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The thorax is a mobile osteocartilaginous enclosure with two pleural compartments and a central mediastinum; its visceral boundaries change normally with breathing and posture. The sketch is an anterior projection, with the subject's right on the viewer's left. It distinguishes the lower margin of a lung from the lower reflection of its pleura: those are different boundaries.

The posterior wall is formed by the twelve thoracic vertebrae and adjacent parts of the ribs; laterally the ribs and intercostal muscles form a flexible wall. Anteriorly lie the sternum, costal cartilages and anterior intercostal structures. The superior aperture communicates with the neck, while the respiratory diaphragm closes the inferior aperture. The lower thoracic wall therefore overlaps upper abdominal organs: not every organ under a lower rib is inside the pleural compartment.

Each lung is covered by visceral pleura. Parietal pleura lines the chest wall, upper surface of the respiratory diaphragm and side of the mediastinum, becoming continuous with visceral pleura at the root. The potential pleural space contains a lubricating fluid film; it is not normally an air-filled gap. The right lung has three lobes, the left two, with the cardiac notch and lingula accommodating the leftward projection of the heart. Each apex projects above the first rib into the root of the neck. The roots carry the bronchi, pulmonary vessels, nerves and lymphatic connections.^[ref]

The heart and pericardium occupy chiefly the middle part of the inferior mediastinum, behind the sternum and between the lungs, with most of the cardiac bulk to the left of the median plane. The great vessels approach superiorly. The trachea divides into main bronchi behind the upper central region; the oesophagus descends behind the airway and heart. The descending thoracic aorta lies posteriorly, chiefly left of the vertebral bodies; the azygos venous route lies chiefly on the right. The thoracic duct and sympathetic chains belong to the posterior relations. A frontal projection superposes these structures and must not be mistaken for their order from front to back.

For a conventional quiet-breathing surface description, the lower lung border reaches approximately the sixth rib in the midclavicular line, eighth in the midaxillary line and tenth posteriorly near the scapular line. The pleural reflection descends approximately two ribs farther at corresponding landmarks: eighth, tenth and twelfth. These are orientation points, not immutable lines in every healthy individual. Inferiorly, the extra pleural extent forms the costodiaphragmatic recess. The right diaphragmatic dome usually stands higher, related to the underlying liver; the left is related to the stomach and other abdominal viscera.

In inspiration the respiratory diaphragm descends, the rib cage expands and lower lung margins move into the recesses; in expiration they retreat. The heart also shifts with the diaphragm and changes its surface projection as neighbouring lung expands. Deep inspiration, quiet expiration and forced expiration therefore cannot share a single normal map. The heart's own beat adds smaller cyclic movements.

Posture shifts the diaphragm and mediastinal contents: a supine position generally raises the domes compared with standing, while lateral positioning displaces mobile contents towards the dependent side. Body build, age, abdominal fullness and pregnancy change the available thoracic shape and diaphragmatic level. A distended stomach can raise the left dome and alter the cardiac projection without implying primary cardiac disease. The clinically useful comparison records posture and respiratory phase before judging an apparent difference in organ position.

Ordinary inspiration is active enlargement of the thorax; ordinary expiration is chiefly passive recoil after the inspiratory muscles relax. The movements increase and decrease the vertical, anteroposterior and transverse dimensions together. Their relative prominence varies with posture and the individual; there is no exclusive division into abdominal and costal kinds of breathing.

The principal inspiratory muscle is the respiratory diaphragm. Its peripheral fibres shorten towards the central tendon, lowering and flattening its domes. This increases the vertical dimension of the thorax and displaces the abdominal contents downwards and forwards, making the relaxed abdominal wall project. Its costal attachments also act on the lower ribs: with abdominal support opposing unlimited descent, shortening can lift and expand the lower costal margin. Thus the respiratory diaphragm does more than pull down a piston. Its motor supply is through the phrenic nerves, principally from cervical segments C3–C5.

The external intercostal muscles elevate the ribs and help keep the intercostal spaces from being drawn inwards as pleural pressure falls. The interchondral, or parasternal, portions of the internal intercostal muscles also contribute to inspiration. It would therefore be inaccurate to label every part of the internal intercostal muscles expiratory. Coordinated activity braces the rib cage so that the shortening of one layer moves the ribs rather than simply deforming the spaces between them.

Rotation about the posterior articulations raises the anterior ends of the upper ribs and the sternum, increasing the anteroposterior diameter: the usual pump-handle description. The more laterally directed portions of the lower ribs rise and move outwards, increasing the transverse diameter: the bucket-handle description. These are descriptions of components of an oblique movement, not two independent sets of hinges. The scalene muscles can stabilize and elevate the uppermost ribs, with recruitment varying in quiet breathing. The sternocleidomastoid muscle, when the head is fixed, is an accessory elevator of the sternum in greater inspiratory effort; it is not required for an ordinary quiet breath.

The lungs follow the expanding chest wall because their surfaces remain coupled to it through the thin fluid-filled pleural cavity. More negative pleural pressure increases the distending transpulmonary pressure; enlargement of the alveoli briefly makes alveolar pressure lower than atmospheric pressure, so air enters. At the end of inspiration, airflow stops when these last two pressures equalize. During quiet expiration, relaxation of the respiratory diaphragm and inspiratory intercostal muscles allows the stretched lungs and chest-wall system to recoil towards their resting balance. The domes rise, the ribs and sternum descend, and alveolar pressure becomes slightly positive relative to atmospheric pressure while air leaves. Active abdominal muscles and the interosseous portions of the internal intercostal muscles become important in forced expiration, rather than supplying the main force in quiet expiration.^[ref]

A simple mechanical demonstration uses two elastic bags in an airtight transparent vessel, connected through its stopper to the air, with a movable rubber sheet forming the base. Pulling the sheet down expands the vessel and inflates the bags; letting it return allows deflation. A side-tube manometer can show the associated pressure change. This illustrates expansion by lowering the floor, but its rigid vessel cannot demonstrate the movements of the ribs, the action of the intercostal muscles, or the real geometry of the pleural cavity. Observing lower-chest widening and abdominal displacement during quiet breathing supplies those missing observations without confusing the model with the anatomy.