Thorax

The thorax or chest (from the Greek θώραξ thorax "breastplate, cuirass, corslet"[1] via Latin: thorax) is a part of the anatomy of humans and various other animals located between the neck and the abdomen.[2][3] The thorax includes the thoracic cavity and the thoracic wall. It contains organs including the heart, lungs, and thymus gland, as well as muscles and various other internal structures. Many diseases may affect the chest, and one of the most common symptoms is chest pain.

Thorax
Chest
Chest
X-ray image of the chest showing the internal anatomy of the rib cage, lungs and heart as well as the inferior thoracic border–made up of the diaphragm.
Surface projections of the organs of the trunk
Surface projections of the organs of the trunk, with the thorax or chest region seen stretching down to approximately the end of the oblique lung fissure anteriorly, but more deeply it its lower limit rather corresponds to the upper border of the liver.
Details
Identifiers
Latinthorax
Greekθώραξ
MeSHD013909
TAA01.1.00.014
FMA9576
Anatomical terminology

Structure

In humans and other hominids, the thorax is the chest region of the body between the neck and the abdomen, along with its internal organs and other contents. It is mostly protected and supported by the rib cage, spine, and shoulder girdle.

Contents

Chest labeled
An X-ray of a human chest area, with some structures labeled

The contents of the thorax include the heart and lungs (and the thymus gland); the (major and minor pectoral muscles, trapezius muscles, and neck muscle); and internal structures such as the diaphragm, the esophagus, the trachea, and a part of the sternum known as the xiphoid process). Arteries and veins are also contained – (aorta, superior vena cava, inferior vena cava and the pulmonary artery); bones (the shoulder socket containing the upper part of the humerus, the scapula, sternum, thoracic portion of the spine, collarbone, and the rib cage and floating ribs).

External structures are the skin and nipples.

The chest

In the human body, the region of the thorax between the neck and diaphragm in the front of the body is called the chest. The corresponding area in an animal can also be referred to as the chest.

The shape of the chest does not correspond to that part of the thoracic skeleton that encloses the heart and lungs. All the breadth of the shoulders is due to the shoulder girdle, and contains the axillae and the heads of the humeri. In the middle line the suprasternal notch is seen above, while about three fingers' breadth below it a transverse ridge can be felt, which is known as the sternal angle and this marks the junction between the manubrium and body of the sternum. Level with this line the second ribs join the sternum, and when these are found the lower ribs can often be counted. At the lower part of the sternum, where the seventh or last true ribs join it, the ensiform cartilage begins, and above this there is often a depression known as the pit of the stomach.

Bones

The bones of the thorax, called the "thoracic skeleton" is a component of the axial skeleton.

It consists of the ribs and sternum.The ribs of the thorax are numbered in ascending order from 1-12. 11 & 12 are known as floating ribs because they have no anterior attachment point in particular the cartilage attached to the sternum, as 1-7 are, and therefore are termed "floating". Whereas ribs 8-10 are termed false ribs as their costal cartilage articulates with the costal cartilage of the rib above.

Anatomical landmarks

The anatomy of the chest can also be described through the use of anatomical landmarks. The nipple in the male is situated in front of the fourth rib or a little below; vertically it lies a little external to a line drawn down from the middle of the clavicle; in the female it is not so constant. A little below it the lower limit of the great pectoral muscle is seen running upward and outward to the axilla; in the female this is obscured by the breast, which extends from the second to the sixth rib vertically and from the edge of the sternum to the mid-axillary line laterally. The female nipple is surrounded for half an inch by a more or less pigmented disc, the areola. The apex of a normal heart is in the fifth left intercostal space, three and a half inches from the mid-line.

Clinical significance

High-resolution computed tomographs of a normal thorax, taken in the axial, coronal and sagittal planes, respectively. This type of investigation can be used for detecting both acute and chronic changes in the lung parenchyma.

