Surface Anatomy

Question 1

Which bones lie lateral and inferior to the jugular notch?

Answer 1

Lateral: clavicles

Inferior: sternum

Question 2

Which vertebral level corresponds to the suprasternal notch?

Why is it lower than T1?

Answer 2

Question 3

Which rib articulates at the sternal angle?

What vertebral level corresponds to the sternal angle? Why?

Answer 3

Question 4

To what vertebral level does the xiphosternal joint correspond?

Answer 4

~ T10

Question 5

The costal cartilages of which ribs contribute to the costal margin?

Answer 5

Ribs 7 - 10

Question 6

[…] is the dermatome for the umbilicus

Answer 6

T10

Question 7

Answer 7

Question 8

Between vertebral levels […] and […] is the site for lumbar punctures and epidural injections.

Answer 8

L4

L5

Question 9

The nipples overlie which rib or intercostal space?

Answer 9

4th intercostal space

Between ribs 4 and 5

*Except in individuals with pendulous breasts*

Question 10

Chest tubes (to reinflate a pneumo- or hemothorax) are usually inserted at the intersection of the […] and the […].

Answer 10

anterior or midaxillary line

nipple

Question 11

The two domes of the diaphragm meet at the […] and peak at the […]. On the right side it peaks just below the […]. On the left it peaks […] cm below the nipple (5th intercostal space).

Answer 11

xiphisternal junction

mid-clavicular line

nipple

2-3

Question 12

Why would it be difficult to hear individual valves by listening directly over each valve?

Answer 12

The sounds are carried with the blood flowing through the valves and can be heard better “downstream”

Question 13

Where are the ascultation points for:

• Aortic valve
• Pulmonary valve
• Tricuspid valve
• Mitral valve

Answer 13

• Aortic valve - 2nd intercostal space to the right of the manubrium
• Pulmonary valve - 2nd intercostal space to the left of the manubrium
• Tricuspid valve – just to the left of the xiphoid process in the 5th intercostal space
• Mitral valve - the apex of the heart (5th intercostal space in mid-clavicular line)

Question 14

The trachea bifurcates at the […]

Answer 14

sternal angle

Question 15

Why are there different number of secondary bronchi in the left and right lungs?

Answer 15

The left lung has two lobes (and thus, two secondary bronchi) and the right lung has three.

Question 16

At what verterbal level is the bifurcation of the trachea?

Answer 16

T4/5

Question 17

The left lung has […] lobes separated by a division called the […].

The right lobe has […] lobes separated by divisions called the […] and the […].

Answer 17

2 (superior and inferior)

oblique fissure

3 (superior, middle, and inferior)

horizontal fissure (superior and middle lobes)

oblique fissure (middle and inferior)

Question 18

Why does the right lung have more lobes than the left?

Answer 18

The heart sits to the left of midline, and thus takes up more of the left thoracic cavity, leaving less room for the left lung.

Question 19

For the right lung, the […] lobes are visible from an anterior and lateral view while the […] lobes are visible from a posterior view.

Answer 19

Superior, middle and inferior

Superior and inferior

Question 20

Why aren’t the kidneys placed symmetrically?

Answer 20

Liver liver liver! It’s so big and located on the right side. It displaces the right kidney more superiorly than the left.

Question 21

Describe the location of the left and right kidneys relative to the ribs.

Answer 21

Question 22

How close do the iliac crests come to the tape approximating the costal margin?

Answer 22

Usually <6”

Question 23

Where does the supra-crestal plane fall relative to the umbilicus?

Answer 23

The supracrestal plane is inferior to the transumbilical plane

Question 24

If you continue following the iliac crests around posteriorly, what bony landmark do you feel at their termination?

Answer 24