The chest, or the thorax (the word is derived through Latin from the Greek word θώραξ, which means breastplate), is an anatomical part of the human body. It is located in between the neck and abdomen. The chest includes the thoracic cavity as well as the thoracic wall. The thorax contains vital organs such as the heart, the lungs, and the thymus gland. It also contains various muscles and internal structures. The thorax is found in the chest region of the body. It is placed between the neck and the abdomen, protected and is supported by the rib cage, the spine, as well as the shoulder girdle.
Bones
The bone construction of the thorax, also known as the thoracic skeleton and rib cage, is a part of the axial skeleton and consists of the ribs and sternum. The ribs are numbered in ascending order – starting from I to XII. The XI and XII-th ribs are called “floating” because of their lack of anterior attachment point to the sternum. Ribs from VIII to X are known as “false” ribs. Their costal cartilage articulates with the previous (the one placed above) rib’s costal cartilage.
Anatomical landmarks
The anatomy of the chest is often described through the use of so called “anatomical landmarks” on the front and back of the thorax to describe the nearing locations of certain anatomical structures. This is possible with imaginary lines that cover the frontal side and the back of the thorax.
There are three vertical lines going on the anterior wall that help with certain referring points:
• midsternal (anterior median) line (running down the middle of the sternum)
• right and left midclavicular lines (passing through the midpoint of each clavicle, parallel with the midsternal line)
Other three vertical lines mark the lateral portion of the rib cage:
• anterior axillary line (along the anterior axial fold and close to the thoracic frontal side)
• posterior axillary line (parallel with the anterior axillary line)
• midaxillary line (between the anterior and posterior axillary lines, startis at the deepest part of the axilla)
Three lines help describe surface locations on the back:
midvertebral (posterior median line, down the midpoint of the spine, vertically)
right and left scapular lines (passing through the inferior angles of the scapulae, parallel with the midvertebral line)
Anterior chest wall
The anterior of the chest is the main area for physical examination in case of chest problems, injuries and prophylactic examinations . It has several important landmarks which are indicated by bones and muscles:
• clavicles sternal angle
• sternum aortic area pulmonic area
• tricuspid area
• mitral area
• subcostal angle
• costal margins
Posterior chest wall
The scapulae (shoulder blades) are flat, triangular bones that are located in the upper portion of the posterior chest wall.
The superior angles (found at the top of the scapulae) are nearing the level of the second thoracic vertebrae. The spines of the scapulae run towards the shoulders and are easy to palpate.
The posterior quadrant of the thorax could be distorted due to various conditions such as scoliosis or spondylitis.
Contents of the thorax
The following organs and internal structures are to be found in the chest cavity:
• heart lungs
• thymus gland
• major and minor pectoral muscles
• trapezius muscles
• neck muscle
• diaphragm
• esophagus
• trachea
• xiphoid process (which is a part of the sternum)
The contents of the thoracic abdomen include:
• stomach
• spleen
• lower oesophagus
• kidney, adrenal
• pancreas
Arteries and veins are also contained in the chest area:
• aorta
• superior vena cava
• inferior vena cava
• pulmonary artery
Some of the major bone structures in the chest are:
• shoulder socket
• upper part of the humerus
• scapula
• sternum
• thoracic portion of the spine
• collarbone
• rib cage
• floating ribs
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