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Lung borders
In the anterior thorax, the apices of the lungs extend for
approximately 3 – 4 cm above the clavicles. The inferior borders
of the lungs cross the sixth rib at the midclavigular line.
In the posterior thorax, the apices extend of T10 on expiration to
the spinous process of T12 on inspiration.
In the Lateral Thorax, the lungs extend from the apex of the
axilla to the 8th rib of the midaxillary line.
Lung Fissures
The right oblique (diagonal) fissure extend from the area of the
spinous process of the 3rdthoracic vertebra, laterally and
downward unit it crosses the 5th rib at the midaxillary line. It
then continues ant medially to end at the 6th rib at
the midclavicular line.
The right horizontally fissure extends from the 5th rib slightly
posterior to the right midaxillary line and runs horizontally to
thee area of the 4th rib at the right sternal border.
The left oblique (diagonal) fissure extend from the spinous
process of the 3rd thoracic vertebra laterally and downward to the
left mid axillary line at the 5th rib and continues anteriorly and
medially until it terminates at the 6th rib in the midclavicular
line.
Borders of the Diaphragm.
Anteriorly, on expiration, the right dome of the diaphragm is
located at the level of the 5th rib at themidclavicular line and he
left dome is at the level of the 6th rib. Posteriorly, on expiration,
the diaphragm is at the level of the spinous process of T10;
laterally it is at the 8th rib at themidaxillary line. On inspiration
the diaphragm moves approximately 1.5 cm downward.
Inspection of the Thorax
For adequate inspection of the thorax, the client should be sitting
upright without support and uncovered to the waist.
The examiner should observe:
A.
1. Shape of the thorax and its symmetry.
2. Thoracic configuration.
3. Retractions at the ICS on inspiration.
(suprasternal, costal, substernal)
4. Bulging structures at the ICS during expiration.
5. position of the spine.
6. pattern of respiration.
Normal Findings:
The shape of the thorax in a normal adult is elliptical;
masses.
No fail chest which is suggestive of rib fracture.
Distension
Respiratory movement.
Visible peristalsis.
Pulsations
Normal Findings:
Skin color is uniform, no lesions.
No venous engorgement.
No involuntary movements.
No edema
Color is even.