The procedure for locating the second intercostal space (ICS) is to first locate
a. Erb's point. c. the apical impulse.
b. the angle of Louis. d. the xiphoid process.
B
To locate the second ICS, first locate the angle of Louis. Lightly place your finger on this angle. Then move your finger laterally to the right of the sternum to the rib. This is the second rib. Move your finger down beneath the second rib to the ICS which is the second intercostal space. You would first locate Erb's point in order to locate the third ICS. The apical impulse, which used to be called the point of maximum impulse, is a pulsation created as the left ventricle rotates against the chest wall during systole. When visible, it occupies the fourth or fifth ICS, inside the midclavicular line.
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