. American practice of surgery ; a complete system of the science and art of surgery . areas uncovered by pleura: the superior lies behindthe manubrium, with the apex at the level of the second costal cartilage, andcorresponds to the situation of the thymus gland; the inferior is in direct contactwith the under surface of the sternum and some of the costal cartilages. Theapex of the latter is on a level with the fourth rib, and the base is situated atthe upper extremity of the ensiform. For the purpose of obtaining som3 defi-nite knowledge with regard to the width of this triangle, we made ele
. American practice of surgery ; a complete system of the science and art of surgery . areas uncovered by pleura: the superior lies behindthe manubrium, with the apex at the level of the second costal cartilage, andcorresponds to the situation of the thymus gland; the inferior is in direct contactwith the under surface of the sternum and some of the costal cartilages. Theapex of the latter is on a level with the fourth rib, and the base is situated atthe upper extremity of the ensiform. For the purpose of obtaining som3 defi-nite knowledge with regard to the width of this triangle, we made eleven observa-tions on the cadaver. At a level with the fifth costal cartilage the averagewidth was from 4 to 5 cm.; but that the space is very variable in width is shownby the measurements, it being 8 cm. in one case, and 1 cm. in another. In thecase with a width of 1 cm., the edge of the left pleura just reached the border ofthe sternum. In two other cases, in which the widths were 3 and 4 cm., respec-tively, the left pleura reached nearly to the edge of the sternum. In the remain-. FiG. 62.—Diagram Showing Average Situationof the Pleural Culs-de-Sac and Borders of theLungs. (1) Cardiac notch of left lung; (2) Inferiorinterpleural triangle. Heavy Une represents out^line of lung; doited Une, outUne of pleura. (Ter-rier and Reymond, Chirurgie du cceut et dup^ricarde, Paris, 1898.) 148 AMERICAN PRACTICE OF SURGERY. ing cases the border of the pleura was located at some distance from the right pleura in every instance reached beneath the sternum. It is veryrare that the right pleura comes from beneath the sternum above the seventhrib, and the left border of the pleura may not come from beneath the sternumuntil the sixth rib is reached. Therefore, a wound of the heart to the right ofthe sternum will almost invariably traverse the pleural cavity, while woundsnear the left edge of the sternum may or may not traverse the pleura, accordingto the disposition of the left bor
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectsurgery, bookyear1906
