surface anatomy by az and izzy. plan for this session we’ll run through this presentation, that...
TRANSCRIPT
Plan for this session
We’ll run through this presentation, that (hopefully) will tell you everything you need to know
We’ll have a little play about
If you’re anything like us – you’ll forget some/all of it
Use this slide show for revision (later)
Before thinking about the lungs...
It’s worth being familiar with the markers people like to use:
Levels of superiority / inferiority are almost always described by a rib (or costal cartilage)
The lateral landmarks we care about are:Anterior MidlineMid ClavicularMid AxilliaryScapularPosterior midline (spinous process)
Lungs – Where are they?
Apex
Joins Midline
Lower Sternal level
Mid Clavicular
Mid Axillary
2-3 cm above middle of the clavicle
Sternal Angle / 2nd CC / T4
6th Costal Cartilage
6th Rib
8th Rib
Scapular / back midline
10th Rib10th Spinous Process
There’s a little kink at 4th CC in the left lung
What about the Pleura?
Apex
Joins Midline
Lower Sternal level
Mid Clavicular
Mid Axilliary
2-3 cm above middle of the clavicle
Sternal Angle
6th Costal Cartilage
6th Rib
8th Rib
Scapular / back midline
10th Rib10th Spinous Process
Sternal Angle
6th Costal Cartilage
8th Rib
10th Rib
12th Rib12th Spinous Process
Where are the fissures?
Right Left
Oblique Fissure 2nd SP -> 6th rib MCL 2nd SP -> 6th rib MCL
Cheeky approximation?
Hand on head, follow the inf edge of scapula
Hand on head, follow the inf edge of scapula
Horizontal Fissure 5th rib MAL -> 4th CC
Borders of the Heart
Upper Right corner Right 3rd CC – 1cm right of sternum
Upper Left Corner Left 2nd CC – 1cm left of sternum
Lower Left Corner (Apex) Left 5th intercostal space – Mid Clavicular Line
Lower Right Corner Right 6th/7th CC (sterno-costal margin)
Special moves
Mitral Stenosis – Lean left, Exhale - BELL
Aortic regurgitation – Sit forwards, Exhale - DIAPHRAGM
Carotids – With your bell
ECG Leads
V1 – 4th IC , right parasternal boarder;
V2 – 4th IC left parasternal boarder;
V4 – apex beat (mid clav);
V3 – half way between V2 and V4;
V6 – horizontal line from V4 in the axillary line;
V5 – midway between V4 and 6
Plus each limb
Systolic and Diastolic Murmurs
As Mr Ar Ms
• Aortic stenosis• Mitral
regurgitation• Aortic
regurgitation• Mitral stenosis
Where would you put a chest drain in?
Triangle of safety
Anterior axilliary fold (Pec maj) Posterior axilliary fold (Lat Dorsi)Horisontal Line just above Nipple
Important Message
If you’re looking at this presentation before your OSCEs…
GOOD LUCK!!!Remember:
Practise makes perfect
There is A LOT of room for error
What song is the lyric from?
“I hear the ticking of the clock, I’m lying here the room’s pitch dark…”
Heart – Alone(US #1 1987)
What song is the lyric from?
“Cos you know, questions are never that easy, and never the same, You have the answer believe me, if you have the faith
Phil Collins –Find a way to my heartReleased in 1989