The thoracic outlet is the part of the body where the neck meets the torso. The thoracic outlets are present on either side of the base of the neck. This is where all the structures that pass in either direction from the body to the head and arms must traverse.

The thoracic outlet transmits nerves (the brachial plexus, sympathetic nerves), subclavian artery and vein as well as lymphatics into the upper extremity and lies above the apex of the lung on that side. The outlet is bound by the musculo-skeletal structures of the neck and shoulder consisting on bones (the clavicle and first rib) and muscles (e.g. the scalenius muscles) together with their associated ligaments and fascia. There are three areas in the thoracic outlet where compression is likely to occur: the scalenius anterior triangle, the costo-clavicular space and the pectoralis minor space. Compression in each of these areas often give rise to specific clinical features and can co-exist.

The cartoon below illustrates the main anatomical features.

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Mr Colin Chan
Consultant Vascular Surgeon
Wirral University Teaching Hospital
Wirral CH49 5PE

Mrs Louise Rule
Wirral University Teaching Hospital
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(+44 151 604 7530)


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