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A 52-Year-Old Woman Was Admitted to the Hospital with a Diagnosis

Question 5

Multiple Choice

A 52-year-old woman was admitted to the hospital with a diagnosis of right-sided pleurisy with pneumonia. It was decided to remove a sample of pleural fluid from her pleural cavity. The resident inserted the needle close to the lower border of the eighth rib in the anterior axillary line. The next morning he was surprised to hear that the patient had complained of altered skin sensation extending from the point where the needle was inserted downward and forward to the midline of the abdominal wall above the umbilicus.
-The altered skin sensation in this patient after the needle thoracostomy could be explained by which?


A) The needle was inserted too low down in the intercostal space.
B) The needle was inserted too close to the lower border of the eighth rib and damaged the eighth intercostal nerve.
C) The needle had impaled the eighth rib.
D) The needle had penetrated too deeply and pierced the lung.
E) There is a peritoneal abscess beneath the diaphragm on the left side.

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