4.

2 THORACIC MUSCLES
 LEARNING OBJECTIVES

• List the thoracic muscles which act on the

pectoral girdle
• Explain the functions of each of the
accessory muscles of respiration
• Fully label diagrams of the diaphragm,
including the structures which pass through it
or lie nearby.
• Explain in detail how the diaphragm works.
• Explain the functions of the intercostal
muscles and the mechanisms of breathing
 Summary: Muscles of the back

• Summary: Muscles of the back

• Are divided into
– 1. superficial,
– 2. intermediate and
– 3. deep
 Back muscles
• Muscles of the back
– Superficial – associated with shoulder movement
– Intermediate – associated with trunk movement
– Deep – associated with movement of vertebral column
• Superficial muscles of the back
– Trapezius
– Lastisimus dosi
• Deeper muscles of the back
– Rhomboid major
– Rhomboid minor
– Serratus posterior superior
– Serratus posterior inferior
• Deep muscles of the back
– Erector spinae muscles
• Iliocostalis
• Longissimus
• Spinalis

– Semispinalis
– Multifidus
– Others (rotatores, minor intrinsic deep muscles)
 rhomboid minor
trapezius levator scapulae

latissimus dorsi

Posterior
trapezius
latissimus dorsi
levator scapulae
rhomboid major &
minor
Serratus posterior superior
serratus posterior inferior
splenius capitis / cervicis
Erector spinae muscles

3 mucles that act on the spine

•Spinalis
•longissimus
•Iliocostalis
 Minor deep intrinsic muscles
• Interspinales – acts to stabilise spinal column
• Intertransversarii – acts to stabilise spinal column
• Levatores costarum – acts to raise / elevate ribs

Rotatores
• Stabilise spinal column, proprioception
 A group of small muscles that act on
the spine
levatores costarum longi
levatores costarum breves
rotatores thoracis longi
v rotatores thoracis breves
intertransversarii mediales lumborum
intertransversarii laterals lumborum
spinalis thoracis
interspinales lumborum
 EXTRINSIC THORACIC MUSCLES
Muscles acting on pectoral girdle
Anterior
• pectoralis major & minor
• subclavius
• serratus anterior
Posterior
• trapezius
• latissimus dorsi
• levator scapulae
• rhomboid major & minor
Anterior
pectoralis major &
minor
subclavius
serratus anterior
vius
 INTRINSIC THORACIC MUSCLES

• Diaphragm – major muscle of inspiration

• Intercostal muscles (external, internal & innermost) – forced
inspiration and expiration
 External intercostal m
internal intercostal m
innermost intercostal m

Internal & innermost run

in the same direction &
therefore have the same
function
 Also
Scalene grp
Transversus
sternoclydomastoid
thoracics

Subcostal
muscles
DIAPHRAGM

•Divides thoracic from abdominal

cavity

•Origin is thoracic outlet

•Insertion is central tendon

•Radiating fibres
•Dome shaped
•Right dome higher than left

•Innervated by Phrenic nerve

(supply most of diaphragm),
lower intercostal nerves (supply
peripheral diaphragm)
 Apertures
Apertures : T8 ___________; T10 ________________ T12 ___________________ •IVC (T8)
•oesophagus (T10)
•aorta (T12)
central tendon
caval opening
esophageal hiatus
aortic hiatus
right & left crus
The diaphragm

Right & left phrenic nerve,

Right & left inferior phrenic artery
Superior: R & L superior phrenic a; pericardiacophrenic a; musculophrenic a
• Venous drainage of the diaphragm
• The blood supply to the diaphragm is from the superior phrenic,
musculophrenic, inferior phrenic, pericardiacophrenic, and lower internal
intercostal arteries.
• The superior phrenic arteries arise from the thoracic aorta. The musculophrenic
and pericardiacophrenic arteries are both branches of the internal thoracic artery.
The inferior phrenic arteries often arise from the anterior trunk of the aorta above
the celiac artery.
• The venous drainage of the diaphragm includes the brachiocephalic veins,
azygos veins, and the smaller tributaries of both the inferior vena cava
and the left suprarenal vein.
DIAPHRAGM

Inspiration
•contract muscle fibres
•lower domes
• thoracic volume
• intrathoracic pressure
•suck air in
Expiration
•relax muscle fibres
•raise domes
• thoracic volume
• intrathoracic pressure
•exhale air
Venous return to heart
•lower domes
• intrathoracic pressure
• intra-abdominal pressure
 INTERCOSTAL MUSCLES and others
Intercostal muscles and their membranes
• external – elevate ribs during forced inspiration
• internal - depress ribs during forced expiration
• innermost - depress ribs during forced expiration
• Others : Scalenes grp, sternocleidomstoid, pectoralis minor, abdominal m
 SUMMARY
Anterior muscles of the pectoral girdle:
pectoralis major & minor, subclavius, serratus anterior

Posterior muscles of the pectoral girdle:

