The sternal notch (suprasternal notch / jugular notch) is the midline concavity at the superior manubrium between the two clavicular notches, forming a palpable landmark for the tracheal midline and the junction of the superior mediastinum. It is bordered by the medial clavicle heads, the sternoclavicular joints, and the interclavicular ligament.
The sternal notch is the landmark for central venous line placement via the internal jugular route, where the sternocleidomastoid triangle guides needle direction toward the contralateral nipple. Sternal notch palpation confirms tracheal position in airway assessment. Mediastinal masses may expand into and distort the sternal notch. In transcervical thymectomy, the dissection proceeds behind the sternal notch into the anterior mediastinum.
Superior mediastinal tumour or lymphoma extending into the sternal notch space producing a palpable suprasternal mass with tracheal deviation, requiring CT characterisation and biopsy.
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