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RIBS & SURFACE ANATOMYLEARNING OBJECTIVES Demonstrate the main anatomical features and surface landmarks of the thoracic vertebrae, ribs and sternum Describe anatomy of joints between ribs, vertebrae, costal cartilages and sternum Describe the anatomy of intercostal muscle. Describe the neurovascular bundle in a typical intercostal space and outline the structures its components supplyDIFFERENTIATING THE VERTEBRAETHORACIC VERTEBRAE ANATOMY Characteristic Features: • Heart shaped vertebral body • Presence of demi-facets on the sides of the vertebral body • Presence of costal facets on the transverse processes (T1-T10 only) • Spinous processes are long and slant inferiorly Typical vertebrae: T5-T8 (Contain features present in all thoracic vertebrae. They have the greatest rotational ability of thoracic vertebrae) Atypical vertebrae: Atypical vertebrae display variation in the size, location and number of the demi-facets T1 (Superior facet is not a demi-facet, as this is the only vertebrae to articulate with the 1 rib) T10 (A single pair of whole facets is present which articulate with th the 10 rib. These facets are located across both the vertebral body and the pedicle) T11/T12 (Each have a single pair of entire costal facets, which are located on the pedicles) Ribs 1-7 (True Ribs) Ribs 8-10 (False Ribs) RIB ANATOMY Ribs 11/12 (Floating Ribs) Typical: Ribs 3-9 Head – Wedge shaped, 2 articular facets separated by a wedge of bone. Rib articulates with its corresponding vertebra and superior vertebra (eg: Atypical: Rib 4 with T4 and T3) Rib 1 – Shorter and wider. Only 1 facet to only articulate with T1. Superior surface marked by Neck – No bony prominences, simply connects 2 grooves, for the subclavian vessels. the head with the body. Where the neck meets the body is a rough Rib 2 – Thinner and longer than rib 1. 2 facets like tubercule, with a facet for articulation normal. Roughened area on the upper surface, with the transverse process of the where serratus anterior originates. corresponding vertebra Rib 10 – Only 1 facet to only articulate with T10. Body – Flat and curved. Internal surface has a groove for neurovascular supply Ribs 11/12 – No neck. Only 1 facet. STERNUM ANATOMY Manubrium: Superior portion of the sternum. Trapezoid shape. Superior aspect is concave, producing the jugular notch Lateral edge contains a facet for articulation with rib 1, and a demi-facet for articulation with rib 2 Inferior aspect articulates with body of sternum, forming the sternal angle (Angle of Louis) Body: Flat and elongated. Largest part of sternum Articulates superiorly with manubrium Articulates inferiorly with xyphoid process Lateral edges have facets for ribs 3-6 and demi-facets for ribs 2 & 7 Xyphoid process: Most inferior and smallest part of sternum Tip located ~T10 Mostly cartilaginous and ossifies ~40 years old In some people, articulates with rib 7LEARNING OBJECTIVES Demonstrate the main anatomical features and surface landmarks of the thoracic vertebrae, ribs and sternum Describe anatomy of joints between ribs, vertebrae, costal cartilages and sternum Describe the anatomy of intercostal muscle. Describe the neurovascular bundle in a typical intercostal space and outline the structures its components supply THORACIC ARTICULATIONS Posterior: All 12 ribs articulate with the vertebrae. Each rib forms 2 joints: • Costotransverse joint (between tubercule of rib and transverse costal facet of corresponding vertebra) • Costovertebral joint (between head of rib, superior costal facet of the corresponding vertebra, and the inferior costal facet of the vertebra above) Anterior: Ribs 1-7 attach independently to the sternum (true ribs) Ribs 8-10 attach to costal cartilages superior to them (false ribs) Ribs 11 & 12 don’t attach anteriorly (floating ribs)VERTEBRAL JOINT DIAGRAM Inferior costal demi-facet T3 Intervertebral disc Transverse costal facet Superior costal demi-facet T4 Rib 4LEARNING OBJECTIVES Demonstrate the main anatomical features and surface landmarks of the thoracic vertebrae, ribs and sternum Describe anatomy of joints between ribs, vertebrae, costal cartilages and sternum Describe the anatomy of intercostal muscle. Describe the neurovascular bundle in a typical intercostal space and outline the structures its components supply INTERCOSTAL MUSCLES Internal: Innermost: External: Attachments – Originates from the lateral Attachments – Originates from the medial edge of the costal groove edge of the costal groove and Attachments – Originates at lower and inserts into the superior inserts into the superior surface border of rib, attaches at superior border of rib surface of the rib below of the rib below below Actions – The interosseous part reduces the Actions – The interosseous part reduces the Actions – Elevates ribs, increasing thoracic volume by depressing the thoracic volume by depressing the thoracic volume ribcage, and the interchondral part ribcage, and the interchondral part elevates the ribs elevates the ribs Innervation – Intercostal nerves (T1-T11) Innervation – Intercostal nerves (T1-T11) Innervation – Intercostal nerves (T1-T11) Direction – Inferoanterior Direction – Inferoposterior Direction – Inferoposterior INTERCOSTAL NEUROV ASCULAR SUPPLY Neurovascular bundle runs through the costal groove on the inferior aspect of T1-T11 from the sternum Nerves: and vertebrae, meeting in the middle Origin – Anterior rami of nerves T1-T11 Types – Typical (T3-T6), Atypical (T1/T2, T7-T11) Rib Vein Branches – Muscular branches, collateral branches, lateral cutaneous Artery branch, anterior cutaneous branch, communicating branches Nerve Supply – T2-T6 (Intercostal muscles, parietal pleura, the skin Rib overlying thoracic wall), T7-T11 (Abdominal muscles, parietal peritoneum, skin over anterior abdomen) Arteries: Posterior intercostal: Origin – Superior intercostal artery & thoracic aorta Veins: Branches – Dorsal, spinal, medial and lateral musculocutaneous Posterior intercostal – Drains into brachiocephalic vein Anterior intercostal: Anterior intercostal – Drains into internal thoracic and musculophrenic vein Origin – Internal thoracic Branches – Superior and inferiorLEARNING OBJECTIVES Demonstrate the main anatomical features and surface landmarks of the thoracic vertebrae, ribs and sternum Describe anatomy of joints between ribs, vertebrae, costal cartilages and sternum Describe the anatomy of intercostal muscle. Describe the neurovascular bundle in a typical intercostal space and outline the structures its components supplyAny Questions?