Transcript Surface Anatomy

Anterior Chest Wall and Lungs
Joanna Lumb
Planes
• Anterior Median/Midsternal
• Midclavicular
• Midpoints, parallel to midsternal
• Suprasternal
• Sternal
• Xiphisternal
• Midaxillary
• Apex of the axillary fossa (armpit)
• Anterior axillary
• Anterior fold
• Posterior axillary
• Posterior fold
Surface Markings
• Clavicles
• Jugular notch: T2
• Manubrium: T3/4; Ribs 1-2
• Body of Sternum: T5-9; Ribs 2-7
• Xiphisternum: T9; Rib 7
• Sternal angle: T4/5; Rib 2
• Infrasternal/subcostal angle:
• formed by the costal margins
Breast
• Male
• Nipple: Intercostal space 4 (ICS 4)
• Female:
• Ribs 2-6
• Sternal border to midaxillary line
• Areola: pigmented area round the
nipple
Breast - Lymph
• Axillary nodes:
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Lateral (humeral)
Anterior (pectoral)
Posterior (subscapular)
Central
Apical
• Supra/infraclavicular nodes
• Parasternal nodes
• Abdominal lymph nodes
Breast - Lymph
• Lymphatic drainage is important for
the spread of cancer
• Breast exams:
• Always exam contralateral
(opposite) breast and abdomen
cancer can spread there via the
lymphatics
Lungs - Pleura
• Parietal and Visceral layers
• Parietal = body wall
• Visceral = organs
• Pleural cavity (potential space)
and pleural fluid
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Cervical (neck)
Costal (ribs)
Diaphragmatic
Mediastinal parts
Lungs – Pleural recesses
• Spaces between the parietal and visceral pleura
• No lung tissue except during deep inspiration
• Costadiaphragmatic
• Costamediastinal
Lungs – surface anatomy
• Visceral pleura:
• 2, 4, 6, 8, 10
• Together cc2-4, cardiac notch to cc6, midaxillary cc8, rib 10 posteriorly
• Parietal pleura:
• 2, 4, 6, 8, 10, 12
• Together cc2-4, cardiac notch to cc6, midclav cc8, midaxillary cc10, 12 rib
posteriorly
Lungs - clinical
• Recesses are potential spaces: fluid can collect there
• Blood (haemothorax)
• Air (pneumothorax)
• Pleural fluid (pleural effusion)
• Requires aspiration/drainage
• Pics from Moore and Agur, and google
• Questions? [email protected]