Question

A 3rd-year medical student was doing her first physical exam. In order to properly place her stethoscope to listen to heart sounds, she palpated bony landmarks. She began at the jugular notch, then slid her fingers down to the sternal angle. At which rib (costal cartilage) level were her fingers?

A) 1
B) 2
C) 3
D) 4
E) Can't be determined

Answer 1

When sliding fingers down from the jugular notch to the sternal angle, the fingers would be at the second rib level, which attaches at the sternal angle and is the highest rib palpably identifiable.

Step-by-step explanation:

The student's question asks at which rib (costal cartilage) level one's fingers would be when sliding down from the jugular notch to the sternal angle. The sternal angle is a notable anatomical landmark because it is the point where the manubrium and the body of the sternum meet, forming a slight angle. Importantly, the second rib attaches to the sternum at the sternal angle.

Since the first rib is largely obscured behind the clavicle and cannot be easily felt by palpation, the second rib is the highest rib that can be palpably identified. So, when the 3rd-year medical student slides her fingers down to the sternal angle after starting at the jugular notch, her fingers would be at the level of the second rib.