resp Flashcards
sternal angle level
t4/5
2nd CC
aortic arch
trachea bifurcation
subcostal plane
costal margin lower border of 10th rib
L3
true rib
false rib
floating rib
1-7
8-10
11-12
right and left lung surface marking
right: 6th -> 8th MAL -> 10th scapular line
left: 4th deviation
fissures surface marking
oblique: 6th CC and T3 connect
right horizontal: 4th CC, connect to oblique at MAL
parietal pleura surface marking
right: 8th -> 10th MCL -> 12th scapular line
left: 4th deviation 2-3cm
visceral pleura surface marking
same as lung
space not filled by lung between parietal and visceral pleura =
recess
eg. costodiaphragmatic recess
symmetrical lung inflation investigation
hands around lower border of costal margin, pulling skiing around from back -> breathe out ->
thumbs meeting in the midline ->
patient breathe in ->
see how much thumbs move apart in each direction
“lungs expanding symmetrically, thumbs move equally in each direction by 2/3cm”
breathing pattern and breathing rate
patient lying down
measure for 30secs and multiply by 2
(pretend to take the pulse as patient knowing will affect their breathing rate)
“rate normal(low/high) of n breaths per minute, pattern regular(irregular)”
percussion of lobes
apex: onto clavicle
upper lobe: 3rd ICS MCL, T1-T3
middle lobe: 5th ICS & just below axilla
lower lobe: 7th ICS MAL, 8th rib scapular line
“drum sound - normal”
dull - fluid
flat - solid
hyperresonant - pneumothorax
auscultation of lobes
apex: just above clavicle
upper: 3rd ICS MCL, T3
middle: 5th ICS & just below axilla
lower: 7th ICS MAL, 8th rib scapular line
“sound during inspiration, less on expiration)
triangle of safety
base of axilla
lateral border of pectoralis major
anterior border of latissimus dorsi
5th ICS MAL
when to perform chest drain
pneumothorax, pleural effusion, haemothorax, post-operative lungs