Different types of diseases or conditions that affect the chest include pleurisy, flail chest, atelectasis, and the most common condition, chest pain. These conditions can be hereditary or caused by birth defects or trauma. Any condition that lowers the ability to either breathe deeply or to cough is considered a chest disease or condition.

Injury

Injury to the chest (also referred to as chest trauma, thoracic injury, or thoracic trauma) results in up to ¼ of all deaths due to trauma in the United States.[4]

The major pathophysiologies encountered in blunt chest trauma involve derangements in the flow of air, blood, or both in combination. Sepsis due to leakage of alimentary tract contents, as in esophageal perforations, also must be considered. Blunt trauma commonly results in chest wall injuries (e.g., rib fractures). The pain associated with these injuries can make breathing difficult, and this may compromise ventilation. Direct lung injuries, such as pulmonary contusions (see the image below), are frequently associated with major chest trauma and may impair ventilation by a similar mechanism.

Pain

Chest pain can be the result of multiple issues, including respiratory problems, digestive issues, and musculoskeletal complications. The pain can trigger cardiac issues as well. Not all pain that is felt is associated with the heart, but it should not be taken lightly either. Symptoms can be different depending on the cause of the pain.[5] While cardiac issues cause feelings of sudden pressure in the chest or a crushing pain in the back, neck, and arms, pain that is felt due to noncardiac issues gives a burning feeling along the digestive tract or pain when deep breaths are attempted. Different people feel pains differently for the same condition. Only a patient truly knows if the symptoms are mild or serious.

Chest pain may be a symptom of myocardial infarctions ('heart attack'). If this condition is present in the body, discomfort will be felt in the chest that is similar to a heavy weight placed on the body. Sweating, shortness of breath, lightheadedness, and irregular heartbeat may also be experienced. If a heart attack occurs, the bulk of the damage is caused during the first six hours, so getting the proper treatment as quickly as possible is important. Some people, especially those who are elderly or have diabetes, may not have typical chest pain but may have many of the other symptoms of a heart attack. It is important that these patients and their caregivers have a good understanding of heart attack symptoms.

Non-cardiac causes of chest pain

Just like with a heart attack, not all chest pain is suffered because of a condition involving the heart. Chest wall pain can be experienced after an increase in activity. Persons who add exercise to their daily routine generally feel this type of pain at the beginning. It is important to monitor the pain to ensure that it is not a sign of something more serious. Pain can also be experienced in persons who have an upper respiratory infection. This virus is also accompanied by a fever and cough. Shingles is another viral infection that can give symptoms of chest or rib pain before a rash develops. Injuries to the rib cage or sternum is also a common cause of chest pain. It is generally felt when deep breaths are taken or during a cough.

Atelectasis

Another non cardiac cause of chest pain is atelectasis. It is a condition that suffered when a portion of the lung collapses from being airless. When bronchial tubes are blocked, this condition develops and causes patients to feel shortness of breath. The most common cause of atelectasis is when a bronchi that extends from the windpipe is blocked and traps air. The blockage may be caused by something inside the bronchus, such as a plug of mucus, a tumour, or an inhaled foreign object such as a coin, piece of food, or a toy.[6] It is possible for something outside of the bronchus to cause the blockage.

Pneumothorax

Pneumothorax is the condition where air or gas can build up in the pleural space. It can occur without a known cause or as the result of a lung disease or acute lung injury.[7] The size of the pneumothorax changes as air or gas builds up, so a medical procedure can release the pressure with a needle. If it is untreated, blood flow can be interrupted and cause a drop in blood pressure known as tension pneumothorax. It is possible for smaller cases to clear up on their own. Symptoms of this condition are often felt only on one side of the lung or as a shortness of breath.

Other animals

Trilobite sections-en
The trilobite body is divided into three major sections, a cephalon with eyes, mouthparts and sensory organs such as antennae, a thorax of multiple similar segments (that in some species allowed them to roll up into a ball), and a pygidium, or tail section.
Scheme ant worker anatomy-en
In the worker ant, the abdomen consists of the propodeum fused to the thorax and the metasoma, itself divided into the narrow petiole and bulbous gaster.

