
Cartilages
Central tendon
8th
Costal part
Left vagus
Inferior vena cava
9th
Oesophagus
Right phrenic nerve
Oesophageal branch of lst
artery and accompanying vers
Right vagus
Aorta
Azygos vein
10th
Median arcuate ligament
11th
Thoracic duct
-Medial arcuate ligament
12th
Lateral arcuate ligament
Greater splanchnic nerve
Subcostal vessels and nerve
Lesser splanchnic nerve
Left crus of diaphragm
Right crus of diaphragm
Sympathetic trunk
Fig. 12.16: Structures
Structures Passing through the Diaphragm
There are three large and
several small
passing through the diaphragm
and 7th costal
danha
lenoAN
oftheasforant
slip
40
TheThorax: Part lThe Thoracic Wall
skin superficial
fascia
serratus
anterior
pleural
cavity (space)
lung
skin
superficial
fascia
serratus
anterior
intercostal vein
-intercostal artery
intercostal nerve
syringe
external
intercostal
A
visceral pleura
pleural cavty s
parietal pleuraa
endothoracic t
innermost interc
internal intercos
external
internal
intercostal
FIGURE 2.8
lung
innermost
intercostal
visceral pleura
parietal pleura
A. Section
through an intercostal space. B.
to pleural cavity.
Depending on the site of
rior muscle.
divided intothree portions (see Fig.
less separate from one
another.
intercostal
B
by
penetration, theStructures
pectoralpenetrated
muscles wil! b f
2.9), which are more or
su
skin
when it passes from:Seratusa
: in addition to the
0
