Clinical thoracic cage

Question 1

What is manubriosternal angle useful for?

Answer 1

For clinical examination of patient, 2nd rib can be palpated laterally from the angle of louis

Question 2

Patient is having pain in shoulder and X ray imaging shows accessory rib between transverse process of C7 and rib I. Explain the clinical significance.

Answer 2

The band of cervical rib can compress the brachial plexus and cause “thoracic outlet syndrome”-> causing pain in patients arm and shoulders.

Question 3

Patient is suspected of leukemia. Describe how you would take a sample to send to haematology labs?

Answer 3

-Collection of sternal bone marrow is done at the manubrium of sternum, through the outer cortex and into the medulla-> used to investigate blood disorders like leukemia

Question 4

75 year old lady was involved in a vehicle accident. She presents with sharp pain across her left chest. CXR shows these features:

What is your diagnosis?

Answer 4

Flail chest (3 or more contiguous ribs are broken). This causes ribs to go in a paradoxical direction when breathing-> causing underventilation of the lungs