Anatomy Bones and Muscles · MU Pleven

212. Thoracic wall.

Covers the layers of the thoracic wall from skin to parietal pleura, with the intercostal spaces and their three muscle layers. It explains the neurovascular bundle's position in each space, including the collateral bundle and the costal groove, and notes the pleural puncture caution. It also describes the lateral pectoral and inframammary regions, with their boundaries, veins, nerves and fascial layers, plus brief clinical notes on chest expansion and chest trauma.

Inside: 6 sections · 4 labelled pictures · 12 flashcards · 4 min

Topic 211 of 236 in the MU Pleven syllabus for Anatomy Bones and Muscles (Medicine, Year 2). The free AceMed note covers it in 6 sections, about 598 words (4 min of reading), with 12 flashcards.

In this note

  1. THORACIC WALL
  2. Surface anatomy:
  3. Clinical Significance:
  4. Intercostal Spaces:
  5. LATERAL PECTORAL Region
  6. INFRAMAMMARY Region

Surface anatomy:

  1. 1. Skin : over the ant. & lateral regions → thin
  • the post. region → thicker.
  1. 2. Subcutaneous tissue.
  • Run along it:
  1. 1. Ant. & lat. intercostal nerves
  2. 2. Venous network (thoracoepigastric v.)
  3. 3. Superficial fascia (thoracic fascia)
  4. 4. Deep fascia : Envelope the muscles of the thoracic wall.
  • Over the sternum, it's thicker & fuses with the periosteum.
  1. 5. Parietal Pleura

Clinical Significance:

  • Chest Expansion: Assessing chest expansion (symmetric or asymmetric) provides clues about chest wall pathology, lung volume loss, or obstruction 2.
  • Trauma: Patients with chest wall trauma are at risk for intrathoracic or intraabdominal injuries, warranting diagnostic imaging 3.

Line the inner surface of the chest wall.

* In the Asculation triangle this muscle layer is absent

So its suitable for auscultation of the lung.

Intercostal Spaces:

Intercostal spaces are located between adjacent ribs. They contain three layers of intercostal muscles. From superficial to deep these are the external intercostal muscles, internal intercostal muscles and the innermost intercostal muscles. The intercostal neurovascular bundle runs between the internal and innermost intercostal muscles. It passes just below the lower margin of the rib in the costal groove.

Content

  1. 1 External intercostal muscles
  2. 2 Internal intercostal muscles
  3. 3 Intercostal neurovascular bundle (listed in a craniocaudal direction)
  • 3.1 Anterior and posterior intercostal vein ← Superficial
  • 3.2 Anterior and posterior intercostal artery ← Middle
  • 3.3 Intercostal nerve ← Inferior
  1. 4 Collateral neurovascular bundle
  • 4.1 Collateral branch of posterior intercostal artery
  • 4.2 Collateral branch of intercostal nerve
  • – runs in the inferior and posterior part of the intercostal space
  1. 5 Innermost intercostal muscles

As a rule, the intercostal NVB runs between m. intercostalis internus and m. intercostalis intimus. Along the posterior parts of the ICSs the vessels lie in the costal groove (sulcus costae), and the nerve courses along the inferior costal margin. Anteriorly, however, the whole intercostal NVB runs in the middle of the ICS. Therefore, pleural punctures must

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