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Where do we insert the needle?
Do you insert needle over the top of the rib or below the rib?

User JoCa
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1 Answer

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Final answer:

The needle should be inserted just above the superior border of the rib to avoid injury to the intercostal vessels and nerve. The quadrants approach is a commonly used method to identify the area for needle insertion, dividing the abdominal cavity into four regions for simplicity.

Step-by-step explanation:

When performing a procedure involving the insertion of a needle into the thoracic cavity, it is important to understand the correct anatomical landmarks to avoid injury to the intercostal vessels and nerve. The standard practice is to insert the needle just above the superior border of the rib. This technique is used because the intercostal vessels and nerve run along the inferior border of each rib, within the costal groove. Therefore, inserting a needle over the top of the rib helps to minimize the risk of puncturing these structures.

To locate the appropriate insertion site, medical professionals often use the quadrants approach, identifying the area of interest based on the intersection of horizontal and vertical lines drawn through the patient's navel. This approach divides the abdominal cavity into four sections, simplifying the identification of the region that requires attention. For thoracic procedures, however, the more detailed regional approach may be considered, which involves dividing the cavity into nine regions using additional lines below the ribs and above the pelvis, and vertical lines from the midpoints of the clavicles.

It is important to avoid the rib itself, as going over the top of the rib can potentially cause damage to the lung or other internal structures.

The subcostal approach is commonly used for procedures such as liver biopsies, where access to the liver is needed. By going below the rib, the needle can be inserted safely and accurately without causing harm.

User Trismi
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