This article uses a few professional terms to explain certain anatomical details. These words apply only when the body is in the anatomical position, i.e., standing up with hands facing forward. Please visit the anatomical position page for more detailed information.

Superior thoracic aperture
The thorax from in front. (Superior thoracic aperture visible at top.)
Vasculature
Latin	apertura thoracis superior

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. The clinical entity called the Thoracic outlet syndrome does not refer to the inferior thoracic aperture.

Contents 1 Boundaries 2 Relations 3 Contents 4 References 5 External links

[edit] Boundaries

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.

[edit] Relations

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.

[edit] Contents

Structures that pass through the superior thoracic aperture include:

• trachea
• oesophagus
• thoracic duct
• nerves
  • phrenic nerve
  • vagus nerve
  • Left recurrent laryngeal nerves
  • sympathetic trunks
• vessels
  • arteries
    • common carotid arteries
    • brachiocephalic trunk
    • subclavian arteries
  • veins
    • internal jugular veins
    • brachiocephalic veins
    • subclavian veins
• lymph nodes and lymphatic vessels

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. Furthermore, they extend slightly superior past the level of the inlet (e.g. the horizontal plane of the first rib).

[edit] References

McMinn, RMH (Ed) (1994) Last's Anatomy: Regional and applied (9th Ed). London: Churchill Livingstone. ISBN 0-443-04662-X

[edit] External links

• -2033188804 at GPnotebook

v • d • e Bones of torso (TA A02.2,3, GA 2.96-128) Sternum Suprasternal notch, Manubrium, Sternal angle, Body of sternum, Xiphisternal joint, Xiphoid process Rib specific ribs (1, 2, 9, 10, 11, 12, true – 1–7, false – 8–12, floating – 11–12) · parts (Angle, Tubercle, Costal groove, Neck, Head) Superior thoracic aperture · Inferior thoracic aperture · Intercostal space · Thoracic wall/Thoracic cage Vertebra General structures body of vertebra, vertebral arch (pedicle, lamina, vertebral notch), foramina (vertebral, intervertebral), processes (transverse, articular/zygapophysis, spinous), spinal canal Cervical vertebrae C1 (anterior arch, posterior arch, lateral mass), C2 (dens), C3, C4, C5, C6, C7 anterior tubercle, posterior tubercle, foramen transversarium Thoracic vertebrae T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12 costal facets (superior, inferior, transverse) Lumbar vertebrae accessory process, mammillary process, L5 Sacrum pelvic surface (anterior sacral foramina), dorsal surface (posterior sacral foramina, median sacral crest, medial sacral crest, lateral sacral crest), lateral surface (sacral tuberosity), base, sacral hiatus · presacral space · sacral promontory · sacral canal  · ala of sacrum · sacrovertebral angle Coccyx