Retrospective analysis of adult thoracic surface anatomy in Indian population using computed tomography scans

Abstract

Introduction: Recent studies on human surface anatomy observed inconsistencies in standard surface markings from that given in contemporary anatomy texts, particularly in thoracic surface landmarks. The present study was conducted to reevaluate the thoracic surface anatomy of adults of Indian origin which has not been done so far and compare the observations with the descriptions obtained from other population groups. Material and Methods: The thoracic surface anatomy was analyzed in 100 thoracoabdominal computed tomography scans of the Indian population. Results: It was observed that the positions of the xiphisternal joint, sternal angle, central veins, apex of lungs, cardiac apex, and dome of the diaphragm were within the normal limits with slight deviations from that described in standard anatomy texts. However, certain landmarks showed high degree of difference among the races as well as from the descriptions of the textbooks such aortic arch, bifurcations of the trachea and pulmonary trunk, inferior border of right and left lung adjacent to the vertebral column, and vertebral level of inferior vena cava piercing the diaphragm. Discussion and Conclusion: The surface anatomical landmarks of the thorax are not static, and there is a need to accommodate for a range of values than the constant markings. The relationship of the thoracic structures with the overlying surface landmarks were more variable in relation to vertebral levels than the costal references.