Anatomy and Physiology of the Chest Wall and Sternum with Surgical Implications

Eric Sceusi, Joseph I. Miller

Key Points

  • The anatomy of chest wall and sternum is important from a surgical standpoint.
  • Knowledge of the thoracic inlet and outlet of thorax, knowledge and understanding of the importance of the extrathoracic muscles of the chest wall, and knowledge of chest wall mechanics are prerequisites in the training of the cardiothoracic surgeon.
  • Various muscle flaps may be used to provide coverage, wrapping, and filling of defects.

The anatomy and physiology of the chest wall and sternum are completely intertwined. The superior border of the sternum is slightly concave; forming what is called the suprasternal notch. The suprasternal notch on the superior aspect of the manubrium is palpable between the prominent medial ends of the clavicle and it lies opposite the lower border of the body of the second thoracic vertebra.[1] The musculoskeletal structure of the chest wall and sternum serve to protect the lungs and thoracic viscera. Surgeons must have a thorough knowledge of the external bony landmarks, the muscles of the chest wall, and their intertwined workings to appreciate the physiology of respiration and anatomic movement.

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