Superficial Anatomy+Valve Sounds

Structures in Superior Mediastinum

internal jugular+subclavian veins→form brachiocephalic V

• behind sternal ends of clavicles

• near sternoclavicular joints

L brachiocephalic V

from left to right behind manubrium

brachiocephalic Vs→combine→form superior vena cava V

• behind lower border of costal carilage of right rib 1

aortic arch A

begins+ends at plane between:

• anterior→sternal angle

• posterior→T4-T5 vertebrae

Visualizing Margins of Heart→Upper+Right Sides

upper limit

• right side→costal cartilage 3

• left side→intercostal space 2

right margin

• right costal cartilage 3→right costal cartilage 6

Visualizing Margins of Heart→Left+Lower Sides

left margin

• descends laterally

• intercostal space 2→apex

• apex location→midclavicular line @ intercostal space 5

lower margin

• sternal end of R costal cartilage 6→apex of intercostal space 5 (near midclavicular line)

Where to Listen to Heart Sounds

valve sounds

• position stethoscope downstream

• from: flow of blood→through valves

tricuspid valve

• left of the lower part of sternum

• near 5th intercostal space

mitral valve

• over apex of heart

• left 5th intercostal space

• at midclavicular line

pulmonary valve

• medial end of left 2nd intercostal space

aortic valve

• medial end of right 2nd intercostal space