Thorax: Topographic Anatomy

Thorax > Topographic Anatomy > Study Aims
At the end of your study, you should be able to:
Identify the major features of the surface anatomy of the chest wall
Identify the location of the sternoclavicular and manubriosternal joints
Know the types of these joints
Palpate the sternum and its parts

Thorax > Topographic Anatomy > Guides

3-1: Thorax: Topographic Anatomy
  • The thorax lies between the neck and the abdomen and lies within a cage formed by the vertebrae, the ribs, the sternum, the costal cartilages, and their attached muscles. The thoracic cage protects the contents of the thorax, whereas the muscles assist in breathing.
  • It is important to identify and count ribs as they form key landmarks to the positions of the internal organs.
  • In a fit muscular person one can identify a number of landmarks. For topographic anatomy of the chest wall ( Plate 181) .
    • Jugular (suprasternal) notch: at the level of the inferior border of the T2 vertebra
    • Sternal angle (manubriosternal join): at the level of the T4/5 intervertebral disc and where the second costal cartilages articulate with the sternum.
    • Manubrium: The left brachiocephalic vein runs beneath the manubrium from the upper left to lower right, where it joins the right brachiocephalic vein to form the superior vena cava
    • Body of the sternum: Anterior to the T5 through T9 vertebrae and the right border of the heart
    • Nipple: Anterior to the 4th intercostal space in males and the dome of the right hemidiaphragm; sits on the pectoralis major muscle
    • Xiphoid process: At the level of the T10 vertebra
    • The costal margins: Comprises the 7th through 10th costal cartilages
  • On yourself, palpate the following:
    • The sternoclavicular joints, lateral to the jugular notch
    • The sternum and its parts: manubrium, body, and xiphoid process
    • The manubriosternal joint (sternal angle)
    • The second pair of ribs on either side of the sternal angle—the surface landmark for rib counting
  • Surface lines can be drawn to identify regions of the thorax
    • Imaginary perpendicular lines passing through the midpoint of each clavicle are called the midclavicular lines.
    • Midaxillary lines are perpendicular lines through the apex of the axilla on both sides
  • Cephalic vein can be seen in some subjects lying in the deltopectoral groove between the deltoid and pectoralis major muscles.
Thorax > Topographic Anatomy > Figures
Plate 181: Thorax—Topographic Anatomy
Thorax > Topographic Anatomy > Tables

Table 3-1-1: Outline of the surface landmarks of the heart
Border Area covered
Superior border From the superior border of the second left costal cartilage to the third right costal cartilage
Right Border From the third right costal cartilage to the sixth right costal cartilage
Left Border From the second left costal cartilage to the apex of the heart
Inferior Border From the sixth right costal cartilage to the apex
Apex Lies in the fifth intercostal space, in the midclavicular line
(From: Granger NA. Crash Course Anatomy, 3rd Edition Elsevier 2007, Fig. 4-3 [Currently in Production])

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