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