In tetrapods

In mammals, the thorax is the region of the body formed by the sternum, the thoracic vertebrae, and the ribs. It extends from the neck to the diaphragm, and does not include the upper limbs. The heart and the lungs reside in the thoracic cavity, as well as many blood vessels. The inner organs are protected by the rib cage and the sternum. Thoracic vertebrae are also distinguished in birds, but not in reptiles.

In arthropods

In insects, crustaceans, and the extinct trilobites, the thorax is one of the three main divisions (or tagmata) of the creature's body, each of which is in turn composed of multiple segments. It is the area where the wings and legs attach in insects, or an area of multiple articulating plates in trilobites. In most insects, the thorax itself is composed of three segments; the prothorax, the mesothorax, and the metathorax. In extant insects, the prothorax never has wings, though legs are always present in adults; wings (when present) are restricted to at least the mesothorax, and typically also the metathorax, though the wings may be reduced or modified on either or both segments. In the Apocritan Hymenoptera, the first abdominal segment is fused to the metathorax, where it forms a structure known as the propodeum. Accordingly, in these insects, the functional thorax is composed of four segments, and is therefore typically called the mesosoma to distinguish it from the "thorax" of other insects.

Each thoracic segment in an insect is further subdivided into various parts, the most significant of which are the dorsal portion (the notum), the lateral portion (the pleuron; one on each side), and the ventral portion (the sternum). In some insects, each of these parts is composed of one to several independent exoskeletal plates with membrane between them (called sclerites), though in many cases the sclerites are fused to various degrees.

Additional Images

3D CT of thorax, annotated

Volume rendering of a high resolution computed tomography of the thorax. The anterior thoracic wall, the airways and the pulmonary vessels anterior to the root of the lung have been digitally removed in order to visualize the different levels of the pulmonary circulation.

Slide2DENNO

Thorax. Anterior view.

Slide2DENNNO

Thorax. Anterior view.

See also

References

  1. ^ θώραξ, Henry George Liddell, Robert Scott, A Greek-English Lexicon, on Perseus Digital Library
  2. ^ "thorax" at Dorland's Medical Dictionary
  3. ^ Thorax at the US National Library of Medicine Medical Subject Headings (MeSH)
  4. ^ Shahani, Rohit, MD. (2005). Penetrating Chest Trauma. eMedicine. Retrieved 2005-02-05.
  5. ^ Chest Diseases Retrieved on 2010-1-26
  6. ^ Atelectasis Lung and Airway Disorders. Retrieved on 2010-1-26
  7. ^ Pleurisy Lung Diseases. Retrieved on 2010-1-26

External links

  • Sam Gon III. "A guide to the Orders of Trilobites". Retrieved August 23, 2005.
Abdomen

The abdomen (less formally called the belly, stomach, tummy or midriff) constitutes the part of the body between the thorax (chest) and pelvis, in humans and in other vertebrates. The abdomen is the frontal part of the abdominal segment of the trunk, the dorsal part of this segment being the back of the abdomen. The region occupied by the abdomen is termed the abdominal cavity. In arthropods it is the posterior tagma of the body; it follows the thorax or cephalothorax. The abdomen stretches from the thorax at the thoracic diaphragm to the pelvis at the pelvic brim. The pelvic brim stretches from the lumbosacral joint (the intervertebral disc between L5 and S1) to the pubic symphysis and is the edge of the pelvic inlet. The space above this inlet and under the thoracic diaphragm is termed the abdominal cavity. The boundary of the abdominal cavity is the abdominal wall in the front and the peritoneal surface at the rear.

Aorta

The aorta ( ay-OR-tə) is the main artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries (the common iliac arteries). The aorta distributes oxygenated blood to all parts of the body through the systemic circulation.

