Lung markings

Question 1

Apex of lung

Answer 1

extends 3 cm above medial 1/3 of clavicle

Question 3

Anterior marking 1

Answer 3

Descends from apex behind sterno-clavicular joint

Question 4

anterior marking 2

Answer 4

Come together at manubriosternal joint (angle of Louis) find the 3rd rib

Question 5

left 1

Answer 5

Find the 3rd rib, down off it to the level of 4th costal cartilage

Question 6

left 2

Answer 6

The right border continues straight down to the 6 costal cartilage and the border continues round to mid axilla, and follows the 8th rib

Question 7

left 3

Answer 7

goes laterally and inferiorly (cardiac notch) to reach the inferior border at the level of the 6 costal cartilage in the mid clavicular line.

Question 8

left 4

Answer 8

It then goes to the 8th rib in the mid-axillary line

Question 9

right 1

Answer 9

Descends sown to the 6th costal cartilage

Question 10

right 2

Answer 10

To the 6th rib in the mid-clavicular line

Question 11

right 3

Answer 11

the 8th rib in the mid-axillary line

Question 12

3

posterior markings

Answer 12

• Passes down from apex 2 cm lateral to the spinous processes to the level of 10th rib
• They come across the 10th rib horizontally
• Join the lungs at the mid axillary line

Question 13

fissures & lobes

Answer 13

Each lung has an oblique fissure; the right lung in addition also has a horizontal fissure.

The right lung therefore has an upper, middle and lower lobe while the left has only an upper and lower.

Question 14

oblique fissure

Answer 14

• diagonal line From a point 2 cm lateral to spine of T3
• crossing mid axillary line at the 5 rib reaching inferior border of the lung at 6 costal cartilage
• The medial border of the scapula gives (a good guide for the direction of this line when the arm is raised above the head)

Question 15

Oblique fissure 6 points

Answer 15

Indicated by a line drawn from:
1. Starts at the spinous process of T3
2. Descends downwards and laterally following the medial boarder of the scapula (ask model to abduct arm out to 90° to follow boarder)
3. To the 5 rib in the mid axillary line
4. Continues from the 5th rib in the mid-axillary line to the 6th costal cartilage
5. This causes a divide into the upper and lower lobe
6. Same on both sides

Question 16

horizontal fissure 3 points

Answer 16

Indicated by a line drawn from:
1. starts anteriorly at the 4th costal cartilage
2. down to the 5th rib in the mid axillary line
3. where it meets the oblique fissure

Question 17

horizontal fissure seperates

Answer 17

the superior and middle lobes

Question 18

oblique fissure seperates

Answer 18

middle and inferior lobes

Question 19

left lung size

Answer 19

The left lung is smaller than the right because the heart lies slightly to the left within the thoracic cage

Question 20

lung sacs are enclosed by

Answer 20

pleural sac double layered

Question 21

Visceral pleura

Answer 21

forms the outermost layer of the lungs

Question 22

Parietal pleura

Answer 22

• lines the pulmonary cavities.

Question 23

Pleural cavity

Answer 23

• lies between the visceral and parietal pleura
• contains a small film of serous fluid that reduces friction between the layers.

Question 24

pleura markings

Answer 24

• Follow the same surface markings of the lungs except for inferiorly
• At the mid-axillary line at the 10th rib anteriorly and the 12th rib posteriorly
  Same on both sides

Question 25

inferior angle of scap

Answer 25

T7