The thorax or thorax ( ancient Greek θώραξ , breastplate ' , plural thoraces ) of vertebrates is a section of the trunk in anatomy . The wall of the thorax is formed by the thoracic spine , sternum and ribs (bony thorax) as well as muscles . It encloses the thoracic cavity ( Cavum thoracis ) and, due to the dome shape of the diaphragm , also the upper (in animals, front) part of the abdominal cavity . The respiratory muscles attached to the outside and inside of the thorax enable breathing in terrestrial vertebrates .
In humans, the sternum angle ( angulus sterni ) is at the level of the 2nd rib. The cartilaginous tip of the 11th rib can be felt laterally, that of the 12th rib behind. The lower angle ( angulus inferior ) of the shoulder blade ( scapula ) is at the level of the 7th rib and the 7th intercostal space .
Inside the rib cage ( intrathoracic ) is the chest cavity . It is divided into two pleural cavities by a septum ( mediastinum ) . In the mediastinum are the heart , the thymus , large blood vessels (chest part of the aorta , vena cava , pulmonary vessels), trachea and esophagus , various nerves ( phrenic nerve , vagus nerve , trunk ), lymph nodes , the dexter lymphatic duct and thoracic duct . The lungs lie to the side of the mediastinum . Due to the curvature of the diaphragmatic dome , some organs of the upper abdomen are also still within the thorax (“intrathoracic”).
Injuries to the chest lead to hemothorax (accumulation of blood), pneumothorax (accumulation of air), tension pneumothorax, or chylothorax (accumulation of lymph). Severe compression of the chest can lead to traumatic asphyxia . It is difficult to differentiate between chest pain that is not caused by heart disease and real angina pectoris . The suction of fluids from the thorax is called thoracentesis .
To malformations of the thorax include vertically extending input or protuberances ( Kiel breast , funnel chest ), transverse constrictions ( bell thorax , Harrison-groove ), and chest asymmetries, such as a rib hump in scoliosis or twists of the breastbone ( expectation stone deformity ). An incomplete closure of the thorax in the embryo is called a thoracoshisis .
The thoracic surgery ( chest surgery ) includes the prevention and diagnosis , including the instrumental investigation procedures and post-operative treatment of surgical diseases and malformations of the lung , the pleura , the bronchial system , of the mediastinum and the chest wall, especially in the context of tumor treatment . She used to deal with the now independent field of cardiac surgery . It is mostly performed as a thoracotomy , i.e. with opening of the thorax, which could be used more frequently with the invention of Sauerbruch in 1904 (a vacuum chamber in which the patient and surgeon were while the patient's head was ventilated outside the chamber). Video-assisted minimally invasive surgical techniques such as thoracoscopy are becoming more and more important : they enable minimal skin incisions, which result in significantly reduced surgical trauma compared to open operations.
As a chest tube , a hose or will cannula denotes that establishes a connection from the inside of the rib cage to the exterior of the body. The drainage of pleural empyema has been known since ancient times . In 1856 the Hamburg pediatrician Gotthard Bülau introduced negative pressure drainage for the treatment of tubercular empyema. This Bülau drainage made a decisive contribution to avoiding postoperative complications in all thoracic opening operations. The term thoracic drainage includes mediastinal drainage, pleural drainage and pericardial drainage. As a rule, these drainages open into collecting vessels that are connected to a suction device, a surge tank or a Heimlich valve. The size varies according to type and function up to 36 charrière .
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