Sinopsis
The clinical anatomy of the thorax is in daily use in clinical practice. The routine examination of the patient’s chest is nothing more than an exercise in relating the deep structures of the thorax to the chest wall. Moreover, so many common procedures – chest aspiration, insertion of a chest drain or of a subclavian line, placement of a cardiac pacemaker, for example – have their basis, and their safe performance, in sound anatomical knowledge.
Since the 1st and 12th ribs are difficult to feel, the ribs should be enumerated from the 2nd costal cartilage, which articulates with the sternum at the angle of Louis.
The spinous processes of all the thoracic vertebrae can be palpated in the midline posteriorly, but it should be remembered that the first spinous process that can be felt is that of C7 (the vertebra prominens).
The position of the nipple varies considerably in the female, but in the male it usually overlies the 4th intercostal space approximately 4 in (10 cm) from the midline. The apex beat, which marks the lowest and outermost point at which the cardiac impulse can be palpated, is normally in the 5th intercostal space 3.5 in (9 cm) from the midline and within the midclavicular line. (This corresponds to just below and medial to the nipple in the male, but it is always better to use bony rather than soft-tissue points of reference.)
Content
- The Thorax
- The Abdomen and Pelvis
- The Upper Limb
- The Lower Limb
- The Head and Neck
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