Articular processes

The articular processes or zygapophyses (Greek ζυγον = "yoke" (because it links two vertebrae) + απο = "away" + φυσις = "process") of a vertebra, are projections of the vertebra that serve the purpose of fitting with an adjacent vertebra. The actual region of contact is called the articular facet.Articular processes spring from the junctions of the pedicles and laminæ, and there are two right and left, and two superior and inferior. These stick out of an end of a vertebra to lock with a zygapophysis on the next vertebra, to make the backbone more stable.

The superior processes or prezygapophysis project upward from a lower vertebra, and their articular surfaces are directed more or less backward (oblique coronal plane).

The inferior processes or postzygapophysis project downward from a higher vertebra, and their articular surfaces are directed more or less forward and outward.The articular surfaces are coated with hyaline cartilage.

In the cervical vertebral column, the articular processes collectively form the articular pillars. These are the bony surfaces palpated just lateral to the spinous processes.

CT scan

A CT scan, also known as computed tomography scan, and formerly known as a computerized axial tomography scan or CAT scan, makes use of computer-processed combinations of many X-ray measurements taken from different angles to produce cross-sectional (tomographic) images (virtual "slices") of specific areas of a scanned object, allowing the user to see inside the object without cutting.

Digital geometry processing is used to further generate a three-dimensional volume of the inside of the object from a large series of two-dimensional radiographic images taken around a single axis of rotation. Medical imaging is the most common application of X-ray CT. Its cross-sectional images are used for diagnostic and therapeutic purposes in various medical disciplines. The rest of this article discusses medical-imaging X-ray CT; industrial applications of X-ray CT are discussed at industrial computed tomography scanning.

The term "computed tomography" (CT) is often used to refer to X-ray CT, because it is the most commonly known form. But, many other types of CT exist, such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT). X-ray tomography, a predecessor of CT, is one form of radiography, along with many other forms of tomographic and non-tomographic radiography.

CT produces data that can be manipulated in order to demonstrate various bodily structures based on their ability to absorb the X-ray beam. Although, historically, the images generated were in the axial or transverse plane, perpendicular to the long axis of the body, modern scanners allow this volume of data to be reformatted in various planes or even as volumetric (3D) representations of structures. Although most common in medicine, CT is also used in other fields, such as nondestructive materials testing. Another example is archaeological uses such as imaging the contents of sarcophagi or ceramics. Individuals responsible for performing CT exams are called radiographers or radiologic technologists.Use of CT has increased dramatically over the last two decades in many countries. An estimated 72 million scans were performed in the United States in 2007 and more than 80 million a year in 2015. One study estimated that as many as 0.4% of current cancers in the United States are due to CTs performed in the past and that this may increase to as high as 1.5 to 2% with 2007 rates of CT use; however, this estimate is disputed, as there is not a consensus about the existence of damage from low levels of radiation. Lower radiation doses are often used in many areas, such as in the investigation of renal colic.Side effects from intravenous contrast used in some types of studies include kidney problems.

Cardiothoracic surgery

Cardiothoracic surgery (also known as thoracic surgery) is the field of medicine involved in surgical treatment of organs inside the thorax (the chest)—generally treatment of conditions of the heart (heart disease) and lungs (lung disease). In most countries, cardiac surgery (involving the heart and the great vessels) and general thoracic surgery (involving the lungs, esophagus, thymus, etc.) are separate surgical specialties; the exceptions are the United States, Australia, New Zealand, and some EU countries, such as the United Kingdom and Portugal.

Cephalothorax

The cephalothorax, also called prosoma in some groups, is a tagma of various arthropods, comprising the head and the thorax fused together, as distinct from the abdomen behind. (The terms prosoma and opisthosoma are equivalent to cephalothorax and abdomen in some groups.) The word cephalothorax is derived from the Greek words for head (κεφαλή, kephalé) and thorax (θώραξ, thórax). This fusion of the head and thorax is seen in chelicerates and crustaceans; in other groups, such as the Hexapoda (including insects), the head remains free of the thorax. In horseshoe crabs and many crustaceans, a hard shell called the carapace covers the cephalothorax.

