Regional Anatomy of the Chest Wall and Its Clinical Application

With the thoracic cage as the bony framework, the chest wall is superficially covered by skin, fascia, and muscle and intrinsically linked with the endothoracic fascia. The chest wall connects with the neck superiorly through the jugular notch, the sternoclavicular joint, the supraclavicular margin, and the line connecting the acromion to the spinous process of C7; with the abdomen inferiorly through the xiphoid process, costal arch, the anterior end of the 11th pair of ribs, the inferior end of the 12th pair of ribs and the spinous process of T12; and laterally with the upper extremities through the superior portion of anterior and posterior deltoid muscle, and the line connecting the points where the lower portions of anterior and posterior axillary folds meet the chest wall. It superiorly extends the neck, inferiorly separates the abdominal cavity, and laterally connects the upper extremities. Each side of the chest wall is divided into anterior, lateral, and dorsal regions. The anterior region lies between the anterior median line and the anterior axillary line, the lateral region between the anterior and posterior axillary lines, and the dorsal region between the posterior median line and the posterior axillary line.