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OSPE > Thorax > Flashcards

Thorax Flashcards

1
Q

Vertebral level of superior angle of scapula

A

T2

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2
Q

Vertebral level of spine of scapula - medial end

A

T3

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3
Q

Vertebral level of inferior angle of scapula

A

T7

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4
Q

Vertebral level of manubrium

A

T2/3-T4/5

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5
Q

Vertebral level of jugular notch

A

T2/3

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6
Q

Vertebral level of sternal angle

A

T4/5

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7
Q

Vertebral level of tracheal bifurcation

A

T4/5

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8
Q

Vertebral level of start and end of aortic arch

A

T4/5

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9
Q

Vertebral level of body of sternum

A

T5-8

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10
Q

Vertebral level of xiphisternum

A

T8/9

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11
Q

Vertebral level of transpyloric plane

A

L1

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12
Q

Vertebral level of subcostal plane

A

L2

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13
Q

How many places do you auscultate/percuss for each lobe

A 
Upper 4 (front and back)
Middle 2
Lower 2 (front and back)
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14
Q

What does stony percussion of lungs indicate

A

Pleural effusion

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15
Q

What does a hyper resonant percussion indicate

A

Pneumothorax

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16
Q

How does a pneumothorax percussion sound

A

hyperresonant

17
Q

How does a pleural effusion percussion sound

18
Q

Surface marking of upper/middle/lower lobes

A
  • Upper lobes – from apex above clavicles to horizontal fissure in right lung (4th CC) or oblique fissure in left lung (6th CC)
  • Middle lobe – between 4th and 6th CC in right lung
  • Lower lobe found laterally between 6th and 7th CC
19
Q

Describe & demonstrate the surface markings of the oblique and horizontal fissures of
right/left lung.

A
  • Oblique – from T3/4 posteriorly to meet the 6th rib/CC anteriorly
  • Horizontal – from 4th CC anteriorly to meet the oblique fissure in the mid-axillary line
20
Q

Describe & demonstrate the surface marking of the inferior margin of parietal pleura of
right/left lung.

A
  • Apex in the root of the neck above medial third of clavicle
  • Just right of midline at level of 2nd CC
  • Just right of midline at level of 6th CC
  • MCL at level of 8th rib (just above costal margin)
  • MAL at level of 10th rib (lowest point of costal margin)
  • Scapular line crossing 12th rib
  • Transverse process of T1 vertebrae
  • Cardiac notch in left lung between 2nd and 6th CC
21
Q

Describe & demonstrate the surface marking of inferior margin of the visceral pleura of
right/left lung.

A
  • Apex in the root of the neck above medial third of clavicle
  • Just right of midline at level of 2nd CC
  • Just right of midline at level of 6th CC
  • MCL at level of 6th rib
  • MAL at level of 8th rib
  • Scapular line at level of 10th rib posteriorly
22
Q

Describe and demonstrate the triangle of safety for insertion of a chest drain

A
  • Posterior - Latissimus dorsi - posterior axillary fold
  • Anterior - Pectoralis major - anterior axillary fold
  • Inferior - 4th/5th intercostal space at mid-axillary line
  • Superior - below apex of axilla
  • Lies over 2nd-5th ICS
23
Q

Describe & demonstrate the surface marking of mediastinal pleura of right & left lung
on the anterior chest wall

A
  • Sternal angle to T4
  • At hilum, reflected on to vessels and bronchi
  • Continuous with visceral pleura
24
Q

Demonstrate the surface marking of upper/right/inferior/left borders of the heart.

A
  • Just lateral to right sternal border at the 3rd CC
  • Just lateral to the right sternal border at the 6th CC (at level of xiphisternal joint)
  • At the position of apex beat, which is normally palpable just medial to the MCL in the 5th left ICS)
  • Lateral (about 2.5 cm) to the left sternal border at the 2nd CC
25
Q

Demonstrate where you would auscultate for aortic/pulmonary/mitral/tricuspid valves
using a stethoscope.

A
  • Aortic – right 2nd ICS near sternum
  • Pulmonary – left 2nd ICS near sternum
  • Mitral – left 5th ICS at mid-clavicular line (apex beat)
  • Tricuspid – left 5th ICS near sternum
26
Q

Describe the surface marking of the apex beat of the heart and demonstrate palpation

A

• 5th left ICS just medial to MCL

27
Q

Demonstrate the sites of routine venepuncture

A

• Antebrachial vein in the cubital fossa

28
Q

Describe and demonstrate the surface marking of the arch of the aorta

A
  • Beginning of arch (from ascending aorta) at level of right 2nd CC
  • Top of the arch midway between jugular notch and sternal angle
  • End of arch (becoming thoracic aorta) at level of left 2nd CC
29
Q

Describe and demonstrate the surface markings of the internal jugular vein & common carotid artery.

A
  • Common carotid artery from the right SCJ to the lobe of the ear
  • Internal jugular vein lateral to the common carotid artery to the SCJ
30
Q

Which ribs are the cardiac notch inbetween

OSPE (7 decks)

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