Thorax Flashcards
How do you record chest movement?
Place hands firmly on subject’s anterior chest wall (just below 5th or 6th ribs) with fingers extended around the sides of the chest. The thumbs should just meet in anterior midline, resting lightly on chest wall to allow its movement during respiration (below breasts in women)
Ask patient to take deep breath and observe how far tips of examiner’s thumbs move apart (at least 5 cm). Repeat on posterior chest wall with thus meeting in posterior midline T10 (T7 is inferior angle of scapula)
Where is the vertebral prominence?
C7
At what level is the superior angle of the scapula?
T2
Where is the spine of the scapula?
Medial end is T3
Where is the inferior angle of the scapula?
T7
At what level is manubrium?
T2/3-T4/5
Where is the jugular notch?
T2/3
Where is the sternal angle?
T4/5 and 2nd costal cartilage
Where is the body of the sternum?
T5-8
Where is the xiphersternum?
T8/9
At what level is the subcostal plane?
Rib 10/ L2?
Where is the apex of the pleura?
In the root of the neck above the medial 1/3 of the clavicle
How is the left parietal pleura different from the right?
The pleura defects sharply to allow for cardiac notch
When you auscultate the lungs, where do you listen to?
Apex, super, middle and inferior lobe of both lungs and over the trachea
on front and same on back but hilum instead of trachea
Where is the lung hilum found?
Mid point of scapular and posterior medial line opposite the spines of T4-T6
What are chest drain used for?
Pneumothorax
Pleural effusion
Haemothorax
Post-operative
What is the safe triangle used in chest drains?
Posterior- latissimus dorsi- posterior axillary fold
Anterior- pectoralis major- anterior axillary fold
Inferior- 4th intercostal space- level of male nipple
Superior- below apex of axilla
Where do you place the chest leads in an ECG?
V1- Right 4th intercostal space next to sternum
V2- Left 4th intercostal space next to the sternum
V3- Left 5th intercostal space between V2 and V4
V4- Left 5th intercostal space at mid clavicular line
V5- Left 5th intercostal space at anterior axillary line
V6- left 5th intercostal space at mid-axillary line
Where are the 4 corners of the heart?
Just lateral to right sternal border at 3rd CC
Just lateral to right sternal border at 6th CC (xiphisternal joint level)
At position of apex beat which is normally palpable just medial to MCL in the 5th ICS
Lateral (about 2.5 cm) to the left sternal border at 2nd CC