1. Chest Wall Anatomy
A. Azami, Ph.D.

2. Surface Landmarks

3. Boundaries of the thorax
Superior:
jugular notch, sternoclavicular joint, superior border of clavicle, acromion, spinous processes of C7
Inferior:
xiphoid process, costal arch, 12th and 11th ribs, vertebra T12

4. Thoracic wall Skin Superficial fascia Breast Deep fascia Muscles
Fat tissue
Cutaneous nerves
Superficial vessels
Breast
Deep fascia
Muscles

11. Fig The approximate segmental distribution of the cutaneous nerves on the front of the trunk. The contribution from the first thoracic spinal nerve is not shown and the considerable overlap that occurs between adjacent segments is not indicated.

12. The segmental innervation of anterior surface of trunk

14. Thoracic wall Skin Superficial fascia Breast Deep fascia Muscles
Fat tissue
Cutaneous nerves
Superficial vessels
Breast
Deep fascia
Muscles

18. Thoracic wall Skin Superficial fascia Breast Deep fascia Muscles
Fat tissue
Cutaneous nerves
Superficial vessels
Breast
Deep fascia
Muscles

19. Fig Anatomical territories of cutaneous blood vessels on the lateral trunk. (By permission from Cormack GC, Lamberty BGH 1994 The Arterial Anatomy of Skin Flaps, 2nd edn. Edinburgh: Churchill Livingstone.)

20. Fig. 58.6 Early development of breast epithelium.

21. Fig. 58. 1B A, The macroscopic structure of the breast
Fig. 58.1B A, The macroscopic structure of the breast. B, Changes during lactation.

23. Fig Anatomical territories of cutaneous blood vessels on the lateral trunk. (By permission from Cormack GC, Lamberty BGH 1994 The Arterial Anatomy of Skin Flaps, 2nd edn. Edinburgh: Churchill Livingstone.)

24. Fig. 58.4 Lymph vessels of the breast and the axillary lymph nodes.

25. Thoracic wall Skin Superficial fascia Breast Deep fascia Muscles
Fat tissue
Cutaneous nerves
Superficial vessels
Breast
Deep fascia
Muscles

26. Back muscles

27. Ant. Thoracic muscles
Serratus anterior

28. Thorax Muscles
Intercostales externi
Intercostales interni

29. Intercostales externi
Origin: lower border of rib
Insertion: upper border of rib below origin
Action: elevate ribs adding in forced inspiration
Intercostales interni
Origin: upper border of rib
Insertion: lower border of rib above origin
Action: depress ribs for forced expiration

30. Diaphragm Shape and position: Origin Insertion
dome-shaped between thorax and abdomen
Origin
Sternal part: xiphoid process
Costal part: lower six and costal cartilages
Lumbar part: arises from upper 2-3 lumbar vertebrae
Insertion
central tendon

31. Diaphragm

32. Inspiration
movements of:
Diaphragm
Sternum
Ribs

33. sternum
Ribs

34. Intercostal space