Trapezius, latissimus dorsi, levator scapulae, rhomboid
major & minor

Diaphragm and intercostals are the principal muscles of

respiration
Accessory muscles of respiration are: pectoralis major
and minor, serratus anterior and scalene muscles
 Further reading - thorax
• The thorax is the body cavity, surrounded by the bony rib cage, that
contains the heart and lungs, the great vessels, the esophagus and
trachea, the thoracic duct, and the autonomic innervation for these
structures. The inferior boundary of the thoracic cavity is the respiratory
diaphragm, which separates the thoracic and abdominal cavities.
Superiorly, the thorax communicates with the root of the neck and the
upper extremity. The wall of the thorax contains the muscles involved
with respiration and those connecting the upper extremity to the axial
skeleton. The wall of the thorax is responsible for protecting the contents
of the thoracic cavity and for generating the negative pressure required
for respiration. The thorax is covered by skin and superficial fascia, which
contains the mammary tissue.
• Several muscles of the thoracic wall, including the most superficial ones that create some of the contours of the thoracic
wall, are muscles that act on the upper extremity. Some of these muscles form important surface landmarks on the thorax,
and others have relationships to vessels that communicate with the thorax. In addition to moving the upper extremity,
some of these muscles also can play a role in movement of the thoracic wall and participate in respiration.
• The pectoralis major muscle forms the surface contour of the upper lateral part of the thoracic wall. It originates on the
clavicle (clavicular head) and the sternum and ribs (sternocostal head) and inserts on the greater tubercle of the humerus.
The lower margin of this muscle, passing from the thorax to the humerus, forms the major part of the anterior axillary fold.
The pectoralis major muscle is a powerful adductor and medial rotator of the arm.
• The pectoralis minor muscle is a much smaller muscle and lies directly beneath the pectoralis major muscle. It originates on
ribs 3-5 and inserts on the coracoid process of the scapula. This muscle forms part of the anterior axillary fold medially. It
acts to depress the scapula and stabilizes it when upward force is exerted on the shoulder. The anterior part of the deltoid
muscle also forms a small aspect of the anterior thoracic wall. This muscle has its origin on the lateral part of the clavicle
and the acromion and spine of the scapula. It inserts on the deltoid tubercle of the humerus and is the most powerful
abductor of the arm. The deltoid muscle borders the pectoralis major muscle. The depression found at the junction of these
two muscles is called the deltopectoral groove. Importantly, within this groove the cephalic vein can consistently be found.
The muscles diverge at their origins on the clavicle, creating an opening bordered by these two muscles and the clavicle
known as the deltopectoral triangle. Through this space the cephalic vein passes to join the axillary vein.
• The subclavius is a small muscle originating on the lateral inferior aspect of the clavicle and inserting on the sternal end of
the first rib. This muscle depresses the clavicle and exerts a medial traction on the clavicle that stabilizes the
sternoclavicular joint. In addition to these actions, the subclavius muscle provides a soft surface on the inferior aspect of
the clavicle that serves to cushion the contact of this bone with structures passing under the clavicle (i.e., nerves of the
brachial plexus and the subclavian artery) when the clavicle is depressed during movement of the shoulder girdle, especially
when the clavicle is fractured.
• The serratus anterior muscle originates on the lateral aspect of the first eight ribs and passes laterally to insert on the
medial aspect of the scapula. This muscle forms the "serrated" contour of the lateral thoracic wall in individuals with good
muscle definition. The serratus anterior forms the medial border of the axilla and acts to pull the scapula forward
(protraction) and to stabilize the scapula against a posterior force on the shoulder.
• The Intercostal Muscles
• Each rib is connected to the ones above and below by a series of three intercostal muscles.
• The external intercostal muscles are the most superficial. These muscles course in an obliquely medial
direction as they pass from superior to inferior between the ribs. Toward the midline anteriorly, the
external intercostal muscle fibers are replaced by the external intercostal membrane.
• Deep to the external intercostals are the internal intercostals. The direction of the internal intercostal
muscle fibers is perpendicular to the external intercostals. On the posterior end of the ribs, the internal
intercostal muscle fibers are replaced by the internal intercostal membrane.
• The deepest layer of intercostal muscles is the innermost intercostal muscles . These muscles have a fiber
direction similar to that of the internal intercostals, but form a separate plane. The intercostal nerves and
vessels pass between the internal and innermost intercostal muscles.
• There are two additional sets of muscles in the same layer as the innermost intercostals: the subcostals
and the transversus thoracis muscles. The subcostal muscles are located posteriorly and span more than
one rib. The transversus thoracic muscles are found anteriorly and are continuous with the innermost
muscle layer of the abdomen, the transversus abdominus, inferiorly. The transversus thoracis muscles
pass from the internal surface of the sternum to ribs 2-6. The intercostal muscles, especially the external
and internal intercostals, are involved with respiration by elevating or depressing the ribs. The external
intercostal muscles and the anterior interchondral part of the internal intercostals act to elevate the ribs.
The lateral parts of the internal intercostal muscles depress the ribs. The innermost intercostals most
likely have an action similar to that of the internal intercostals. The subcostal muscles probably help to
elevate the ribs. The transversus thoracis muscles have little, if any, effect on respiration.
 MECHANISM OF BREATHING
With elevation of ribs

Both pump handle and

bucket handle to 
thoracic dimensions
­AP dimension
AP ­transverse
with pump dimension with during forced inspiration
handle bucket handle (reverse with expiration)
movement movement
 MECHANISM OF BREATHING

Diaphragm is the major muscle of respiration

http://image.tutorvista.com/content/respiration-animals/breathing-mechanism-
demonstration.jpeg
 DIAPHRAGM
Diaphragm from thoracic cavity
 DIAPHRAGM
Diaphragm from abdominal cavity
External intercostal membrane
Internal intercostals – Quiet
interchondral part Elastic recoil of lung and diaphragm
Active
Internal intercostals (not interchondral part)
Abdominals
Quadratus lumborum
 The diaphragm
Innervated by phrenic nerve
inferior phrenic artery / vein