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Anatomy

Thorax

Question 75 of 180

Regarding the thoracic inlet, which of the following statements is CORRECT:

Answer:

The recurrent laryngeal nerve ascends through the thoracic inlet in the tracheo-oesophageal sulcus between the trachea anteriorly and the oesophagus posteriorly.

Thoracic Inlet

Anatomy / Thorax / Thoracic Inlet

Last Updated: 27th February 2020

The thoracic inlet is bordered anteriorly by the manubrium of the sternum and the first costal cartilages, laterally by the first ribs and posteriorly by the body of vertebra T1.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Thoracic Inlet. (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

At the thoracic inlet, the superior aspects of the pleural cavities lie on either side of the entrance to the mediastinum, extending approximately 2 - 3 cm above rib I and the costal cartilage into the neck.

Relations of Key Structures

The thoracic inlet is traversed in the median plane by (from anterior to posterior):

  • the sternohyoid muscle
  • the sternothyroid muscle
  • the thymic remnants
  • the inferior thyroid veins
  • the trachea
  • the recurrent laryngeal nerves (in the tracheo-oesophageal sulcus)
  • the oesophagus
  • the thoracic duct (displaced slightly to the left)
  • the longus colli muscles
  • the anterior longitudinal ligament.

To the left, it is traversed by (from anterior to posterior):

  • the left brachiocephalic vein
  • the left vagus and left phrenic nerves
  • the left common carotid artery and the left subclavian artery.

To the right, it is traversed by (from anterior to posterior):

  • the right brachiocephalic vein
  • the right vagus and right phrenic nerves
  • the brachiocephalic trunk.

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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