Adult right first (I) atypical rib – A from above; B from below
1 Head
2 Neck
3 Tubercle
4 Shaft
5 Groove for subclavian artery
6 Scalene tubercle
7 Groove for subclavian vein
8 Anterior end
The first (I) rib:
➤ Is an atypical rib.
➤ Is the most curved, flattest and shortest of all the ribs.
➤ Articulates with only one vertebra, at its own level, the first (TI) thoracic vertebra.
Other atypical ribs are:
➤ The second (II), tenth (X), eleventh (XI) and twelfth (XII).
Adult right typical rib – A from above; B from below
1 Head
2 Neck
3 Tubercle
4 Angle
5 Shaft
6 Anterior end
7 Articular facet of head
8 Articular facet of tubercle
9 Costal groove
The seven typical ribs are the third to ninth (III–IX):
➤ Have a head with two facets and a tubercle that has both articular and non-articular parts; the facets and tubercle are situated each end of the ribs neck and articulate with the body of two separate vertebra, one at the rib’s own level and the one above.
➤ For example, the fifth (V) rib articulates with the body of the fifth (TV) thoracic vertebra and also the body of the one above, the fourth (TIV) thoracic vertebra.
Adult skeleton of the thorax – from the front
1 Seventh (CVII) cervical vertebra – vertebra prominens
2 Suprasternal notch
3 Sternoclavicular joint
4 Body of clavicle
5 Acromioclavicular joint
6 Scapula
7 Shoulder joint
8 Head of humerus
9 Surgical neck of humerus
10 Shaft of humerus
11 Manubrium of sternum
12 Manubriosternal joint
13 Body of sternum
14 Xiphisternal joint
15 Xiphoid process of sternum
16 First (I) rib
17 Second (II) rib
18 Third (III) rib
19 Fourth (IV) rib
20 Fifth (V) rib
21 Sixth (VI) rib
22 Seventh (VII) rib
23 Eighth (VIII) rib
24 Ninth (IX) rib
25 Tenth (X) rib
26 Eleventh (XI) rib
27 Twelfth (XII) rib
28 First costal cartilage
29 Second costal cartilage
30 Third costal cartilage
31 Fourth costal cartilage
32 Fifth costal cartilage
33 Sixth costal cartilage
34 Seventh costal cartilage
35 Twelfth (TXII) thoracic vertebra
36 First (LI) lumbar vertebra
37 Costochondral junction
The ribs are defined as:
➤ The seven true ribs, the first to seventh (I–VII): are joined to the sternum by their costal cartilages.
➤ The five false ribs, the eighth to twelfth (VIII–XII): are joined by their cartilages to the cartilage above.
➤ The two floating ribs, eleventh and twelfth (XI, XII): are short and are not joined to others.
Muscles of the external thoracic wall – from the front
1 Sternohyoid
2 Sternothyroid
3 Sternal head of sternocleidomastoid
4 Clavicular head of sternocleidomastoid
5 Capsule of sternoclavicular joint
6 Body of clavicle
7 Cephalic vein in deltopectoral groove
8 Deltoid
9 Clavicular part of pectoralis major
10 Sternocostal part of pectoralis major
11 Suprasternal notch
12 Manubrium of sternum
13 Body of sternum
14 Xiphoid process of sternum
15 Approximate position of heart (outlined)
16 Serratus anterior
17 External oblique
18 Rectus sheath
19 Linea alba
20 Tendinous intersection of rectus abdominis
21 Rectus abdominis
22 Fourth (IV) rib
23 Third (III) rib
24 Second (II) rib
25 First (I) rib
26 External intercostals
27 Pectoralis minor
Superficial structures of the female breast and external thoracic wall – from the front and left
1 Fascia overlying body of clavicle
2 Supraclavicular nerves
3 Fascia overlying pectoralis major
4 Branches of lateral thoracic artery
5 Fat of breast
6 Areola of breast
7 Nipple of breast
8 External oblique
9 Serratus anterior
10 Latissimus dorsi
11 Cutaneous branches of intercostal nerves
The female breast:
➤ Is situated in the subcutaneous tissue of the anterior thoracic wall.
