Median sternotomy
Approach
- Expose as to examine the chest
- Inspect
- Median sternotomy scar runs from suprasternal notch vertically in the midline to the xiphisternum
- Subtotal median sternotomy involves an incision from the sternomanubrial junction to the 5-6th intercostal space
- Palpate
- Occassionally there is non-union of the two sides of themanuibrium sternum thena "click" can be felt on palpation
- Unless there is co-morbidity, rest of thoracic examination should be normal
- Percuss
- Auscultate
Indications for median sternotomy
- Emergency
- Following penetrating chest trauma
- Cardiac surgery
- Resection of lung cancer
- Elective
