
Surface anatomy is key to examination, especially when it comes to percussion and auscultation. Here are some of the major landmarks to guide your examinations:
Heart:
- The apex of the heart is in the mid-clavicular line, 5th intercostal space. This is where the tricuspid valve is best auscultated
- The mitral valve should be auscultated at the lower left sternal edge, medial to the apex in the 5th intercostal space
- The pulmonary valve can auscultated just lateral to the sternum in the left 2nd intercostal space
- The aortic valve should be auscultated just lateral to the sternum in the right 2nd intercostal space
Lung borders:
- The apices of the lungs extend 3cm above the mid clavicular point
- In quiet respiration, the inferior margin of the lungs are:
- T6 (midclavicular)
- T8 (midaxillary)
- T10 posteriorly (median plane)
- Pleura surface markings two ribs lower
Lung Fissures:
- Oblique fissure – T3 to 6th costochondral junction
- Horizontal fissure – from the oblique fissure in the mid-axillary line to the 4th costal cartilage
Spleen:
- Marked on left side of the back, with its long axis corresponding with that of 10th rib
- Upper border corresponds to upper border of 9th rib & lower border to lower border of 11th rib
Liver:
- The upper surface of the liver is percussed at the level of the fifth intercostal space
- Lower border is the costal margin
Kidneys:
- Posteriorly: T11-L3 (Right lower than left)