1. Chest cavity, vertebral column and back muscles. Respiratory muscles.
Sándor Katz, M.D.

2. Chest cavity- bony structures

3. Chest cavity- bony structures

4. Sternum

5. Ribs
True ribs: first seven pairs connect to the sternum directly by costal cartilages.
False ribs: remaining five pairs connect to the sternum indirectly, forming costal arch.
Last two pairs: floating ribs.

6. Ribs

7. Ribs

8. Vertebral column

9. General vertebral features

10. Atlas and axis

11. Cervical vertebrae

12. Thoracic vertebrae

13. Costovertebral attachments

14. Lumbar vertebrae

15. Sacrum

16. Synchondrosis (A type of the continuous bony connections.)

17. Atlanto-occipital joint
Condylar joint.
Ligaments connecting the bones are:
posterior atlanto-occipital membrane and
anterior atlanto-occipital membrane.
Permitted movements:
flexion-extension,
slight lateral flexion

18. Atlanto-axial joint PIVOT PART: Anterior median atlanto-axial joint:
Between the dens axis (ant. articular facet) and fovea dentis of the atlas.
Posterior median atlanto-axial joint:
Between the dens axis (post. articular facet) and transverse ligament of atlas.
PLANE PART:
Lateral atlanto-axial joint:
Between the articular processes.
MOVEMENTS:
50% of the cervical rotation (50°) comes from the atlanto-axial joint.
Flexion: 10°. Extension is really limited.

20. Zygapophysial (facet) joint
Cevical region:
All movements are possible such as flexion, extension, lateral flexion and rotation.
Thoracic region:
Lateral flexion and rotation.
No flexion/extension.
Lumbar reion:
Flexion and extension.

21. Covering structures

22. Covering structures

23. Spinal curvatures

24. Scoliosis (S-shaped deformity of spine)

25. Superficial back muscles-spinohumeral muscles
Function:
Move the upper limb.

26. Deep (axial) muscles Functions:
Unilateral innervation: lateral flexion.
Bilateral innervation: extension.

27. Transversospinal muscles (from a transverse process to a spinous process)
Semispinalis muscles:
Cover 5-6 vertebrae.
Multifidi muscles:
Cover 3-4 vertebrae.
Rotatores muscles:
Cover 1-2 vertebrae.
Functions:
Unilateral innervation: lateral flexion.
Bilateral innervation: extension.

28. Respiratory muscles
Intercostalis muscles
Diaphragm
Accessory muscles

29. Intercostalis muscles
External intercostal muscles:
Arise from the lower border of the
ribs and insert on the upper border
of the ribs below.
Function:
Elevate the ribs, reinforce the
intercostal space in deep inspiration.
Internal intercostal muscles:
Arise from the ridge of the inner
surface of ribs and insert on the
inferior border of the ribs above.
Depress the ribs, reinforce the
intercostal space in deep expiration.

30. Diaphragm (inspiration)
CENTRAL PART
Caval hiatus for inferior vena cava.-T8
MUSCULAR PART:
Sternal part
Superior epigastric artery.
Costal part
Lumbar part:
Left/right crus and both have medial
and lateral parts.
Esophageal hiatus for esophagus.-T12
Aortic hiatus for aorta and thoracic duct.-L1
Azygos and hemiazygos veins and
Greater and lesser splanchnic nerves.-L2

31. Movements of the thoracic wall during breathing
A: Pump handle movement of ribs
and sternum.
B: Bucket handle movement of ribs.

32. Accessory respiratory muscles
Inspiration: scalene muscles
and sternocleidomastoid.
Expiration: abdominal muscles.

33. Thank you for your attention!
Reference: Gray’s Anatomy for Students