A 40-year-old woman presented to the office due to shortness of breath for a one-week duration. The patient complains of left-sided chest pain, exacerbated by deep inspiration. Physical examination shows diminished tactile fremitus, dullness on percussion, and diminished breath sounds over the left lower lung. Imaging shows left-sided effusion with a left lower lobe consolidation. Thoracentesis is done, where the needle is inserted at the upper border of the 10th rib in the midaxillary line. Which of the following structures is most at risk for injury in this procedure?

Question

Quizplus · Accepted Answer

Eductional Objective: The proper site of thoracentesis is necessary to minimize lung injuries. IT is performed below the 6th rib in the midclavicular line, under the 8th rib in the midaxillary line, or the 10th rib in the paravertebral line. Needles inserted lower than the 9th rib maximize the risk of injuring abdominal structures. Thoracentesis needles should be inserted along the upper border of the rib to prevent intercostal vessels injury.

A 40-Year-Old Woman Presented to the Office Due to Shortness