Surface Marking Of The Lungs

Question 1

Apex

Answer 1

Apex of each lung extends 3cm above the medial 1/3 of clavicle

Question 2

Anterior marking

Answer 2

Descends from apex behind sternoclavicular joint
Come together at manubriosternal joint (angle of Louis)
Left - at level of 4 costal cartilage, the border goes laterally and inferiorly (cardiac notch) to reach the inferior boarder at the level of the 6 costal cartilage in the mid clavicle line
Right - the right border continues straight down to the 6 costal cartilage

Question 3

Posterior marking

Answer 3

Passes down from apex
2cm lateral to the spinous processes
To the level of 10 rib

Question 4

Inferior marking

Answer 4

Passes almost horizontally around the chest wall
Anterior - 6 costal cartilage
Mid axillary line - 8 rib
Posterior - 10 rib

Question 5

Fissures

Answer 5

Each lung has an oblique fissure
The right lung in addition also has a horizontal fissure causing the right lung to hula an upper, middle and lower lobe.
The left lung has an upper and lower lobe

Question 6

Horizontal fissure

Answer 6

On the right lung
Begins at the level of 5 rib and mid axillary line
Goes horizontally across underneath the 5 rib
To the 4 costal cartilage

Question 7

Oblique fissure

Answer 7

Marked by a line drawn obliquely downward and forward
From a point 2cm lateral to spine of T3
Crossing mid axillary line at the 5 rib
Reaching inferior border of the lung at 6 costal cartilage
Medial border of scapula gives a good guid when the arm is raised

Question 8

Transverse fissure

Answer 8

From the oblique fissure at the level of the 5 rib in the mid axillary line
Running along lower border of the 4 rib
To the medial border of right lung

Question 9

Pleura

Answer 9

Parietal pleural extends approximately 5cm (2 rib spaces) below the inferior border of the lung
Anterior - 6 costal cartilage
Mid axillary line - 10 rib
Posterior - 12 rib

Question 10

Apex beat

Answer 10

Left 5 intercostal space in mid clavicle line
In line with nipple

Question 11

Carina

Answer 11

Lies behind the manubriosternal joint
Also represents the level where - second ribs join the sternum, both lungs reach the midline