Surface Marking 2-1

Surface marking
Heart borders
Right border
• Put a point 1.2 cm from the margin of sternum on the upper border
of the
• right 3rd costal cartilage
• Put a point in the right fourth interspace 3.7 cm from the median
plane
• Mark the end of the right sixth costal cartilage
• Draw a line joining these points with a gentle convexity to the right
Lower border
• Put a point on the end of the right sixth costal cartilage
• Mark the xiphisternal junction
• Locate the apex beat
• Draw a line joining these points
Heart borders
Left border
• Mark the apex beat
• Put a point 1.2 cm from the sternal margin on
the lower border of the left second costal
cartilage
• Join these points by a line with an upward
convexity
Upper border
• Join the upper ends of the right and left borders
Surface marking of lungs
Apex
• Put a point in the neck 2.5 cm above the medial third of the clavicle.
• Draw a convex line upwards through this point
Anterior Border
Right lung
• Mark the right sterno-clavicular joint
• Put a mark on the midpoint of the sternal angle
• Mark the sixth right chondro-sternal junction
• Join these points to represent the anterior margin of right lung
Left lung
• Mark the left sterno-clavicular joint
• Put a mark on the midpoint of the sternal angle
• Mark the fourth left chondro-sternal junction
• Put another point on the sixth costal cartilage 2.5 cm from the left margin of the
sternum
• Join these points by a line which becomes concave between the last two points to
Fissures & Lobes of lungs
Oblique Fissures
• Put a point 2 cm lateral to the second thoracic spine.
• Mark a point 3 cm lateral to and at the level of the nipple
• Put another point on the 6th costal cartilage 7.5 cm from the median plane
• The upper part of the fissure can be drawn by a line joining the first two points or
following the vertebral border of the scapula when the corresponding hand of the
subject has been placed on the back of the head
The second and third points can then be joined by continuing this line on the front of
the chest, downwards and medially
Transverse Fissure of the Right Lung
• Put a point in the median plane at the level of 4th costal cartilage
• Draw the midaxillary line
• Join the first point to the mid-axillary line by a transverse line along the right fourth
costal cartilage
Surface marking of pluera
Lines of Pleural Reflection
Right Costo-mediastinal Reflection
• Mark the sterno-clavicular joint
• Put another mark on the mid-point of the sternal angle
• Mark the xiphisternal joint
• Draw a line joining these points
Left Costo-mediastinal Reflection

• Mark the mid-point of sternal angle
• Put another point in the midline at the level of left fourth costal cartilage
• Draw a line to join the first three points then carry it to the left to reach the sternal
margin and follow that margin to reach the left extremity of xiphisternal joint
Surface marking of pluera
Costo-diaphragmatic Reflection
• Draw the mid-clavicular line and put a mark where it passes over the 8th
rib
• Draw the mid-axillary line and mark the point where it crosses the 10th rib
• Mark the tip of the twelfth costal cartilage or the lateral border of the
sacrospinalis muscle
• Put a point 2 cm lateral to the upper border of the twelfth thoracic spine
• Draw a line joining these points. On the right side the pleura descends
below the costal margin in the right xiphocostal angle
Cervical Pleura
• Put a point on the junction of the medial and middle-third of the clavicle
• Put another point between the above two points but 3.5 cm above the
clavicle
McBurney’s point
• McBurney's point is situated at the junction of the outer and middle
third of a line drawn from the right anterior superior iliac spine to the
umbilicus
• This point corresponds to the usual seat of maximum pain on
palpation in an attack of appendicitis
Liver
Upper border
• Put a point a little below the right nipple
• Mark a point a little below and medial to the left nipple
• Draw a line through the xiphisternal joint ascending to
the right point and ascending less sharply to the left
point
Right Border
• Put a point 1 cm just below the tip of the right tenth
costal cartilage
• Draw a convex line from below the right nipple to the
Liver
Lower border
• Draw the median and transpyloric planes
• Mark the tip of the right ninth costal cartilage
• Join the lower end of the right border to the left end of the
upper border by a line crossing the median plane at the
transpyloric plane
• This border should show a slight notch opposite the tip of
the ninth right costal cartilage for the fundus of gall bladder
Renal angle
Pterion
• Pterion is neither a visible nor a palpable surface landmark
• Its centre can be located approximately 3.5 cm behind and 1.5 cm
above the fronto-zygomatic suture
• It can also be located by placing the thumb behind the frontal process
of the zygomatic bone and two fingers above the zygomatic arch
• The angle thus formed lies on pterion
Parotid gland
• For anterior border join the following points:

• Mark the upper border of the mandibular condyle
• Take a point a little above the centre of the masseter muscle
• Mark another point 2 cm below and behind the angle of mandible
• Upper border is drawn by a curved line below the external
auditary meatus acrossthe lobule of the ear and joining the
following points:
• Upper border of the mandibular condyle
• Mastoid process
• Posterior border is a straight line joining
• The apex of mastoid process
• A point 2 cm below and behind the angle of mandible
Parotid gland and duct
Brachial artery
• Put a point on the pulsation of the lower part of axillary artery on the
medial side of the arm, just in front of the posterior axillary fold
• Mark a point at the level of the neck of the radius in the middle line of
the limb.
• Join these points to get the surface marking
Radial artery
• Mark a point opposite the neck of radius on the medial side of
tendon of biceps
• Put a mark on the pulsation of radial artery at the wrist in the interval
between the tendon of flexor carpi radialis medially and the
prominent lower part of the anterior border of the radius laterally
• Put a mark on its pulsation in the 'anatomical snuff box‘
• Join the first two points by a line running downwards across the
medial part of the brachioradialis, and superficial extensor's elevation
• The second and third points are joined by a line passing backwards
across to the tendons forming the anterior boundary of 'anatomical
snuff box' towards the base of the first interosseous space
Dorsalis pedis artery
• Put a point between two malleoli
• Put a point at the proximal end of first intermetatarsal space
• Join these two points
Great saphenous vein
• Mark the pubic tubercle
• Put a point 4cm below and lateral to the pubic tubercle to
represent centre of saphenous opening
• Put a point a little below the centre of saphenous opening
• Put a point on adductor tubercle
• Put a point on the medial border of tibia at the junction of
its upper 2/3rd & lower 1/3rd
• Put a point on anterior surface medial malleollus
• Put a point on the dorsum of foot at the medial end of
dorsal venous arch
Cephalic vein
• Put a point in the delto-pectoral groove below
the coracoid process
• Mark a point in front of the elbow in the
groove between the brachioradialis and biceps
• Join these points by a line which first ascends
up and then arches towards the first point

Surface Marking 2-1

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Surface Marking 2-1

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Surface marking

Left Costo-mediastinal Reflection

• For anterior border join the following points:

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