Triangle of Auscultation
By : zahraa Al-ObaidiDefinition
It is a small triangle space its diameter (3.5-4.5cm) , it is an important site and the landmark which allows for a more accurate examination of the lung and its functions due to the thinness of the muscles in this part.
The examination is done by using a stethoscope ، This is the most important step in a physical examination.
it is not covered with huge muscles, so they are thin and allow sounds to be heard.
The examination is done by using a stethoscope ، This is the most important step in a physical examination.
it is not covered with huge muscles, so they are thin and allow sounds to be heard.
Location
It is located in the posterior lateral aspect of the thorax, on the side of the medial border of scapula bone.
In the depth of triangle of auscultation there is a cardiac orifice of the stomach on the left side (esophageal opening in the stomach).
figure no 1
In the depth of triangle of auscultation there is a cardiac orifice of the stomach on the left side (esophageal opening in the stomach).
figure no 1
Function
1-helps to hear the sound of breathing, heart, lung and digestive system as well, and helps to diagnose them correctly.
2- also allows the sounds of the epics of the lower lobes of lung to be heard.
This area has a great importance even before the X-ray machines discovery , as it was done by esophagus tumors were discovered by hearing the sounds (the sound of swallowing liquids).
2- also allows the sounds of the epics of the lower lobes of lung to be heard.
This area has a great importance even before the X-ray machines discovery , as it was done by esophagus tumors were discovered by hearing the sounds (the sound of swallowing liquids).
Borders
Triangle of auscultation has three borders:
• medial border : the trapezius muscle (the lower fibers of trapezius)
• lateral border : medial border of the scapula bone.
• inferior border : Latissimus dorsi(the upper border of latissimus dorsi).
The apex is formed by the meeting of the medial and lateral borders
The floor 6th and 7th ribs, 6th intercostal space and rhomboid major muscle.
figure no2
• medial border : the trapezius muscle (the lower fibers of trapezius)
• lateral border : medial border of the scapula bone.
• inferior border : Latissimus dorsi(the upper border of latissimus dorsi).
The apex is formed by the meeting of the medial and lateral borders
The floor 6th and 7th ribs, 6th intercostal space and rhomboid major muscle.
figure no2
Examination
•In order to increase the examination accuracy and clearness, the doctor should ask the patient to sit and extend his hand forward or bend it towards the other shoulder.
•This position allows the triangle of auscultation to be expanded to hear the sound in a more clear way.
•The place must be quiet to provide the appropriate ambience for the doctor for an accurate examination, and the patient must be declared comfortable.
•It is also used to perform the rhomboid intercostal block (RIB) .
As it helps to reduce pain when a rib is broken or during a thoracotomy(an operation in which the ribs are cut to access the lung and other organs). By injecting a syringe with a level of the upper intercostal muscle and down to the rhomboid muscle.
•This position allows the triangle of auscultation to be expanded to hear the sound in a more clear way.
•The place must be quiet to provide the appropriate ambience for the doctor for an accurate examination, and the patient must be declared comfortable.
•It is also used to perform the rhomboid intercostal block (RIB) .
As it helps to reduce pain when a rib is broken or during a thoracotomy(an operation in which the ribs are cut to access the lung and other organs). By injecting a syringe with a level of the upper intercostal muscle and down to the rhomboid muscle.
References
1. Thorax-Triangle of Auscultation ; Nazish Malik; Brandon L. Tedder; Michael R. Zemaitis;National Library of Medicine; 2020-11-02; www.ncbi.nlm.nih.gov/books/NBK539834
2. Thoracotomy through the auscultatory triangle Michael D. Horowitz, MD, Nelson Ancalmo, MD, and John L. Ochsner, MD.; Department of Surgery, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana, and Division of Thoracic and Cardiovascular Surgery, University of Miami School of Medicine, Miami, Florida; (May 1989);www.annalsthoracicsurgery.org/article/0003-4975(89)90148-3
3. Surgical techniques;Gandy, Kimberly L., Hoffman, George M., Vanderwal, Patrick; Tweddell, James S.; Paediatric Cardiology (Third Edition), Philadelphia: Churchill Livingstone; retrieved 2020-11-02; pp. 219–237; www.sciencedirect.com/science/article/pii/B9780702030642000138
4. An alternative plane block for multiple rib fractures: Rhomboid Intercostal and SubSerratus block (RISS);Yayik, Ahmet Murat, Aydin, Muhammed Enes, Tekin, Erdal, Ulas, Ali Bilal, Ahiskalioglu; he American Journal of Emergency Medicine; (December 2012); /www.sciencedirect.com/science/article/abs/pii/S0735675719305789?via%3Dihub
2. Thoracotomy through the auscultatory triangle Michael D. Horowitz, MD, Nelson Ancalmo, MD, and John L. Ochsner, MD.; Department of Surgery, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, Louisiana, and Division of Thoracic and Cardiovascular Surgery, University of Miami School of Medicine, Miami, Florida; (May 1989);www.annalsthoracicsurgery.org/article/0003-4975(89)90148-3
3. Surgical techniques;Gandy, Kimberly L., Hoffman, George M., Vanderwal, Patrick; Tweddell, James S.; Paediatric Cardiology (Third Edition), Philadelphia: Churchill Livingstone; retrieved 2020-11-02; pp. 219–237; www.sciencedirect.com/science/article/pii/B9780702030642000138
4. An alternative plane block for multiple rib fractures: Rhomboid Intercostal and SubSerratus block (RISS);Yayik, Ahmet Murat, Aydin, Muhammed Enes, Tekin, Erdal, Ulas, Ali Bilal, Ahiskalioglu; he American Journal of Emergency Medicine; (December 2012); /www.sciencedirect.com/science/article/abs/pii/S0735675719305789?via%3Dihub
References of figures
interface figure : Triangle of Auscultation
http://pattayathailand.ru
figure no1 Figure triangle of auscltation image courtesy s bhimji
https://images.app.goo.gl/1pSLEVjNBYWmkEtC8
figure no2 shoulder muscles by Asklepios medical atlas
https://images.app.goo.gl/AAJzQkjpEEHr4YEu5
JaypeeDigital | eBook Readerhttps://images.app.goo.gl/V6xcHFZVfmJaLTYX8
http://pattayathailand.ru
figure no1 Figure triangle of auscltation image courtesy s bhimji
https://images.app.goo.gl/1pSLEVjNBYWmkEtC8
figure no2 shoulder muscles by Asklepios medical atlas
https://images.app.goo.gl/AAJzQkjpEEHr4YEu5
JaypeeDigital | eBook Readerhttps://images.app.goo.gl/V6xcHFZVfmJaLTYX8
