TRIPASS XR تري باس

Organization of the thoracic and abdominal walls.

The architecture of tendon fibers of the two abdominal

oblique muscles in the rectus sheath is shown.

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1 Clavicle

2 Pectoralis major muscle

3 Sternum

4 Linea alba

5 Anterior layer of rectus sheath

6 Umbilicus

7 Internal abdominal oblique muscle

8 Inguinal ligament

9 External abdominal oblique muscle

The anterior abdominal and thoracic walls

reveal a segmental structure. The ribs are

connected by intercostal muscles forming

defined skeleto-motoric and neuro-vascular

segments.

At the abdominal wall, the segments form

great flat muscles, that end anteriorly in

strong sheet-like aponeuroses. The aponeurosis

interlace at the linea alba with their counterparts from the opposite side to form the

tough tendinous sheath of the rectus muscle.

Movements of the abdominal wall also support

the process of respiration functionally related

to the diaphragm.

Anterior thoracic and abdominal walls with superficial musculature.

The fascia of pectoralis major muscle and the abdominal wall have been removed;

the anterior layer of the sheath of the rectus abdominis muscle is displayed.

3 Trunk

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Median sagittal section through the vertebral column,

head, and thorax of the adult.

Skeleton of the trunk, vertebral column, thorax, and pelvis

(posterior aspect).

1 Atlas

2 Axis

3 Seventh cervical vertebra (vertebra prominens)

4 Vertebral canal

5 First rib

6 Clavicle

7 Manubrium sterni

8 Body of sternum

9 Costal arch

10 Acromion

11 Spine of scapula

12 Glenoid cavity (lateral angle of scapula)

13 Eleventh rib

14 Twelfth rib

15 Lumbar vertebrae

16 Sacral promontory

17 Hip bone

18 Pubic symphysis

19 Sacrum

20 Obturator foramen

21 Acetabulum

22 Scapula with coracoid process

23 Posterior superior iliac spine

24 Posterior inferior iliac spine

25 Ischial spine

26 Ischial tuberosity

Skeleton

Skeleton 189

1 Manubrium sterni

2 Clavicle

3 Acromion

4 Coracoid process

5 Glenoid cavity

6 Body of sternum

7 Costal cartilage

8 Body of the twelfth thoracic vertebra

9 Body of the first lumbar vertebra

10 Hip bone

11 Sacral promontory

12 Sacrum

13 Anterior superior iliac spine

14 Obturator foramen

15 Atlas

16 Seventh cervical vertebra

17 First rib

18 Xiphoid process

19 Twelfth rib

20 Body of the fifth lumbar vertebra

21 Iliac crest

22 Coccyx

23 Pubic symphysis

Skeleton of the trunk, vertebral column, pelvis, thorax, and shoulder girdle (anterior

aspect).

190 Vertebrae

Representative vertebrae from each region of the vertebral column (superior aspect).

From top to bottom: atlas (C1), axis (C2), cervical vertebra (C), thoracic vertebra (Th),

lumbar vertebra (L), and sacrum (S).

General organization of ribs and vertebrae (schematic drawing).

Atlas and axis.

Typical cervical and thoracic vertebrae.

Typical lumbar vertebra and sacrum.

Representative vertebrae from

each region of the vertebral column

(lateral aspect, ventral surface on the

right).

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Vertebrae 191

1 Foramen transversarium

2 Vertebral foramen

3 Body of vertebra

4 Superior articular facet

5 Base of sacrum

6 Anterior tubercle of atlas

7 Superior articular facet of atlas

8 Transverse process

9 Posterior tubercle of atlas

10 Dens of axis

11 Superior articular surface

12 Transverse process

13 Arch of vertebra

14 Anterior tubercle of transverse process

15 Posterior tubercle of transverse process

16 Spinous process

17 Shaft of rib

18 Body of vertebra and head of rib articulating with each other

(costovertebral joint)

19 Superior articular process

20 Transverse process and tubercle of rib articulating with each other

(costotransverse joint)

21 Costal process

22 Auricular surface

23 Lateral part of sacrum

24 Lateral sacral crest

25 Intermediate sacral crest

26 Median sacral crest

27 Inferior articular facet

28 Superior demifacet for head of rib

29 Inferior demifacet for head of rib

30 Inferior vertebral notch

31 Superior vertebral notch

32 Apex of the sacrum

33 Sacral cornu

34 Coccyx

35 Dorsal sacral foramina

36 Mamillary process

37 Pedicle

38 Inferior articular process

General characteristics of the vertebrae.

Typical cervical, thoracic, and lumbar vertebrae

and sacrum.

General characteristics of lumbar vertebrae

and sacrum (posterior aspect).

Green = ribs or homologous processes

Red = muscular processes

(transverse and spinous processes)

Orange = laminae and articular processes

Yellow = articular facets

and blue

192 Vertebral Column and Thorax

Skeleton of the thorax (anterior aspect).

