2. Sternal angle of Louis as a useful anatomical
and clinical landmark
3. At the level of the sternal angle,
• Manubrium sterni articulates
with the body of the sternum
• to form manubriosternal joint
• a secondary cartilaginous joint or
symphysis
• Second costal cartilage
articulates with the sternum
• T4 and T5 vertebrae articulate
with each other
• an intervertebral disc intervening
between them
5. • Trachea bifurcates into right
and left main bronchi
• Pulmonary trunk divides into
right and left pulmonary
arteries
• Tracheobronchial nodes
surround tracheal bifurcation
• Azygos vein joins SVC from
behind
• Deep cardiac plexus of nerves
lies anterior to the bifurcation
of the trachea
• Ligamentum arteriosum
connects the aortic arch to the
left pulmonary artery
6. • Ascending aorta is continuous
with the aortic arch anteriorly,
• while the aortic arch is
continuous with the descending
thoracic aorta posteriorly
7. • Thoracic duct
crosses from the
right to the left of
midline
• as it ascends on the
vertebral column
8. •Auscultation for the
pulmonary and aortic
valves
• At the 2nd intercostal
space
• Close to sternal margin
• Pulmonary valve
auscultated near the
left sternal margin
• and aortic valve
auscultated near the
right sternal margin