Chest injury

A chest injury, also known as chest trauma, is any form of physical injury to the chest including the ribs, heart and lungs. Chest injuries account for 25% of all deaths from traumatic injury. Typically chest injuries are caused by blunt mechanisms such as motor vehicle collisions or penetrating mechanisms such as stabbings.

Chest radiograph

A chest radiograph, colloquially called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.

Like all methods of radiography, chest radiography employs ionizing radiation in the form of X-rays to generate images of the chest. The mean radiation dose to an adult from a chest radiograph is around 0.02 mSv (2 mrem) for a front view (PA, or posteroanterior) and 0.08 mSv (8 mrem) for a side view (LL, or latero-lateral). Together, this corresponds to a background radiation equivalent time of about 10 days.

Hexapoda

The subphylum Hexapoda (from the Greek for six legs) constitutes the largest number of species of arthropods and includes the insects as well as three much smaller groups of wingless arthropods: Collembola, Protura, and Diplura (all of these were once considered insects). The Collembola (or springtails) are very abundant in terrestrial environments. Hexapods are named for their most distinctive feature: a consolidated thorax with three pairs of legs (six legs). Most other arthropods have more than three pairs of legs.

Isopoda

Isopoda is an order of crustaceans that includes woodlice and their relatives. Isopods live in the sea, in fresh water, or on land. All have rigid, segmented exoskeletons, two pairs of antennae, seven pairs of jointed limbs on the thorax, and five pairs of branching appendages on the abdomen that are used in respiration. Females brood their young in a pouch under their thorax. Isopods have various feeding methods: some eat dead or decaying plant and animal matter, others are grazers, or filter feeders, a few are predators, and some are internal or external parasites, mostly of fishes. Aquatic species mostly live on the seabed or bottom of freshwater bodies of water, but some taxa can swim for a short distance. Terrestrial forms move around by crawling and tend to be found in cool, moist places. Some species are able to roll themselves into a ball as a defence mechanism or to conserve moisture.

There are over 10,000 species of isopod worldwide, with around 4,500 species found in marine environments, mostly on the seabed, 500 species in fresh water, and another 5,000 species on land. The order is divided into eleven suborders. The fossil record of isopods dates back to the Carboniferous period (in the Pennsylvanian epoch), at least 300 million years ago, when isopods lived in shallow seas. The name Isopoda is derived from the Greek roots iso- (from ἴσος ísos, meaning "equal") and -pod (from ποδ-, the stem of πούς poús, meaning "foot").

Prothorax

The prothorax is the foremost of the three segments in the thorax of an insect, and bears the first pair of legs. Its principal sclerites (exoskeletal plates) are the pronotum (dorsal), the prosternum (ventral), and the propleuron (lateral) on each side. The prothorax never bears wings in extant insects, though some fossil groups possessed wing-like projections. All adult insects possess legs on the prothorax, though in a few groups (e.g., the butterfly family Nymphalidae) the forelegs are greatly reduced. In many groups of insects, the pronotum is reduced in size, but in a few it is hypertrophied, such as in all beetles (Coleoptera), in which the pronotum is expanded to form the entire dorsal surface of the thorax, and most treehoppers (family Membracidae, order Hemiptera), in which the pronotum is expanded into often fantastic shapes that enhance their camouflage or mimicry. Similarly, in the Tetrigidae, the pronotum is extended backward to cover the flight wings, supplanting the function of the tegmina.

Rib

In vertebrate anatomy, ribs (Latin: costae) are the long curved bones which form the rib cage, part of the axial skeleton. In most tetrapods, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax. In some animals, especially snakes, ribs may provide support and protection for the entire body.

Rib cage

The rib cage is the arrangement of ribs attached to the vertebral column and sternum in the thorax of most vertebrates, that encloses and protects the heart and lungs. In humans, the rib cage, also known as the thoracic cage, is a bony and cartilaginous structure which surrounds the thoracic cavity and supports the shoulder girdle to form the core part of the human skeleton. A typical human rib cage consists of 24 ribs in 12 pairs, the sternum and xiphoid process, the costal cartilages, and the 12 thoracic vertebrae.

