Download INF border of the left 2nd costal cartilage

Cardiovascular system
Surface Anatomy
By
Dr. Nabil Khouri MD, MSc, P.hD
Thoracic landmarks
The angle of Louis
marks the site of
the bifurcation of
the trachea into
the right and left
main bronchi and
corresponds with
the upper border
of the atria of the
heart.
Apex And Borders Location

The Apex of the heart: In the left 5th inter-costal space
at mid-clavicular line (~ 9 cm from the midline).

Superior border: From the INF border of the left 2nd
costal cartilage, ~ 1 cm from the sternum, to the SUP
border of the right 3rd costal cartilage, ~ 1 cm from the
sternum.

Right border: From the SUP border of the right 3rd
costal cartilage, ~ 1 cm from the sternum, to the right
6th costal cartilage ~ 1 cm from the sternum.

Left border: From the INF border of the left 2nd costal
cartilage, ~ 1 cm from the sternum, to the apex.

Inferior border: From the apex to the right 6th costal
cartilage ~ 1 cm from the sternum.
Borders of the heart
1
Inf. border of the 2nd CC
2
3
Sup. border of the 3rd CC
4
5
6
7
5th intercostals space
The 7th CC
Cardiac
sounds
“Ascoltation”
Rt 2nd IC
Lower Lt Sternal border
4th inter-costal space
LT 2nd IC
5th IC
The sounds associated with each heart valve best heard with a
stethoscope?
1. Mitral: 5th left inter-costal space Mid-clavicular line
2. Tricuspid: 4th left inter-costal space
3. Pulmonary: Lower left sternal border at the 2nd inter-costal space
4. Aortic: Right upper sternal border 2nd intercostal space
Simi lunar valve
X: The pulmonary orifice is located
in the upper angle of the third left
sterno-costal articulation;
O: The aortic
orifice is a little
below and
medial to
pulonary
orifice, close to
the the third
left sternocostal
articulation;
Tricuspid valve
O: The right
atrioventricular
opening valve
is a little lower,
opposite the
fourth
intercostal
space of the
right side
Bicospidic valve
The left
atrioventricular
opening is
opposite the
fourth costal
cartilage, and
rather to the left
of the midsternal
line
•
Trachea.—This may be marked out on the back by a line from the spinous
process of the sixth cervical to that of the fourth thoracic vertebra where it
bifurcates; from its bifurcation the two bronchi are directed downward and
lateralward. In front, the point of bifurcation corresponds to the sternal angle.
•
Esophagus.—The extent of the esophagus may be indicated on the back by a
line from the sixth cervical to the level of the ninth thoracic spinous process,
2.5 cm. to the left of the middle line.
Aortic arch
Pulmonary
arch
SVC
Cardiac notch
Lingula
Right Atrium
Diaphragmatic
recess
1. Superior vena cava
2. Inferior vena cava
3. Right atrium (blue)
4. Right ventricle (blue)
5. Left ventricle (red)
6. Aorta
7. Pulmonary trunk
Transverse section at T2 level
T3
Level of the Ascending Aorta T5.
T8 http://www.wesnorman.com/thoraxcrosssections.htm
Pulse Points
Can also be
used as
pressure points
to stop bleeding
Pulls
Superficial Temporal Artery
Common Carotid Artery: lies along the
line connecting The st-cl-jointwith a
point 2 cm lateral to the Superior border
of the thyroid carilage
Upper limb Pulse
1
2
1. Brachial Artery: Medpoint between
the two epicodiles
2. Basilic Vein
Radial Artery: lateral to the flexor
carpi radialis tendon




Alternating expansion
and recoil of arteries
with each heart beat
Measured in beats per
minute
Normal resting pulse:
60 – 100 bpm
Taken at pulse points:
place where pulse is
easily palpated (felt)
Arterial Pulse
Lower Limbs Pulse
Popliteal Artery
Femoral Artery Mid inguinal point
Pulls
Dorsalis Pedis Artery: lateral to the
extensor hallucis longus 5cm distal
to the extensor retinaculae
Posterior Tibial Artery posterior
to medial malleolus