Tension Pneumothorax & ICC

Current · V5 (2025) → C1.v Historical · V4 (2023) → X.iii 4 exam appearances

2024B Q18

Exam question

Describe the anatomy relevant to the insertion of an intercostal catheter.

CICMWrecks answer

Master answer

Triangle of safety
- Lateral border of pectoralis major
- Anterior border of latissimus dorsi
- Superior to the 5^th intercostal space – be aware the diaphragm (and liver/spleen) may be unexpectedly superior
Layers (Superficial → Deep)
- Skin
- Subcutaneous connective tissue
- Fat
- Ribs and intercostal muscles
  - Neurovascular bundle (intercostal artery, vein and nerves) lie in intercostal groove on infero-interior surface of the ribs
  - External intercostal muscle
  - Internal intercostal muscle
  - Innermost intercostal muscle
- Parietal pleura
- Potential pleural space (pneumothorax)
- Visceral pleura
- Lung

Sakurai / Mooney 2016

Answer by Mooney, Sakurai

Past papers

4 appearances

Exam	Exact exam wording	Candidate success
2024B Q18	Describe the anatomy relevant to the insertion of an intercostal catheter.	36%
2018B Q11	Describe the anatomy relevant to the insertion of an intercostal catheter.	56%
2013A Q14	Describe the relevant anatomy for insertion of an intercostal catheter. (60% of marks) How does breathing 100% oxygen help in the resolution of a pneumothorax? (40% of marks)	—
2010B Q06	Outline the physiological consequences of a tension pneumothorax. (60% of marks) Describe the anatomy relevant to the insertion of an intercostal catheter. (40% of marks)	60%