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NBME 21 Answers

nbme21/Block 4/Question#22

A 57-year-old woman is brought to the emergency ...


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 +4  upvote downvote
submitted by burak(21),

Pleural space: Midcavicular line: 6-8th ribs Midaxillary line: 8-10th ribs Paravertebral line: 10-12nd ribs

So physician must insert a needle in 8-10th ribs in midaxillary line; but insertion below the 9th rib still has a risk to damage abdominal organs such as liver. Upper border of 9th rib is fine.

Uw question ID: 844

et-tu-bromocriptine  Visual aid that may seem familiar: https://imgur.com/a/JRrN8XH +8  
burak  thanks! +  
madojo  Make sure you don't do a midclavicular or mid axillary thoracentesis on the LEFT like me or else you'll hit the spleen.... +1  
pwaddlecakes  @madojo bet you'll never get a question like this one wrong ever +  

 +1  upvote downvote
submitted by lizard(6),

Inserting the needle into the 9th intercostal space, midaxillary line during expiration will avoid the inferior border of the lung.

lizard  Midclavicular line--> 7th intercostal space Paravertebral --> 10th intercostal space. +5