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Functional Anatomy of Thorax and Chest Wall
Rafael Vazquez, MD
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TERMINOLOGY

  • Abbreviations

    • Pectoralis major muscle (PMM)
    • Pectoralis minor muscle (PMiM)
    • Erector spinae muscle (ESM)
    • Latissimus dorsi muscle (LDM)
    • Serratus posterior inferior muscle (SPI)
    • Serratus posterior superior muscle (SPA)
    • Rhomboid (minor and major) muscle (RMM)
    • Trapezius muscle (TPM)
    • Levatores costarum muscle (LCM)
    • Innermost intercostal muscle (InIM)
    • Internal intercostal muscle (IIM)
    • External intercostal muscle (EIM)
    • Serratus anterior muscle (SAM)
  • Synonyms

    • Costal facet = demifacet
  • Definitions

    • Extends from superior thoracic aperture to inferior thoracic aperture
      • Superior thoracic aperture formed by 1st thoracic vertebral body, 1st rib, and manubrium.
      • Inferior thoracic aperture formed by costal margin anterior, distal tip of 11th and 12th ribs, and body of T12 vertebral body; it is closed off by diaphragm
    • Bones include: Thoracic vertebrae, ribs, sternum, and clavicle
    • Major muscular components of anterior chest wall include: PMM and PMiM, SAM, and intercostal muscles
    • Major muscles of posterior thorax include: TPM, RMM, ESM, serratus posterior, latissimus dorsi, intercostal muscles

GROSS ANATOMY

  • Bones of Chest Wall

    • Muscles of Anterior Chest Wall

      • Muscles of Posterior Chest Wall

        Somatic Innervation of Thoracic Wall

        • Anterior Chest Wall

          • Posterior Chest Wall

            Clinical Implications

            • Analgesia of Thoracic Wall

              Selected References

              1. Mittnacht AJC et al: Regional techniques for cardiac and cardiac-related procedures. J Cardiothorac Vasc Anesth. 33(2):532-46, 2019
              2. Ourieff J et al: Anatomy, Back, Trapezius 2019
              3. Krediet AC et al: Different approaches to ultrasound-guided thoracic paravertebral block: an illustrated review. Anesthesiology. 123(2):459-74, 2015
              4. Rea, P: Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Limbs. London: Academic Press is an imprint of Elsevier, 2015
              5. Bakkum BW et al: Muscles that influence the spine. In Cramer GD et al: Clinical Anatomy of the Spine, Spinal Cord, and ANS. 3rd ed. St. Louis: Elsevier Health Sciences. 98-134,  2014
              6. Labronici PJ et al: Clavicle fractures - incidence of supraclavicular nerve injury. Rev Bras Ortop. 48(4):317-21, 2013
              7. Saito T et al: Analysis of the posterior ramus of the lumbar spinal nerve: the structure of the posterior ramus of the spinal nerve. Anesthesiology. 118(1):88-94, 2013
              8. Jacob, S: Human anatomy: A Clinically-Orientated Approach: An Illustrated Colour Text. Edinburgh New York: Churchill Livingstone/Elsevier, 2007
              9. Vilensky JA et al: Serratus posterior muscles: anatomy, clinical relevance, and function. Clin Anat. 14(4):237-41, 2001
              10. Bogduk N et al: The human lumbar dorsal rami. J Anat. 134(Pt 2):383-97, 1982
              11. MORRISON AB: The levatores costarum and their nerve supply. J Anat. 88(1):19-24, 1954
              12. Davies F et al: The Anatomy of the Intercostal Nerves. J Anat. 66(Pt 3):323-33, 1932
              Related Anatomy
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              References
              Tables

              Tables

              TERMINOLOGY

              • Abbreviations

                • Pectoralis major muscle (PMM)
                • Pectoralis minor muscle (PMiM)
                • Erector spinae muscle (ESM)
                • Latissimus dorsi muscle (LDM)
                • Serratus posterior inferior muscle (SPI)
                • Serratus posterior superior muscle (SPA)
                • Rhomboid (minor and major) muscle (RMM)
                • Trapezius muscle (TPM)
                • Levatores costarum muscle (LCM)
                • Innermost intercostal muscle (InIM)
                • Internal intercostal muscle (IIM)
                • External intercostal muscle (EIM)
                • Serratus anterior muscle (SAM)
              • Synonyms

                • Costal facet = demifacet
              • Definitions

                • Extends from superior thoracic aperture to inferior thoracic aperture
                  • Superior thoracic aperture formed by 1st thoracic vertebral body, 1st rib, and manubrium.
                  • Inferior thoracic aperture formed by costal margin anterior, distal tip of 11th and 12th ribs, and body of T12 vertebral body; it is closed off by diaphragm
                • Bones include: Thoracic vertebrae, ribs, sternum, and clavicle
                • Major muscular components of anterior chest wall include: PMM and PMiM, SAM, and intercostal muscles
                • Major muscles of posterior thorax include: TPM, RMM, ESM, serratus posterior, latissimus dorsi, intercostal muscles

              GROSS ANATOMY

              • Bones of Chest Wall

                • Muscles of Anterior Chest Wall

                  • Muscles of Posterior Chest Wall

                    Somatic Innervation of Thoracic Wall

                    • Anterior Chest Wall

                      • Posterior Chest Wall

                        Clinical Implications

                        • Analgesia of Thoracic Wall

                          Selected References

                          1. Mittnacht AJC et al: Regional techniques for cardiac and cardiac-related procedures. J Cardiothorac Vasc Anesth. 33(2):532-46, 2019
                          2. Ourieff J et al: Anatomy, Back, Trapezius 2019
                          3. Krediet AC et al: Different approaches to ultrasound-guided thoracic paravertebral block: an illustrated review. Anesthesiology. 123(2):459-74, 2015
                          4. Rea, P: Essential Clinically Applied Anatomy of the Peripheral Nervous System in the Limbs. London: Academic Press is an imprint of Elsevier, 2015
                          5. Bakkum BW et al: Muscles that influence the spine. In Cramer GD et al: Clinical Anatomy of the Spine, Spinal Cord, and ANS. 3rd ed. St. Louis: Elsevier Health Sciences. 98-134,  2014
                          6. Labronici PJ et al: Clavicle fractures - incidence of supraclavicular nerve injury. Rev Bras Ortop. 48(4):317-21, 2013
                          7. Saito T et al: Analysis of the posterior ramus of the lumbar spinal nerve: the structure of the posterior ramus of the spinal nerve. Anesthesiology. 118(1):88-94, 2013
                          8. Jacob, S: Human anatomy: A Clinically-Orientated Approach: An Illustrated Colour Text. Edinburgh New York: Churchill Livingstone/Elsevier, 2007
                          9. Vilensky JA et al: Serratus posterior muscles: anatomy, clinical relevance, and function. Clin Anat. 14(4):237-41, 2001
                          10. Bogduk N et al: The human lumbar dorsal rami. J Anat. 134(Pt 2):383-97, 1982
                          11. MORRISON AB: The levatores costarum and their nerve supply. J Anat. 88(1):19-24, 1954
                          12. Davies F et al: The Anatomy of the Intercostal Nerves. J Anat. 66(Pt 3):323-33, 1932