2nd Intercostal Space

Second left intercostal space ics left sternal border.

2nd intercostal space. Intercostal space the area between the second and third ribs counting from the top at the mid clavicular line an imaginary line perpendicular to the ribs approximately in line with the casualty s nipple on the same side of the chest as the penetrating wound. Fifth ics left mid clavicular line. Structures in intercostal space. Bordered by the rib above and below the deep fascia of the thorax superficially and the endothoracic fascia and pleura internally the intercostal space contains essential respiratory muscles the nervous and vascular supply to the thoracic wall and.

At the second left intercostal space s 2 is generally louder shorter and sharper than s 1 s 2 has more high frequency energy than s 1 which is why dup a snappier sound than lub is used to characterize s 2. The eleven paired intercostal spaces contain the intercostal muscles nerves arteries veins and investing fascia. The pulmonic point is to the left of the sternal border in the second intercostal space. Several kinds of intercostal muscle.

Splitting best heard in the 2nd left intercostal space close to the sternal border. Slide your finger down to localize the 2nd intercostal space. The intercostal space ics is the anatomic space between two ribs lat. Since there are 12 ribs on each side there are 11 intercostal spaces each numbered for the rib superior to it.

Fourth left ics left sternal border. Use the diaphragm of your stethoscope second heart sounds are best heard when patients are semi recumbent 30 40 degrees upright and in quiet inspiration. Figure 4 5 shows the location of the second intercostal space. The aortic point is located right of the sternal border in the second intercostal space.

The angle of louis also marks the site of bifurcation of the trachea into the right and left main bronchi and corresponds with the upper border of the atria of the heart. The 2nd rib is continuous with the sternal angle. Terms used include. 2 characteristics of the first and second heart sounds.

Reference lines help pinpoint findings vertically. Third left ics left sternal border. In treating a tension pneumothorax we have traditionally been taught to place a large bore catheter in the second intercostal place 2nd ics mid clavicular line and this method is still advocated in atls guidelines. It is the obvious choice in terms of ease of anatomical location where speed is of the essence with a time critical injury.

The intensity of p2 is determined relative the a2. The sound that emits from the aortic and pulmonic points is the s2 dub of the typical lub dub heartbeat.