A reappraisal of pediatric thoracic surface anatomy

Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
Nicholas J FischerS Ali Mirjalili

Abstract

Accurate knowledge of surface anatomy is fundamental to safe clinical practice. A paucity of evidence in the literature regarding thoracic surface anatomy in children was identified. The associations between surface landmarks and internal structures were meticulously analyzed by reviewing high quality computed tomography (CT) images of 77 children aged from four days to 12 years. The results confirmed that the sternal angle is an accurate surface landmark for the azygos-superior vena cava junction in a plane through to the level of upper T4 from birth to age four, and to lower T4 in older children. The concavity of the aortic arch was slightly below this plane and the tracheal and pulmonary artery bifurcations were even lower. The cardiac apex was typically at the 5th intercostal space (ICS) from birth to age four, at the 4th ICS and 5th rib in 4-12 year olds, and close to the midclavicular line at all ages. The lower border of the diaphragm was at the level of the 6th or 7th rib at the midclavicular line, the 7th ICS and 8th rib at the midaxillary line, and the 11th thoracic vertebra posteriorly. The domes of the diaphragm were generally flatter and lower in children, typically only one rib level higher than its anterior level...Continue Reading

References

Jul 1, 1978·Archives of Disease in Childhood·A U AntiaO Ayeni
Aug 1, 1986·Australian Paediatric Journal·B A BlanksbyA R Morton
Aug 5, 2009·The British Journal of Radiology·R MurphyC Ferrett
Sep 11, 2010·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Samuel J M HaleMark D Stringer
Nov 9, 2010·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Govind B ChavhanJacob C Langer
May 12, 2012·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·S Ali MirjaliliMark D Stringer
Aug 14, 2012·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·S Ali Mirjalili, Mark D Stringer
Jun 3, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Xin-Hua ShenChao Ma
Sep 18, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Christine KochS Ali Mirjalili
Sep 26, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·C UzunT S Esmer
Nov 1, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Gregory P TarrS Ali Mirjalili
Nov 18, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Neda PakS Ali Mirjalili
Dec 1, 2015·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Hemanth SubramaniamS Ali Mirjalili

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Citations

Feb 14, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Thiasha NadesanAlbert N van Schoor
Sep 13, 2019·Surgical and Radiologic Anatomy : SRA·Ruchi GoyalDaisy Sahni
Apr 16, 2019·Anatomy & Cell Biology·Stefan LachkarR Shane Tubbs
Oct 19, 2021·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Umut ŞenerYasemin Durum Polat

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