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Normally counting of ribs is done from second costal cartilage at sternal angle.
The CT scan demonstrated that the tip of the right thoracostomy tube was wedged at the right lower costal sternal angle, while the left thoracostomy tube was in an intraparenchymal position (Figure 1B).
23) This places the hypothenar eminence more caudal to the sternal angle, which is a better position for efficacious compressions over the sternal body and heart, especially if the role of hand dominance is considered.