ANATOMY OF THE RESPIRATORY SYSTEM: LABORATORY LEARNING SUPPLEMENT

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1 ANATOMY OF THE RESPIRATORY SYSTEM: LABORATORY LEARNING SUPPLEMENT I. Palpation of the Trachea a. Inspect the attachment of the sternal head of the sternocleidomastoid muscle. b. Instruct the subject to bend his/her head to reduce the tension in the SCM. c. Palpate as far down as possible, near the sternal notch, medial to the SCM head. d. Use the index and middle fingers of both hands, or, index finger and thumb of one hand, in palpating for the trachea. II. III. Palpation of the Intercostal Spaces (ICS) a. Method A Parasternal Palpation. i. Locate the sternal notch and the Angle of Louis. ii. The costal cartilage and rib located lateral to the Angle of Louis is the 2 nd rib. iii. Palpate inferior to the 2 nd rib. The space that you will be able to locate is the 2 nd intercostal space. iv. From the second intercostal space, you may be able to palpate for the 3 rd -6 th ICS by moving inferiorly. b. Method B Posterolateral Ribcage i. Palpate for the location of the 12 th rib. ii. If you are having difficulties locating the 12 th rib, you may ask the patient to raise his/her arm above the head and bend slightly towards the opposite side. iii. The ICS above the 12 th rib is the 11 th intercostal space. You may start from this point in locating the other ICS. Surface Anatomy of the Lungs The surface anatomy of the lungs is a rough representation or estimate of the location of the lung lobes relative to the surface of the thorax. This material has been prepared by Ilona Valerie R. Vidamo, PTRP for the exclusive use of the students of

2 Surface Anatomy of the Lungs: Anterior Thorax Lung Apices Anterior Border Inferior Border Horizontal Fissure (R) Lung Sternoclavicular Joint Midclavicle (approximately between the Medial and Intermediate Areas) Axillary Area (following the contours of the ribcage) Sternoclavicular Joint, going inferiorly parasternal R: Up to 6 th rib or near the Xiphisternal Joint L: Up to 4 th rib Cardiac notch (with 5 th and 6 th rib) Following the line of the 6 th rib, going inferiorly and laterally To the 8 th rib (midaxillary line) Tracing the line of the 4 th rib, junctioning at the midaxillary line with the oblique fissure. This material has been prepared by Ilona Valerie R. Vidamo, PTRP for the exclusive use of the students of

3 Surface Anatomy of the Lungs: Posterior Thorax Lung Apices Posterior Border Inferior Border Oblique Fissure Approximately matching the location of the lung apices of the anterior surface. Paraspinal end of the apex, about 1.5-2cm away from the midline, going inferiorly to the level of the 10 th thoracic vertebra Following the line of the 10 th rib, going medially to meet with the inferior border termination at the 8 th rib (midaxillary line) From the root of the spine of the scapula, going inferiorly and laterally to cross the 6 th rib at the mid-axillary line. Continue moving inferiorly at the anterior surface until this meets with the inferior border. This material has been prepared by Ilona Valerie R. Vidamo, PTRP for the exclusive use of the students of

4 Illustrations of the surface anatomic markers on the Lateral Sides: This material has been prepared by Ilona Valerie R. Vidamo, PTRP for the exclusive use of the students of

5 References: Snell, R. (2004). Clinical Anatomy for Medical Students - 7 th ed. Maryland: Lippincott Williams and Wilkins. Goldberg, C. A Practical Guide to Clinical Medicine. UCSD School of Medicine, The University of California, San Diego. Online content retrieved from meded.ucsd.edu/clinicalmed.htm. This material has been prepared by Ilona Valerie R. Vidamo, PTRP for the exclusive use of the students of

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