Identification of the apex: Located at the 5th intercostal space in the midclavicular line, left of the sternum. Easily located by counting down the ribs from the collarbone otherwise known as the...

Identification of the apex: Located at the 5th intercostal space in the midclavicular line, left of the sternum. Easily located by counting down the ribs from the collarbone otherwise known as the clavicle. The clavicle counts as rib one because the first rib lies underneath it making it inaccessible. Once you have counted down and located the fifth rib, the fifth intercostal space will be between that rib and the sixth rib (Figure 4.3). This landmark is important for the recording of electrocardiograms (ECG) and listening to heart sounds. Practise finding and feeling this area. If you have a willing companion, ask them to undertake some aerobic exercise then locate the area again. When the heart contracts with increased power to meet the intensified cellular demands associated with physical exercise, the heart can be easily felt pounding against the chest wall.

Figure 4.3