Structures at the Level of Sternal Angle

Structures at the Level of Sternal angle "Vimp" 1. The 2nd ob articulate with sternum.... 2. Trachea bifurcates into Left and right- 3. Superficial cardiac plexus..... 4. End of ascending aorta..... 5.begining and ending of arch of acrta..... 6. begin of descending aorta..... 7- Pulmonary trunk divides into right and left pulmonary arteries. 8. Termination of the arch of azygous vein into superior Vena Cava... 9. Ligamentum arteriosum.... 10. The thoracic duct crasses from keft right to Left... 11. Intervertebral disc between the fourth and fifth..... not. imp. *Clincal corelation 80 Sternal Puncture:-*a specimen can be taken by a needle becouse the sternum is subcutaneous... *for hematological examination- *from upper part of Manebrium to avoid Injury to arch of corta... * not advisable in children because the sternum is very thin... RIBS:- extend From thoracic vertebrae POSTERIORLY to sternum ANTERIORLY... *Classification 80 1. According to relation with sternum and Articulation: (a) True ribs 1st 7th "Vertebrosternal" (b) False ribs 8th th vertebro chondral C) Floating ribs 11th, 12th vertebral... 2. According to Features:- (a) Typical ribs: 3rd 9th same general features"... (b) Atypical ribs: 1st, 2nd, 10th, 11th, 12th "s "special features.. A. Typical ribs:- 3rd, 9th Zends.. shaft 2 borders.. 2 surface.. Inferior border "sharp Vimp contains costal groove Lodges the Intercostal vessels and nerve (VAN) Anterior end cup shape.. Posterior end Head ne k tubercle. 2 Inches angle oprib #Smooth Inner surface, concave and related to plura posterior end tubercle... divided into articular part with transverse process of vertebra... non articular part provides attachment to Ligament.. B. Atypical ribs:- 1st RiB shortest (Cshaped)... flatest... Head single facet tubercle 2 surface. 2 Border.. Insertion Scalenus medus post subclavian artery- provides attachment Scalen tubercle to suprapleural membraney Castoclavicularly post. subclavius scle Ant 4 shoft curved and twisted outer surface Convex Krough Superior border rounded dess facet Head 2 demifacet. vimp demifacet Neck -Posterior end. Neck structures related to it... *1. sympathatic chain... 2. Ist post. intercostal vein... •3. superior intercostal artery... #4. Venteral ramus of Ts Insertion to Scalenus ant. Lower trunk of Brachial plens subclavian artery... post to scalen tubercle..... Subclavian vein. anterior to scolen tubercle... outer border: origin to: 1. Intercostal Muscle.... 2.1st digitation of serratus anterior... *Fracture of ribs :- not.imp. in children 1st and 2nd 11th and 12th + Rare the ribs are elastic Protected by clavicle... th mobile "floating" rarely injured... Thoracic Vertebrae 12 thoracic vertebrae... *Classification According to the features:- 1. Typical 2nd 2. Atypical 11th, 11th 12th A. Typical thoracic vertebrae facing paterior lateral.. Lamina... Superior facet... Body 2 costal Facets articulate with heads of ribs... Inferior Facet... superior articular processes Vertebral arch... Transverse processes... artoulate with tubercles of Ribs.. spinous. process Long direded downwards. Pedicle... B. A Typical thoracic vertebrae:- 1st thoracic vertebrea. spine is nearly horizontal dmifacet one complele Facet small costal Facet Inferior articular process facing Manter Transverse process... 11th thoracic vertebrea... only one Complete Facet Vertebral foramen. 11th thoracic vertebra 12th thoracic vertebra.... Transverse process.. No facet... Transverse process No facet. Inferior articular prosess Facing Laterally.... Ligonents of vertebrat Column 1. Anterior Longitudinal Ligaments: Connects anterior surface of the bodies... 2. Posterior Longitudinal Ligaments:- covering posterior surface of vertebral bodies... -Located in the vertebral canal... 3. Ligamentum flavum: Nimp Connect the laminae of adjacent vertebrae... 4. The Inter spinous Ligaments:- Connects the spines..... 5. The Supraspinous Ligament:- Connects the tips of the spines... 6. The Inter transverse Ligament:- short.... Shanect the transverse process...