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Question 1

Where does the oblique fissure end?

Answer 1

T3 posteriorly

Question 2

Describe the course of the horizontal fissure

Answer 2

Runs from 4th CC transversely to meet oblique fissure in MAL

Question 3

Describe the surface markings of the upper, middle and lower lobe of the right lung

Answer 3

Upper - ribs 1-4
Middle - ribs 4-6 medially
Lower - ribs 5-7 laterally

Edges: 6th rib MCL, 8th rib MAL, 10th rib posteriorly

Question 4

Describe the surface markings of the upper and lower lobe of the left lung

Answer 4

Upper - ribs 1-6 medially NOTE MEDIASTINAL REFLECTION AT 4th CC
Lower - ribs 5-7 laterally

Edges: 6th rib MCL, 8th rib MAL, 10th rib posteriorly

Question 5

What is the cardiac notch called and where does it occur on which lobe?

Answer 5

Mediastinal reflection BELOW 4th CC

Left lung, upper lobe

Question 6

Describe the borders for a chest drain

Answer 6

Apex of triangle: base of axila
Lateral border: ANTERIOR border of lat dorsi
Medial border: LATERAL border of pec major
Base: Horizontal line across 5th ICS

Question 7

Where would you insert the chest drain and what would you be trying to avoid?

Answer 7

Anterior to MAL to avoid neurovascular bundle (incl. long thoracic nerve which innervates the serratus anterior (winging of scapula))

Question 8

In relation to the rib, how must you insert the chest drain?

Answer 8

Above the upper border of the rib, upwards and medially to avoid intercostal nerve/ neuro vascular bundle

Question 9

Describe the surface marking of the right mediastinal pleura

Answer 9

Right:
Begins in the root of the neck 2-3cm above MEDIAL 1/3 of clavicle
Runs just right of midline at the level of 2nd, 4th and 6th costal cartilage
Runs obliquely to 8th rib, MCL
10th rib MAL
Crosses 12th rib posteriorly in the scapular line
To meet the transverse processes of L1 vertebrae

Question 10

Describe the surface marking of the right mediastinal pleura

Answer 10

Parietal pleura projects above the 1st CC
Extends into neck above the medial third of the clavicle
Runs down sternum to 4th CC where it deviates 2-3cm to allow for the cardiac notch

Question 11

What sound would you get if you percuss over fluid in the lungs?

Answer 11

DULL

Question 12

What sound would you get if you percuss over too much air?

Answer 12

HYPERresonant

Question 13

How are xrays normally imaged?

Answer 13

PA