Thursday, 27 March 2014

Surface lines - thorax

It's very important to visualize how anatomical structures in the thorax are related. The lines cover the front, side and the back of the chest. They are helpful during the physical examination, auscultation and percussion.
I'm going to show you how to find vertical lines.

Anterior lines of the chest
1. Anterior midline (midsternal)
 - to find Jugular notch (the deepest point of the sternal incision, between clavicles)
 - to find xiphoid process (you feel it with your fingers in the end of the sternum)
Then connect these two points to form the midsternal line.

2. Sternal line
 - lateral side of the sternum (the junction of ribs and sternum)

3. Midclavicular line
 - to find the center of the clavicle. The midclavicular line runs downward from this point.

To make it easier: elevate the shoulder. Then the clavicle is more visible.

4. Parasternal line
 - between the midclavicular and sternal lines.



Lateral lines of the chest
 - to elevate the arm when determining the lines

5. Anterior axillary line
 - it runs downward from lateral border of pectoralis major muscle (along the anterior axial fold, close to the front of the thorax)

6. Posterior axillary line
 - it runs downward from lateral border of latissimus dorsi muscle (along the posterior axillary fold, close to the back)

7. Middle axillary line (Midaxillary line)
 - the axilla has a shape of triangle. The line runs downward from the center of this area (the deepest point).
 - other method: the midaxillary line runs between the posterior and anterior axillary lines, from the deepest point.



Posterior lines of the chest
8. Scapular line
 - projected to the inferior scapular angle

To make it easier: put your hand on the back and bend your arm - then the scapula is more visible.

9. Posterior median line
 - projected to the spinous processes of vertebra

10. Vertebral line
 - projected to the transverse processes of vertebra

11. Paravertebral line
 - between the vertebral and scapular lines


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That's all. Any other ideas?

P.S. These pictures were found on the web. I just added a few amendments to them.

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