Costovertebral articulation (right lateral aspect).

Skeleton of the thorax (posterior aspect).

1 Atlas

2 Axis

3 Cervical vertebrae

4 First thoracic vertebra

5 First rib

6 Facet for clavicle and clavicular notch

7 Manubrium sterni

8 Sternal angle

9 Body of sternum

10 Xiphoid process

11 Twelfth thoracic vertebra and rib

12 Jugular notch

13 Second rib

14 Costal cartilages

15 Infrasternal angle

16 Costal arch

17 Costotransverse joints between the transverse processes

of thoracic vertebra and the tubercles of the ribs

18 Spinous processes

19 Costal angle

20 Costal processes of lumbar vertebrae

21 Facet for articulation with rib

22 Tubercle of rib

23 Superior facet for articulation with head of rib

24 Articulation of head of rib with two vertebrae

25 Inferior facet for articulation with head of rib

26 Body of thoracic vertebra

27 Body or shaft of rib

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T1

T6

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T12

L1

L5

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Vertebral Column and Thorax

Skeleton of the thorax (right lateral aspect).

1 Atlas

2 Axis

3 Cervical vertebrae

4 Seventh cervical vertebra (vertebra prominens)

5 First rib

6 Facet for clavicle

7 Manubrium sterni

8 Sternal angle

9 Body of sternum

10 Costal arch

11 Tenth rib

12 Eleventh rib

13 Twelfth rib

14 Spinous processes of cervical vertebrae

15 Spinous processes of thoracic vertebrae

16 Spinous processes of lumbar vertebrae

17 Costal angle

18 Intervertebral foramina

19 Intervertebral discs

20 Cervical curvature

21 Thoracic curvature

22 Lumbar curvature

23 Sacrum

24 Coccyx

Vertebral column

(right lateral aspect).

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Vertebral Column and Thorax

1 Frontal bone

2 Maxilla

3 Mandible

4 Bodies of cervical vertebrae

5 First rib

6 Manubrium of sternum

7 Sternum (corpus sterni)

8 Seventh rib (last of the true ribs)

9 Costal arch (arcus costalis)

10 Floating ribs (costae fluctuantes)

11 Body of fourth lumbar vertebra

12 Pelvis

13 Occipital bone

14 Atlanto-occipital joint

15 Atlas

16 Axis

17 Spinous processes of cervical vertebrae (C4, C5)

18 Costotransverse joint of first rib

19 Head of second rib

20 Third rib

21 Spinous processes of lumbar vertebrae (L2, L3)

22 Sacrum

Vertebral column and thorax in connection with head and pelvis (lateral aspect).

Vertebral Column and Thorax: Vertebral Joints 195

Cervical vertebrae (lateral aspect, articular facets = blue).

Thoracic vertebrae (lateral aspect, articular facets = blue).

Lumbar vertebrae with sacrum and coccyx

(posterior aspect, articular facets = blue).

1 Atlas

2 Dens of axis

3 Axis

4 Body of cervical vertebra

5 Intervertebral discs

6 Sternocleidomastoid muscle

7 Scalenus muscles

8 Body of vertebra

9 Superior articular facet

10 Vertebral arch

11 Transverse process of vertebra

12 Zygapophysial joint

13 Spinous process

14 Articular facet

of costovertebral joint

15 Transverse process

with articular facet

of costotransverse joint

16 Costal process of lumbar

vertebra

17 Sacrum

18 Median sacral crest

19 Dorsal sacral foramina

20 Coccyx

Coronal section through the neck at the level of the cervical vertebrae (MRI

scan, courtesy of Prof. Heuck, Munich).

196 Vertebral Column and Thorax: Costovertebral Joints and Intercostal Muscles

1 Axillary vein

2 Intercostobrachial nerves

3 Subscapularis muscle and

thoracodorsal nerve

4 Long thoracic nerve, lateral

thoracic artery and vein

5 Latissimus dorsi muscle

6 External intercostal muscles

7 Serratus anterior muscle

8 Lateral cutaneous branches of

intercostal nerves

9 External abdominal oblique muscle

10 Clavicle (divided)

11 Second rib (costochondral

junction)

12 Internal intercostal muscles

13 External intercostal membrane

14 Position of xiphoid process

15 Costal arch or margin

16 Anterior layer of rectus sheath

Effect of intercostal muscles on the costovertebral and

costotransverse joints. Axes of movement indicated by red lines;

direction of movements indicated by red arrows.

A = action of internal intercostal muscles (expiration);

B = action of external intercostal muscles (inspiration).

Muscles of the thorax, superficial layer (lateral aspect). Upper limb elevated.

Pectoralis major and minor muscles have been removed.

A

B

Vertebral Column and Thorax: Costovertebral Joints 197

Two thoracic vertebrae (left lateral aspect).

