Surface marking thorax

Surface marking thorax

1. Surface Marking of Thorax Dr. Mushfiqul Hoque Lecturer  Dhaka National Medical College

2. Important Landmarks to Know

3. Sternal Angle A palpable and sometimes visible transverse ridge at the junction of menubrium sterni and body of the sternum. On each side it articulates with the second costal cartilage.  

4. Counting of ribs and intercostal space   From sternal angle  On both sides of the sternal angle there are the second costal cartilages Below that there is the 2nd intercostal space  

5. Apex of heart Left fifth intercostal space, 9 cm away from midline, slightly below and medial to the left nipple, slightly medial to the midclavicular line.  

6. Viscera

7. Heart

8. Right Border of Heart Right border of the heart is drawn by a line joining the following points: A point at the upper border of the third right costal cartilage 0.8 cm from the sternal margin A point on 4th costal cartilage 3.7cm from the sternal margin.   A point at the lower border of the sixth right costal cartilage close to the sternal margin.

9. Inferior Border of Heart Lower border of the heart is drawn by a line joining the following points: A point at the lower border of the sixth right costal cartilage close to the sternal margin.  A point at the xiphi-sternal joint   A point at the apex of the heart in the left fifth intercostal space 9 cm from the midsternal line.

10. Left Border of Heart Left border of the heart is drawn by a line joining the following points: A point at the lower border of the second left costal cartilage about 1.2 cm from the sternal margin. A point at the apex of the heart in the left fifth intercostal space 9 cm from the midsternal line.

11. Lungs

12. Apex of the Lung  Apex of the Lung is drawn by a line joining the following points: A point at the sterno -clavicular joint A point on the clavicle at the junction of medial one-third and lateral two-thirds A point 2.5 cm above the midpoint between point 1 and 2 

13. Anterior Border of the Right Lung  Anterior Border of the Right Lung is drawn by a line joining the following points: A point about 2.5 cm above the right clavicle at the midpoint between medial 1/3 and sternal end of clavicle  A point at the sternoclavicular joint.  A point in the median plane at the sternal angle A point in the median plane just above the xiphi -sternal joint.

14. Anterior Border of the Left Lung  Anterior Border of the Left Lung is drawn by a line joining the following points: A point about 2.5 cm above the left clavicle at the midpoint between medial 1/3 and sternal end of clavicle   A point at the left sternoclavicular joint.   A point in the median plane at the sternal angle A point in the median plane at the level of 4th costal cartilage A point at the lower border of the left 4th costal cartilage 3.5 cm away from the  median plane A point on the left 6th costal cartilage 4 cm away from the median plane

15. Anterior Border of the Left Lung  Anterior Border of the Left Lung is drawn by a line joining the following points: A point about 2.5 cm above the left clavicle at the midpoint between medial 1/3 and sternal end of clavicle   A point at the left sternoclavicular joint.   A point in the median plane at the sternal angle

16. Anterior Border of the Left Lung  Anterior Border of the Left Lung is drawn by a line joining the following points: A point in the median plane at the level of 4th costal cartilage A point at the lower border of the left 4th costal cartilage 3.5 cm away from the  median plane A point on the left 6th costal cartilage 4 cm away from the median plane

17. Lower Border of the Right Lung  Lower Border of the right Lung is drawn by a line joining the following points: A point at the xiphi-sternal joint  A point on the 6th rib on the mid clavicular line A point on the 8th rib on the mid axillary line A point 2 cm lateral to the 10th thoracic spine

18. Lower Border of the Right Lung  Lower Border of the right Lung is drawn by a line joining the following points: A point at the xiphi-sternal joint  A point on the 6th rib on the mid clavicular line A point on the 8th rib on the mid axillary line A point 2 cm lateral to the 10th thoracic spine

19. Lower Border of the Left Lung  Lower Border of the Left Lung is drawn by a line joining the following points: A point at the left sixth costal cartilage 4 cm away from the midline  A point on the 6th rib on the mid clavicular line A point on the 8th rib on the mid axillary line A point 2 cm lateral to the 10th thoracic spine

20. Lower Border of the Left Lung  Lower Border of the Left Lung is drawn by a line joining the following points: A point at the left sixth costal cartilage 4 cm away from the midline  A point on the 6th rib on the mid clavicular line A point on the 8th rib on the mid axillary line A point 2 cm lateral to the 10th thoracic spine

21. Posterior Border of the Lung  Posterior Border of the Lung is drawn by a line joining the following points: A point at 2 cm lateral to the seventh cervical spine A point at 2 cm lateral to the 10th thoracic spine 

22. Oblique fissure of the Lung  Oblique fissure of the Lung is drawn by a line joining the following points: A point at 2 cm lateral to the second thoracic spine. A point 3 cm lateral to and at the level of nipple A point on the 6th costal cartilage 7.5 cm lateral to the median plane

23. Oblique fissure of the Lung  Oblique fissure of the Lung is drawn by a line joining the following points: A point at 2 cm lateral to the second thoracic spine. A point 3 cm lateral to and at the level of nipple A point on the 6th costal cartilage 7.5 cm lateral to the median plane

24. Vessel

25. Arch of the Aorta Arch of Aorta is drawn by a curved line joining the following points: begins at the right end of the sternal angle arches upwards and to the left through the centre of the manubrium ends at the sternal end of the left second costal cartilage.

26. Trachea Trachea is marked by two parallel lines 2 cm apart, drawn from the lower border of the cricoid cartilage (2 cm below the thyroid notch) to the sternal angle, inclining slightly to the right

27. End of discussion questions?