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Superior thoracic aperture
The superior thoracic aperture refers to the superior opening of the thoracic cavity. It is also referred to anatomically as the thoracic inlet and clinically as the thoracic outlet. It is important to note that the clinical entity called the Thoracic outlet syndrome does not refer to the inferior thoracic aperture.
Additional recommended knowledge
The thoracic inlet is essentially a hole surrounded by a bony ring, through which several vital structures pass.
The superior thoracic aperture is bounded by: the first thoracic vertebra (T1) posteriorly, the first pair of ribs laterally (more specifically, the first ribs form lateral C-shaped curves posterior to anterior), and the superior border of the manubrium anteriorly.
The clavicles articulate with the manubrium to form the anterior border of the thoracic inlet. Superior to the thoracic inlet is the root of the neck, and the superior mediastinum is related inferiorly.
The brachial plexuses are superolateral relations of the thoracic inlet. The brachial plexus emerges between the anterior and middle scalene muscle, superior to the first rib and pass obliquely and inferiorly, underneath the clavicle, into the shoulder and then the arm. Impingement of the plexus in the region of the scalenes, ribs and clavicles is responsible for thoracic outlet syndrome.
Structures that pass through the superior thoracic aperture include:
This is not an exhaustive list. There are several other minor but important vessels and nerves passing through, and an abnormally large thyroid gland may extend inferiorly through the thoracic inlet into the superior mediastinum.
The oesophagus lies against the body of the T1 vertebra, separated from it by the prevertebral fascia, and the trachea lies in front of the oesophagus, in the midline, and may touch the manubrium. The apices of the lungs lie to either side of the oesophagus and trachea, and separated from them by the other vessels and nerves listed above.
McMinn, RMH (Ed) (1994) Last's Anatomy: Regional and applied (9th Ed). London: Churchill Livingstone. ISBN 0-443-04662-X
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Superior_thoracic_aperture". A list of authors is available in Wikipedia.|