8th intercostal space

Generally past the male nipple

It starts at the sternoclavicular joint, goes upward to the level of the chest 1, and then turns downward to the junction of the middle 1/3 and inner 1/3 of the clavicle.

The upper border of the lung extends and contacts the inner surface of the lateral chest wall

At the sternal angle, the anterior inner borders of the left and right lungs go down along the front midline on both sides, until they are separated at the level of the 4th rib. Ribs 4 to 6 go downward to the level of the cartilage of the 6th rib and then to the left to the lower boundary of the lung.

The lower boundary of the lungs in the anterior chest begins at the 6th rib, runs obliquely downward on both sides, reaches the 6th intercostal space at the midclavicular line, and reaches the 8th intercostal space at the midaxillary line. The posterior chest wall is at the level of the 10th intercostal space at the scapular line.

Normal chest wall veins are numerous and not obviously exposed

Retraction of the intercostal spaces during inhalation indicates that the airway is blocked and cannot enter the lungs smoothly during inhalation.

Subcutaneous emphysema is the accumulation of air under the skin of the chest

Palpation can cause gas to move within the subcutaneous tissue, causing a twirling or snow-holding sensation.

Seen in chest trauma, rib fractures, tuberculosis, lung cancer, etc.

Pay attention to sternal tenderness and percussion pain

When a normal person inhales, the intercostal muscles and diaphragm contract, the thorax expands, the negative pressure in the chest increases, the alveoli show negative pressure, and the air circulation pressure difference enters the body from the external environment

Men and children mainly breathe abdominally; women mainly breathe thoracically.

Normal respiratory rate is 12~20 times/min

When palpating the chest, point your thumbs toward the xiphoid process along the costal margins on both sides. The tips of your thumbs are about 2cm apart at symmetrical positions on both sides of the midline. The other fingers are extended and placed on the front chest wall.

When palpating the back, place both thumbs symmetrically at the level of the 10th rib, a few centimeters on both sides of the subject's posterior midline.

The patient takes a deep breath, observes the distance between the thumbs as the thorax expands, and checks the range and symmetry of the respiratory movement.

The subject makes a "1" sound, and the sound waves are transmitted along the trachea, bronchi and alveoli to the chest wall; the doctor uses hypothenar palpation

Top 3

After 4

In pleurisy, the surface of the pleura is rough, and the two layers of the pleura rub against each other during breathing, and a feeling of friction can be felt.

Generally, touch the 5/6th intercostal space on the side of the chest or the mid-axillary line where respiratory activity is greater.

Chest and back first

Up → down, outside → inside, left and right comparison

Front chest 18

Back 12

upper boundary of lung

lower boundary of lung

mobility of lower lung boundary

normal

abnormal

The subject makes the sound "1" and listens to the "front 3, back 4" points with a stethoscope.

Stethoscope listens to the chest area with greater respiratory movement activity