Apprasial of the surface anatomy of the thorax in an adolescent population

Surface anatomy is considered a fundamental part of anatomy curricula and clinical practice. Recent studies have reappraised surface anatomy using CT, but the adolescent age group has yet to be appraised. Sixty adolescent thoracoabdominal CT scans (aged 12–18 years) were examined. The surface anatomy of the central veins, cardiac apex, diaphragmatic openings and structures in relation to the sternal angle plane were analyzed. The results showed that the brachiocephalic vein (left & right) formed mostly posterior to the sternoclavicular joint. The superior vena cava formed close to the 2^nd costal cartilage, ±16.3mm to the right of the midline. The apex of the heart was located in relation to the 5^th intercostal space; ±78.6mm to the left of the midline. The caval hiatus was in relation to T9 and T10; the esophageal hiatus was at T10; while the aortic hiatus was at T11. The sternal angle plane was in relation to the upper half of T5, which was also where the bifurcations of the trachea and pulmonary trunk were observed. The SVC/azygos vein junction and the concavity of the aortic arch were observed to be more than 10mm superior to this plane. The results of this study further highlight the substantial variability of the surface anatomy between age groups. It also emphasizes the notion that surface anatomy is a dynamic variable and cannot be treated as a static observation.

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