Practical 1: Surface Anatomy Flashcards
Identify
Suprasternal notch / Jugular notch
Clinical significance of jugular notch
The trachea lies directly behind it, so it can be used to check for tracheal deviation/shift by palpating for the trachea .
What is tracheal deviation ?
Symptoms ?
When pressure increases within the chest cavity, the trachea may shift to one side, typically the side where the pressure is LOWER or there is LESS lung volume
Symptoms:
- coughing
- difficulty breathing
- wheezing
- chest pain
Some causes of tracheal deviation
Neck injury, trauma
Pneumothorax
Bleeding
Multinodular goiter
Tumors, cancer, mediastinal lymphoma
Pleural effusion
Pneumonectomy
Atelectasis
Pleural fibrosis
Pulmonary fibrosis
What is pneumothorax
A collection of air outside the lung but within the pleural cavity (between parietal and visceral pleura) , which can apply pressure on the lung and make it collapse
What is pleural effusion
The accumulation of fluid in between the parietal and visceral pleura, called the pleural cavity.
It can occur by itself or can result from surrounding parenchymal disease like infection, malignancy, or inflammatory conditions
What is pneumonectomy ?
A surgical procedure to remove one lung.
What is Atelectasis ?
The collapse of part or all of a lung caused by a blockage of the air passages (bronchus or bronchioles) or by pressure on the lung
Which muscle forms the lateral border of the jugular notch ?
Sternocleidomastoid muscles
Identify
What does this structure attach to medially and laterally ?
Clavicles
Medial end attaches to manubrium
Lateral end attaches to acromion process
Identify
Costal margin
Identify
Subcostal angle (left and right costa-xyphoid angle)
Identify the structure
What is the significance of this structure ?
Xyphoid process
It is at the level of the 6th rib
Identify this landmark
What is the clinical significance ?
Manubriosternal junction / Sternal angle / Angle of Louis
At the level of 2nd rib ( also at the level between T4 and T5)
Identify
Spinous process of C7
Identify this structure
What is the clinical significance
Spine of the scapula
Approximately at the level of spinous process of T3
Identify
Medial border of scapula
Identify this structure
What is the clinical significance ?
Inferior angle of the scapula
Approximately the level of T8/T9
Label
Label these lines
Label these lines
Label these lines
Which muscle forms the anterior axillary fold ?
Pectoralis major
Which muscles form the posterior axillary fold ?
Latissimus dorsi
Teres major
Identify the surface protection of the heart
- Lower border of left 2nd costal cartilage (Pulmonary)
- Upper border of right 3rd costal cartilage (Aortic)
- Right 6th costal cartilage (Tricuspid)
- Left 5th intercostal space 10 cm away from midsternal and medial to midclavicular (Mitral - apex of heart)
Hint:
A P
T M
Identify the surface projection of the pleura
Hint : (2,2,4,6,8,10,12)
True or false
This diagram portrays the anatomical positions of the valves
False
All 4 valves are anatomically located behind the sternum. However we can’t auscultate the sternal area because we will hear all the valves at once and cannot differentiate between them.
This diagram shows the auscultatory locations of the valves (where they are BEST heard)
Identify the surface projection of the lungs
Hint: (2,2,4,6,8,10)
The lungs is two ribs higher than the pleura anteriorly, laterally, and posteriorly. WHY?
To allow for full expansion of the lungs during inspiration
The lungs extend anteriorly to the ________ rib.
6th
The lungs extend laterally to the ________ rib.
8th rib
The lungs extend posteriorly to the ________ rib.
10th rib
The pleura extends anteriorly to the ________ rib.
8th rib
The pleura extends laterally to the ________ rib.
10th rib
The pleura extends posteriorly to the ________ rib.
12th rib
True or false
The reflection of the lungs is similar to the pleura except superiorly
False
Inferiorly
True or false
We stop auscultating the lung anteriorly by the 8th rib.
False
6th rib because that’s where the lungs end anteriorly
At what rib level does the cardiac notch start and end
Rib 4 - Rib 6
True or false
The pleura will stop anteriorly at the 10th rib
False
8th rib
Both the apex of the lungs and pleura are located where?
2 cm above the clavicle
How many lobes and fissures in the right lung?
3 lobes:
- upper
- middle
- lower
2 fissures:
- oblique
- horizontal
How many lobes and fissures in the left lung?
2 lobes:
- upper
- lower
1 fissure:
- oblique
Describe the oblique fissure
It starts posteriorly from T3 and runs downward and laterally parallel to the medial border of the scapula when abducted and continues anteriorly
Describe the location of the horizontal fissure
Located at 4th rib anteriorly and it runs horizontally until it crosses the midclavicular line , then it will run downward and laterally to meet the oblique fissure
True or false
The cardiac notch is present only on the LEFT lung and pleura.
True
Which side is BEST to auscultate the lower lobes ?
Posteriorly
Understand the location of the lobes and fissures
Done
Where would you auscultate the right lower lobe laterally?
Posterior to the midaxillary line