Location of costovertebral joints (superior aspect).

Costovertebral joints (schematic drawing). Two thoracic

vertebrae with an articulating rib (separated). Axis of movement

indicated by dashed line. Blue = articular facets.

1 Superior articular process

2 Vertebral canal

3 Body of thoracic vertebra

4 Costovertebral joint

(articular facets)

5 Tubercle of rib

6 Head of rib

7 Shaft or body of rib

8 Transverse process

with articular facet

9 Spinous process

10 Costotransverse joint

(articular facets)

Ligaments of thoracic vertebrae and costovertebral joints

(left antero-lateral aspect). In the upper joint, most of the radiate

ligament and the anterior part of the head of the rib have been

removed to expose the two joint cavities and the interposed

intra-articular ligament.

1 Superior demifacet for head of rib

2 Body of vertebra

3 Inferior demifacet for head of rib

4 Intervertebral disc

5 Inferior vertebral notch

6 Superior articular facet and

superior articular process

7 Pedicle

8 Transverse process and facet

for tubercle of rib

9 Inferior articular process

10 Intervertebral foramen

11 Spinous process

12 Anterior longitudinal ligament

13 Intra-articular ligament

14 Radiate ligament

15 Superior costotransverse ligament

16 Body of rib

17 Intertransverse ligament

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Vertebral Column and Thorax: Ligaments

Median-sagittal section of the bodies of the vertebrae,

showing the intervertebral discs, each of which consists

of an outer laminated portion and an inner core.

The two caudal lumbar vertebrae and the sacrum with

their intervertebral discs (anterior aspect). Anterior longitudinal

ligament removed.

Ligaments of the vertebral column, thoracic part (left lateral

aspect).

Ligaments of the vertebral column (dorsal aspect).

1 Body of vertebra

2 Intervertebral disc

a Outer portion (anulus fibrosus)

b Inner core (nucleus pulposus)

3 Anterior longitudinal ligament

4 Posterior longitudinal ligament and spinal dura mater

5 Costal process of lumbar vertebra

6 Sacrum

7 Supraspinous ligament

8 Interspinous ligament

9 Intertransverse ligament

10 Superior costotransverse ligament

11 Transverse process of thoracic

vertebra

12 Rib

13 Ligamentum flavum

14 Spinous process

15 Intervertebral foramen

Vertebral Column and Thorax: Ligaments 199

Disarticulated thorax skeleton.

The twelve ribs (I–XII) are arranged

in a craniocaudal direction.

Ligaments of thoracic vertebrae and

costovertebral joints (lateral aspect).

Blue = articular facets.

Median-sagittal section of two lumbar vertebrae showing

ligaments and vertebral discs.

1 Anterior longitudinal ligament

2 Body of vertebra

3 Intervertebral disc

4 Intra-articular ligament

5 Radiate ligament

6 Posterior longitudinal ligament

7 Superior articular facet

8 Articular facets of

costovertebral joints

9 Superior costotransverse ligament

10 Costovertebral joint

11 Rib

12 Interspinal ligament

13 Costotransverse joint

14 Lateral costotransverse ligament

15 Spinous process

16 Supraspinal ligament

17 Nucleus pulposus

18 Costal process

19 Vertebral arch

20 Intervertebral foramen

21 Intertransverse ligament

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Vertebral Column and Thorax: Joints Connecting to the Head

Atlas and axis (from above). Median atlanto-axial joint and transverse ligament of

atlas (from above). Dens of axis partly severed.

1 Anterior arch of atlas with anterior tubercle

2 Superior articular facet of atlas

3 Foramen transversarium and transverse

process

4 Posterior arch of atlas and vertebral artery

5 Posterior tubercle of atlas

6 Dens of axis

7 Superior articular surface of axis

8 Body of axis

9 Pedicle and lamina of axis

10 Spinous process

11 Inferior articular process

12 Transverse process and foramen

transversarium of axis

13 Median atlanto-axial joint (anterior part)

14 Articular capsule of atlanto-occipital joint

15 Transverse ligament of atlas

16 Occipital bone

17 Atlanto-occipital joint

18 Lateral atlanto-axial joint

19 Third cervical vertebra

20 Superior longitudinal band of

cruciform ligament

21 Alar ligaments

22 Transverse ligament of atlas

23 Inferior longitudinal band of

cruciform ligament

24 Spinous process of axis

25 Dura mater

26 Occipital bone

Head and cervical spine (posterior aspect).

Bones of atlanto-occipital and atlanto-axial joints.

Atlanto-occipital and atlanto-axial joints (posterior aspect).

Posterior part of occipital bone, posterior arch of atlas, and

axis have been removed to show the cruciform ligament.

Atlas and axis. Left oblique postero-lateral aspect,

demonstrating the articulation of the dens of axis with

atlas (cf. arrows).

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