➤ Mainly comprises variable amounts of fat, which provides the bulk of the breasts volume; within the fat is a framework of fibrous tissue and ducts.
➤ Main part of the breast overlays pectoralis major.
➤ Base of the breast, which is constant in position, extends from near the midline to the midaxillary line, and from the second (II) to the sixth (VI) rib.
➤ Main blood supply to the breast is from the internal thoracic artery and adjacent intercostal vessels.
➤ Lactiferous ducts, about
15 in number, communicate with and open at the nipple.
Sagittal section through the left female breast – from the left
1 Fascia overlying pectoralis major
2 Pectoralis major
3 Fat of breast
4 Condensed glandular tissue
5 Fibrous septum (suspensory ligaments)
6 Retromammary space
7 Lactiferous duct
8 Nipple of breast
9 Areola of breast
10 Skin and subcutaneous tissue of breast
Lymphatic drainage of the breast:
➤ Is mostly to the axillary group of lymph nodes (which may be palpable).
➤ Can also pass through drainage channels that pass through the chest wall to the parasternal group of lymph nodes (which are not palpable), situated within the thorax beside the internal thoracic vessels.
Thorax with ribcage and thoracic viscera in situ – from the front
1 Body of clavicle
2 Capsule of sternoclavicular joint
3 Suprasternal notch
4 Manubrium of sternum
5 Manubriosternal joint
6 Body of sternum
7 Xiphoid process of sternum
8 First (I) rib
9 Second (II) rib
10 Third (III) rib
11 Fourth (IV) rib
12 Fifth (IV) rib
13 Sixth (VI) rib
14 Seventh (VII) rib
15 First costal cartilage
16 Second costal cartilage
17 Third costal cartilage
18 Fourth costal cartilage
19 Fifth costal cartilage
20 Sixth costal cartilage
21 Seventh costal cartilage
22 Superior lobe of right lung
23 Transverse fissure of right lung
24 Middle lobe of right lung
25 Inferior lobe of right lung
26 Subclavian artery
27 Axillary artery
28 Brachial plexus
29 Axillary vein
30 Internal thoracic artery and vein
31 Costochondral junction
32 Superior lobe of left lung
33 Oblique fissure of left lung
34 Superior surface of left dome of diaphragm
35 Central tendon of diaphragm
Thorax with ribcage removed and thoracic viscera in situ – from the front
1 First (I) rib
2 Second (II) rib
3 Third (III) rib
4 Fourth (IV) rib
5 Fifth (V) rib
6 Sixth (VI) rib
7 Seventh (VII) rib
8 Eight (VIII) rib
9 Ninth (IX) rib
10 Ninth costal cartilage
11 Tenth costal cartilage
12 Superior lobe
13 Transverse fissure of right lung
14 Oblique fissure of right lung
15 Inferior lobe of right lung
16 Superior surface of right dome of diaphragm
17 Central tendon of diaphragm
18 Superior surface of left dome of diaphragm
19 Rectus abdominis
20 Linea alba
21 Superior lobe of left lung
22 Oblique fissure of left lung
23 Inferior lobe of left lung
24 Pericardium (pericardial sac)
25 Internal thoracic artery and vein
26 Arch of aorta
27 Left brachiocephalic vein
28 Right brachiocephalic vein
29 Right internal jugular vein
30 Brachiocephalic trunk
31 Trachea
32 Right lobe of thyroid gland
33 Laryngeal prominence of thyroid cartilage
34 Left common carotid artery
35 Left internal jugular vein
36 Subclavian vein
37 Axillary vein
38 Axillary artery
39 Long head of biceps
40 Deltoid
41 Body of clavicle
Right lung, lateral aspect – from the right
1 Apex
2 Superior lobe
3 Middle lobe
4 Inferior lobe
5 Oblique fissure
6 Transverse fissure
Bronchopulmonary segments of the three lobes of the right lung are:
➤ Superior lobe:
Apical segment (SI)
Posterior segment (SII)
Anterior segment (SIII)
➤ Middle lobe:
Lateral segment (SIV)
Medial segment (SV)
➤ Inferior lobe:
Apical (superior) (SVI)
Medial basal (SVII)
Anterior basal (SVIII)
Lateral basal (SIX)
Posterior basal (SX)
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