Right fifth intercostal space at midaxillary line - USMLE Forums
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  #1  
Old 07-26-2013
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Anatomy Right fifth intercostal space at midaxillary line

Knife wound to right fifth intercostal space at midaxillary line. most likely damaged structure?
a) liver
b) superior vena cava
c) upper lobe right lung
d) right atrium

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  #2  
Old 07-26-2013
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if i had to guess using process of elimination i would have to say C
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Old 07-26-2013
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Quote:
Originally Posted by JJacobs152 View Post
if i had to guess using process of elimination i would have to say C
its confusing, in any case thats not the right answer..
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Quote:
Originally Posted by aspiringdoc View Post
knife wound to right fifth intercostal space at midaxillary line.most likely damaged structure?
a)liver
b)sup vena cava
c)upper lobe right lung
d)right atrium
is it liver?
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Old 07-26-2013
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Cannot be an upper lobe .... it has got to be a lower lobe or liver ...considering choices it looks like a liver

Right fifth intercostal space at midaxillary line-surface_projections_of_the_organs_of_the_trunk.jpg
click image to enlarge
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Old 07-26-2013
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npktun ..man that fig is little confusing ..i thought nipple was at T4 and navel is at T10 but that says something else..am i missing something?
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Quote:
Originally Posted by dr,maps View Post
npktun ..man that fig is little confusing ..i thought nipple was at T4 and navel is at T10 but that says something else..am i missing something?
it looks a bit confusing ...because when you look at the left you are more than likely to misinterpret the vertebral numbering with the ribs numbering ... also there are two numbering one corresponds to the middle portion of the vertebral body and the other corresponds to the spinous process ....

as far as i remember nipple is more likely to be found in the 5th intercostal space thats why we often hear for the mitral valve just below/underneath it ....

not sure about the navel though ...
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Quote:
Originally Posted by npktun View Post
it looks a bit confusing ...because when you look at the left you are more than likely to misinterpret the vertebral numbering with the ribs numbering ... also there are two numbering one corresponds to the middle portion of the vertebral body and the other corresponds to the spinous process ....

as far as i remember nipple is more likely to be found in the 5th intercostal space thats why we often hear for the mitral valve just below/underneath it ....

not sure about the navel though ...
yes you are right we hear for mitral valve below the nipple in 5th ICS but according to the fig cardiac apex is above the nipple ....i guess the numbering to the left is wrong
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Old 07-26-2013
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u r right guys the answer to the above question is liver, somehow these wound questions puzzle me..
thanks for posting the diagram..
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Quote:
Originally Posted by aspiringdoc View Post
u r right guys the answer to the above question is liver, somehow these wound questions puzzle me..
thanks for posting the diagram..
i was thinkng liver till that pic totally threw me off

a)liver

its not any of the following so by process of eliminiation

b)sup vena cava
c)upper lobe right lung
d)right atrium
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i will go with liver
since righ atrium is midclavicular and ivc midclav and upper lobe of lung is too high the lower border of lung are 5midc 8 midaxillary 10 paravertebral
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i was confused between lung and liver..these questions are just so impossible..
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Old 07-27-2013
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Aspiring, have you read FA? I was looking at the respiratory chapter, and they talk about how the upper lobe of the right lung, it's bottom border is the 4th rib. This would've made answering this question easier. Wish I had read FA.
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Old 07-28-2013
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Quote:
Originally Posted by JJacobs152 View Post
Aspiring, have you read FA? I was looking at the respiratory chapter, and they talk about how the upper lobe of the right lung, it's bottom border is the 4th rib. This would've made answering this question easier. Wish I had read FA.
thanks for the info..will look that up..
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Old 08-24-2013
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i think is the liver,because in the right side the liver can rise to the 4th intercostal space and you describe that the stab was in the axilary midline,so we have to think liver or lung.
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Old 06-13-2016
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Default Been a long time

i know is a old post, but what was the answer ? xoxo
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Old 06-19-2016
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i go for liver....as of i remember. on percussion dull note of liver begins at 5th space in supine position.. upper lobe of lung ends at 4th...and right atrium.. definitely not ..for svc to damage ..the knife shud first pass through liver parenchyma..


hope im n ot wrong.. if so someone please correct
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Old 06-19-2016
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Quote:
Originally Posted by adithi usmle View Post
i go for liver....as of i remember. on percussion dull note of liver begins at 5th space in supine position.. upper lobe of lung ends at 4th...and right atrium.. definitely not ..for svc to damage ..the knife shud first pass through liver parenchyma..


hope im n ot wrong.. if so someone please correct
you are thinking of midclavicular line. In 5th ICS midaxillary line, i would go with Lung.
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Old 06-21-2016
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Quote:
Originally Posted by Ahmed1992 View Post
you are thinking of midclavicular line. In 5th ICS midaxillary line, i would go with Lung.
yeah obviously lung comes before liver ..but in 5th space either midclaviular or axillary its not the upper lobe ..but middle lobe/....i would have opted for lung if it was middle lobe
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