Together with the skin and associated fascia and muscles, the rib cage makes up the thoracic wall and provides attachments for the muscles of the neck, thorax, upper abdomen, and back.

The rib cage has a major function in the respiratory system.

Scydmaenidae

Scydmaeninae are a subfamily of small beetles, commonly called ant-like stone beetles or scydmaenines. These beetles occur worldwide, and the subfamily includes some 4,500 species in about 80 genera. Established as a family, they were reduced in status to a subfamily of Staphylinidae in 2009 Many scydmaenine species have a narrowing between head and thorax and thorax and abdomen, resulting in a passing resemblance to ants that inspires their common name. The largest measure just 3 millimeters long, while some very small species only reach half a millimeter in length. Scydmaenids typically live in leaf litter and rotting logs in forests, preferring moist habitats. A number of types are known to feed on oribatid mites, using "hole scraping" and "cutting" techniques to get through the mite's hard shells.

In addition to the two living subfamilies, the prehistoric subfamily Hapsomelinae, known only from fossils, has been placed here.

Subclavian artery

In human anatomy, the subclavian arteries are paired major arteries of the upper thorax, below the clavicle. They receive blood from the aortic arch. The left subclavian artery supplies blood to the left arm and the right subclavian artery supplies blood to the right arm, with some branches supplying the head and thorax. On the left side of the body, the subclavian comes directly off the aortic arch, while on the right side it arises from the relatively short brachiocephalic artery when it bifurcates into the subclavian and the right common carotid artery.

The usual branches of the subclavian on both sides of the body are the vertebral artery, the internal thoracic artery, the thyrocervical trunk, the costocervical trunk and the dorsal scapular artery, which may branch off the transverse cervical artery which is a branch of the thyrocervical trunk. The subclavian becomes the axillary artery at the lateral border of the first rib.

Thoracic diaphragm

The thoracic diaphragm, or simply the diaphragm (Ancient Greek: διάφραγμα, translit. diáphragma, lit. 'partition'), is a sheet of internal skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity and performs an important function in respiration: as the diaphragm contracts, the volume of the thoracic cavity increases and air is drawn into the lungs.

The term diaphragm in anatomy can refer to other flat structures such as the urogenital diaphragm or pelvic diaphragm, but "the diaphragm" generally refers to the thoracic diaphragm. In humans, the diaphragm is slightly asymmetric—its right half is higher up (superior) to the left half, since the large liver rests beneath the right half of the diaphragm. There is also a theory that the diaphragm is lower on the other side due to the presence of the heart.

Other mammals have diaphragms, and other vertebrates such as amphibians and reptiles have diaphragm-like structures, but important details of the anatomy vary, such as the position of the lungs in the abdominal cavity.

Thoracic wall

The thoracic wall or chest wall is the boundary of the thoracic cavity.

Thorax (insect anatomy)

The thorax is the midsection (tagma) of the insect body. It holds the head, legs, wings and abdomen. It is also called mesosoma in other arthropods.

It is formed by the prothorax, mesothorax and metathorax and comprises the scutellum; the cervix, a membrane that separates the head from the thorax; and the pleuron, a lateral sclerite of the thorax.

In dragonflies and damselflies the mesothorax and metathorax are fused together to form the synthorax.In some insect pupae, like the mosquitoes', the head and thorax can be fused in a cephalothorax.

Members of sub order Apocrita (wasps, ants and bees) in the order Hymenoptera have the first segment of the abdomen fused with the thorax, which is called the propodeum.

In most flying insects, the thorax allows for the use of asynchronous muscles.

Vagus nerve

The vagus nerve ( VAY-gəs), historically cited as the pneumogastric nerve, is the tenth cranial nerve or CN X, and interfaces with parasympathetic control of the heart, lungs, and digestive tract. The vagus nerves are paired but are normally referred to in the singular. It is the longest nerve of the autonomic nervous system in the human body.

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