Surface Anatomy Workshop

Question 1

The scapula extends from what vertebral level to what vertebral level?

Answer 1

T2 to T7

Question 2

Give the borders of the triangle of auscultation

Answer 2

Medial - Trapezius, Lateral - Rhomboid major (sometimes medial border of scapula), Inferior - Latissimus dorsi

Question 3

Supracristal plane

Answer 3

A transverse plane running along the top of the iliac crest. Generally at the L4 level

Question 4

Give the location of the kidney, the superior and inferior poles of the kidney, and where we strike to assess kidney tenderness

Answer 4

Kidney - Retroperitoneal at T12-L3, Superior poles - Deep to 11th and 12th ribs, Inferior poles - Around L3-L4, Tenderness - Strike at costovertebral angle (12th rib)

Question 5

How do we find the site for a lumbar puncture?

Answer 5

Use the supracristal plane to find L4 (insert needle midline between L3 and L4 or L4 and L5)

Question 6

In males, what intercostal space does the nipple demarcate?

Answer 6

The 4th ICS

Question 7

Superior border of heart margins. CC-costal cartilage, ICS-intercostal space, MCL-midclavicular line

Answer 7

Line connecting superior border of 3rd CC (right) to inferior border of 2nd CC (left)

Question 8

Right border of heart margin. CC-costal cartilage, ICS-intercostal space, MCL-midclavicular line

Answer 8

Line drawn from 3rd CC to 6th CC

Question 9

Left border of heart margin. CC-costal cartilage, ICS-intercostal space, MCL-midclavicular line

Answer 9

Inferior border of 2nd CC to 5th ICS medial to the MCL

Question 10

Inferior Border of heart margin. CC-costal cartilage, ICS-intercostal space, MCL-midclavicular line

Answer 10

Line connecting 6th CC (right) to the 5th ICS medial to left MCL (apex)

Question 11

How far do the left and right sternal lines of pleural reflection descend together?

Answer 11

From Costal Cartilages 2 to 4

Question 12

For the left and right sternal lines of pleural reflection respectively, where does each diverge from the sternum?

Answer 12

Left - At 4th CC passes to left margin of sternum, then inferior to 6th CC. (Down, Left, Down) Right - Moves inferior along midsternal line to xiphoid (straight down, more or less)

Question 13

At what level do costal lines of pleural reflection pass through the following lines: midclavicular, midaxillary, and posterior midsternal line

Answer 13

8th rib (midclavicular), 10th rib (midaxillary), and 12th rib (posterior midsternal)

Question 14

At what level are the inferior lung margins at each of the following lines: midclavicular, midaxial, and scapular

Answer 14

6th rib (MCL), 8th rib (MAL), 10th rib (scapular)

Question 15

How many ribs further inferior does the parietal pleura extend than the lung (and visceral pleura)

Answer 15

2 ribs

Question 16

Where are chest tubes inserted

Answer 16

In the MAL in the 5th or 6th ICS (angled superiorly to remove air, angled inferiorly to remove fluid)

Question 17

Where is the point of insertion for a thoracocentesis and what is the purpose of this procedure?

Answer 17

Into 9th ICS during expiration, needle point upwards. Purpose is to remove small amounts of fluid

Question 18

Give the two insertion points for pericardiocentesis

Answer 18

5th or 6th left ICS near sternum (bare area), or Superoposterioly through infrasternal (subcostal) angle

Question 19

At what vertebral level is the spine of the scapula?

Answer 19

T3

Question 20

At what vertebral level is the inferior angle of the scapula?

Answer 20

T7