Surface projections of the heart

  1. Apex — 5th intercostal space 8-10 cm to left relative to the midline, or can be either left 5th intercostal space 1-2 cm medial to the midclavicular line (imaginary line crosses vertically to the clavicle), the second position is also the position for palpation of the apex beat, called punctum maximum, or the point of maximum impulse (PMI)
  2. Right coronary groove –2cm 6th costal cartilage lateral to the sternal at the right side
  3. Left coronary groove — 3rd costal cartilage 3cm to the left laterally to the sternum
  4. SVC drainage into the right atrium –right 3rd costal cartilage at the parasternal line

Valves — Locations for auscultation

During routine examinations, the physician can listen to different parts of the cardiovascular system using a stethoscope.

The following locations are used for listening to the heart sounds (or more accurately the closing and opening of the cardiac valves, and are referred to as the punctum maximum — latin for maximal impulse):

  1. Aortic valve — Right 2nd intercostal space 2cm parasternally
  2. Pulmonary trunk — Left 2nd intercostal space parasternally
    • The most superficial valve (closest to the chest wall)
  3. Tricuspid valve — Right 4th intercostal space parasternally, another way to find the tricuspid is at the left 4-5th intercostal space parasternally
  4. Bicuspid (Mitral) valve —  Left 5th intercostal space

Subscribe now to continue reading

Join hundreds of successful students who use Meddists to ace their exams.

Gain access to all of the material and topics, custom-made just for you.

Continue