So we’ll now move to interrogating the anterior superior thoracic space, and this is not going to be good for effusion since effusions are inferior, but it does allow us to interrogate the pleural line, both for pneumothorax and for interstitial fluid from something like pulmonary edema or alveolar interstitial syndrome. We can use either the linear probe or the phased array probe, typically the linear probe is going to give us more detail of the pleural line for something like pneumothorax, but the phased array can be quite good for determining artifacts such as b lines that again we’ll talk about with alveolar interstitial syndrome.
So starting with the linear probe, were going to take the probe and point the indicator towards the head just below at the midclavicular line and when you do this you’re using the rib as a land mark, we’re cutting across the rib- here you can see the rib with the rib shadow and just at the back of the rib is that pleural line and that is showing the sliding between the visceral and parietal pleura that goes on with normal lung.
Here’s a labeled still image where you can see the rib, the rib shadow, and that pleural line. In the upper right hand corner you can see that motion which again represents normal sliding of the visceral against the parietal pleura.