Skin Cancer and Melanoma: Surgical Treatment and Reconstruction of the Chest

Abstract

The chest wall provides rigid protection to the heart, great vessels, lungs, and liver. Moreover, through the articulation of the clavicle to the sternum and scapula, it stabilizes the arm and shoulder. Respiration is facilitated by the fact that the thorax is flexible and expands. The framework of the chest is the rib cage. Twelve ribs converge and articulate to the thoracic vertebrae. The upper seven ribs articulate directly to the manubrium and body of the sternum, whereas the 8th–10th ribs are attached via the costal cartilages. The 11th and 12th ribs remain unattached anteriorly and are known as the floating ribs. The sternum comprises of three separate bones: the manubrium, the sternal body, and the xiphoid process. The muscles of the chest are the intercostals and, as their name implies, lie between the ribs, the pectoralis major which attaches to the medial clavicle and lateral sternum and inserts on the lateral lip of the bicipital groove of the humerus. The pectoralis major is supplied by the thoracoacromial artery and perforators arising from the internal thoracic artery [1].