Which finding from your inspection of a patient's thorax is normal?
a. a costal angle of 95°
b. ribs at a 45° angle with the sternum
c. bulging of intercostal spaces
d. dilated superficial veins on the anterior chest wall
B
From inspection of the patient's thorax, a normal finding is ribs articulating at a 45° angle with the sternum. The costal angle should be less than 90° during exhalation and at rest. Bulging of intercostal spaces is abnormal; it tends to occur with expiration. This finding occurs when there is an obstruction to the free exhalation of air, such as in emphysema, asthma, an enlarged heart, aortic aneurysm, etc. Dilated superficial veins on the anterior chest wall are abnormal; they should not be visible. This finding may indicate superior vena cava obstruction.
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