Which of the following anatomic landmark associations is correct?
A) 2nd intercostal space for needle insertion in tension pneumothorax
B) T6 for lower margin of endotracheal tube
C) Sternal angle marks the 4th rib
D) 5th intercostal space for chest tube insertion
A) 2nd intercostal space for needle insertion in tension pneumothorax
The 2nd intercostal space is indeed the correct location for insertion of a needle in tension pneumothorax. The other answers are incorrect. T4 marks the approximate bifurcation of the trachea and therefore marks the inferior limit for an endotracheal tube on chest X-ray. The sternal angle marks the 2nd rib, which helps establish the 2nd interspace for needle insertion as above or locations for cardiac auscultation (aortic and pulmonary areas). Finally, the 4th intercostal space is normally used for chest tube insertion.
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