Tag: chest

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Fun Fact: Manubriosternal Junction

Anatomy def: Manubriosternal junction is a prominent joint between manubrium and body of the sternum (breastbone). 

Outlander def: Wee Mary MacNab’s chest mound, sweetly straining toward the Dunbonnet. Surrender, Jamie! She kens they both need “this.” 😉

Learn about the manubriosternal junction in Anatomy Lesson #15, Crouching Grants –  Hidden Dagger. 

An adult sternum has three parts:

  • manubrium (top)
  • body (middle; a.k.a. gladiolus)
  • xyphoid process (tip)

These parts are typically fused into a single, elongated bony structure in adults.  Notably, the juncture between manubrium and body forms an elevated bump, the manubriosternal junction.

As this word is a real mouthful, many anatomists and clinicians use the term sternal angle, angle of Louis, or sternal angle of Louis, to supplant manubriosternal junction. (Why use one name when three will do?) <G> And, some anatomists push the envelop further, preferring the term, sternomanubrial joint. So many terms, so little time. Gah!

Taking an easier route, the sternal angle of Louis is a splendid topographical feature because it is easily palpated!  It is the site where costal cartilages of the second ribs attach to the sternum. The T4 – T5 intervertebral disc also lies at this level. And, that is not all. This angle is used to locate or define some 15 (!!!) clinically significant structures and/or compartments of the chest. A useful example: starting at the second ribs, a practitioner can count intercostal (between ribs) spaces to locate organs and evaluate normal anatomy. Lots of splendid stuff going on here!

Try this: Place your fingers at the top of your chest in the small bony divot (suprasternal notch); this marks the top of the manubrium. Run fingers downward about 2” or 5 cm and feel the raised knob of bone? This is your sternal angle of Louis. Run fingers to each side – these are your second ribs and their costal cartilages. Feel them? Yay!  

Here’s a useful hint: If you avoid heavy necklaces because they give you neck pain, choose one that sits above the sternal angle. This way, manubrium and clavicles help support the weight of the piece, easing pull on the neck.

Read about the sternum in Voyager book. Herself conjured this scene between Dr. Claire Randall and a dying Scottish patient (not filmed in S3): 

“I have been thinking,” Graham announced. The sound of his voice echoed tinnily through the earpieces of my stethoscope. “Have you?” I said. “Well, don’t do it out loud ’til I’ve finished here, that’s a good lad.” 

He gave a brief snort of laughter, but lay quietly as I auscultated his chest, moving the disc of the stethoscope swiftly from ribs to sternum. “All right,” I said at last, slipping the tubes out of my ears and letting them fall over my shoulders. “What have you been thinking about?” 

“Killing myself.”

Whoa! Best read the book to find out what happens to Graham (and Claire)!

See Mary’s sternal angle (red arrow) in Starz episode 302, Surrender.  Sweet, sweet Mary is so very slender, her sternal angle of Louis with its curved 2nd ribs and costal cartilages are plain as cave light. Way to rock it, Mary! Ye are a bonny lass!

The deeply grateful,

Outlander Anatomist

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Photo credit: Starz episode 302, Surrender

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Fun Fact: Thorax

 

Anatomy Def: Thorax or chest is the torso between base of neck and respiratory diaphragm.

Outlander def: Claire’s sgian dbuh hovers periously close to Angus’ thorax as he bravely bares his chest for a killing lesson!  Careful, Angus, Claire soon becomes adroit with that blade…weil, any blade! <G>

Learn about the thorax in Anatomy Lesson #15, “Crouching Grants –  Hidden Dagger!” 

Sternum (breastbone), thoracic vertebrae and 12 pr. of ribs and cartilages form the bony support for the thorax as it provides safe harbor for heart, lungs, esophagus and trachea.

Read about the thorax with its breastbone, ribs and knobbly spine in Outlander book. Rupert gives the lesson to Claire in the written word.  Angus is the authority in TV version.

“Now, here,” he said, pointing to the center, just under the breastbone, “is the spot to aim for, if ye’re killin’ face to face. Aim straight up and in, as hard as ye can. That’ll go into the heart, and it kills wi’in a minute or two. The only problem is to avoid the breastbone; it goes down lower than ye think, and if ye get yer knife stuck in that soft bit on the tip, it will hardly harm yer victim at all, but ye’ll be wi’out a knife, and he’ll ha’ you. 

See Angus’ thorax in Outlander episode 108, Both Sides Now. Angus, we miss ye, sweet laddie!

The deeply grateful,

Outlander Anatomist

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Photo credit: Sony/Starz

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Fun Fact: pectoralis major

pectoralis-major

Anatomy def: Pectoralis majors (pec majors) are thick, paired, fan-shaped muscles, covering the front of the chest wall. Together they make up the bulk of the male chest and lie deep to the breasts in the female.

Outlander def: Paired chest muscles that Claire looooves to palpate! She is, after all, a health care professional and it is her medical duty to carefully evaluate Jamie’s chest anatomy (clearly, barfing on that ship had nay ill effect on his pec major muscles)! <G>

Learn about Jamie’s chest in Anatomy Lesson #4: “Jamie’s Chest” or “The 8th Wonder of the World!”

Read about Jamie’s chest in Dragonfly in Amber book:

I fought back the memory of our wedding night. He was a virgin; his hands had trembled when he touched me. I had been afraid too—with better reason. And then in the dawn he had held me, naked back against bare chest, his thighs warm and strong behind my own, murmuring into the clouds of my hair, “Dinna be afraid. There’s the two of us now.”

See the contours of Jamie’s pectoralis major muscles in Starz episode 201, Through a Glass, Darkly.

A deeply grateful,

Outlander Anatomist