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The skeleton of the thorax consists of two apertures: the superior and inferior apertures. These regions of the thorax house very important structures of the body. The main focus of this in-depth lecture is the superior aperture of the thorax. It is also known as the Thoracic Inlet, which is the kidney-shaped narrow end of the Thorax, continuous with the neck. It slopes anteroinferiorly. Watch on as was discuss thoracic inlet anatomy, the boundaries, and the plane of the superior aperture. ▬ Superior Aperture Median ▬▬▬▬▬▬▬▬▬▬ The median of the thorax houses the esophagus, trachea, and thymus gland. The esophagus is the muscular food passage lying between the trachea and the vertebral column. Begins at the lower border of the Cricoid Cartilage opposite the C6 Vertebra. The trachea is the non-collapsible part of the airway forming the beginning of the lower part of the respiratory tract. Also enters the Thoracic Cavity through the superior thoracic aperture, and runs most of its course in the midline. We will also discuss the thymus gland, the primary lymphoid organ, located in the inferior part of the neck and the anterior part of the superior mediastinum. ▬ Superior Aperture Blood Supply ▬▬▬▬▬▬▬▬▬▬ We will go over the important blood vessels - arteries and veins of the thorax - that supply the thorax with nutrients. These are as follows: 🟠 Brachiocephalic artery and veins 🟠 Subclavian artery 🟠 Vertebral artery 🟠 Common carotid artery 🟠 Internal Thoracic Arteries (Right and Left) 🟠 Superior Intercostal Arteries (Right and Left) 🟠 1st Posterior Intercostal veins (Right and Left) 🟠 Inferior Thyroid Veins Here's a mnemonic to remember the vessels arising from the top of the aortic arch (and the draining veins): 'Chief Brad Commands Submarines, Veronica Likes Internal Treats & Steals Veins' 🔵 Chief Brad: Brachiocephalic (artery) - Remember "Chief" sounds a bit like "Cephalic" which refers to the head (supplied by the brachiocephalic). 🔵 Commands Submarines: Subclavian (artery) and Vertebral (artery) - Commands both start with "C" like the two arteries. Submarines travel under (supplied by subclavian) and deliver oxygen to the brain (supplied by vertebral). 🔵 Veronica: Common Carotid (artery) - Veronica sounds similar to "Carotid." 🔵 Likes Internal Treats: Internal Thoracic (arteries) - Delivers blood to the internal organs (including the heart) like tasty treats. 🔵 & Steals Veins: Draining veins come last - Superior Intercostal (veins) and 1st Posterior Intercostal (veins) and Inferior Thyroid (veins). Stealing implies taking something, similar to how veins take blood away. Note: This mnemonic rearranges the order slightly (vertebral before subclavian) but focuses on remembering the function and location of each vessel. ▬ Nervous supply of Superior Thorax ▬▬▬▬▬▬▬▬▬▬ 🟠 Vagus Nerves 🟠 Phrenic Nerves 🟠 1st Thoracic Nerves (as they ascend across the first rib to join the brachial plexus) 🟠 Recurrent Laryngeal Nerves 🟠 Sympathetic trunks 🟠 Superior, Middle, and Inferior Cervical Sympathetic Nerves to Cardiac plexus 🟠 Ansa Subclavia Here's a mnemonic to remember the nerves in the neck and upper thorax: 'Party Voice Says Relax, Climb Up, Sing Clearly After Supper' 🔵 Party Voice: Vagus Nerves - Vagus sounds similar to "Voice" and controls functions like speaking. Party implies outgoing nature, similar to the vagus nerve's widespread influence. 🔵 Says Relax: Phrenic Nerves - Phrenic nerves control the diaphragm, which relaxes during inhalation. 🔵 Climb Up: 1st Thoracic Nerves - These nerves climb up over the first rib. 🔵 Sing Clearly After Supper: Recurrent Laryngeal Nerves - These nerves control the larynx, essential for clear speaking. Supper suggests using the voice after eating. 🔵 Sympathetic trunks are not directly mentioned but can be associated with the overall theme of the body's response (like feeling relaxed at a party). 🔵 Superior, Middle, and Inferior Cervical Sympathetic Nerves to Cardiac plexus - These can be remembered for their location (cervical) and function (affecting the heart through the cardiac plexus). 🔵 Ansa Subclavia - This nerve can be learned by association with the other nerves in the region. ▬ Subpleural Membrane ▬▬▬▬▬▬▬▬▬▬ The subpleural membrane lies in the oblique plane of the superior aperture of the thorax. It is triangular, with the apex of the triangle attached to the tip of the transverse process of the C7 vertebra. The base of the triangle is attached to the inner border of the first rib and its costal cartilage.