Thoracic inlet & first rib
Thoracic inlet & first rib First rib Insertions & grooves Attachment of suprapleural membrane
= Sibson's fascia (Origin = C7, transverse process) - attaches to inner margin of 1st rib - spreads out like a tent & forms protective covering over cervical pleura
Thoracic inlet & first rib First rib Insertions & grooves Groove for subclavian vein
Anterior to insertion of ant. scalene
Thoracic inlet & first rib Anterior scalene Relations
Anterior: - Subclavian vein - Phrenic nerve Posterior: - Brachial plexus - Subclavian artery
Thoracic inlet & first rib First rib Insertions & grooves Scalene tubercle
Insertion of anterior scalene
Thoracic inlet & first rib First rib Insertions & grooves Insertion of middle scalene
On long neck - posterior to goove for middle scalene
Thoracic inlet & first rib First rib Insertions & grooves Insertion of serratus anterior
On outer lateral curve - opposite the insertion of ant. scalene
Thoracic inlet & first rib Anterior scalene Origin / insertion Innervation
Origin: - Anterior tubercles C3-6 Insertion: - Scalene tubercle, first rib Innervation: - Ant rami, cervical nerve 5&6
Thoracic inlet & first rib First rib Insertions & grooves Groove for subclavian artery
Posterior to ant. scalene Grooved for: i) Brachial plexus, lower trunk (posterior) ii) Subclavian artery (anterior)
Thoracic inlet & first rib Boundaries of thoracic inlet
Posterior: - T1 vertebral body Lateral: - First rib & costal cartilage Anterior: - Manubrium
Thoracic inlet & first rib First rib Components
i) Head - facet for T1 body ii) Neck iii) Tubercle - for transverse process of T1