Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . upward. The first two are given in the directionof the normal blood current and the last two in the direc-tion of a regurgitating current. The under-surface of the heart rests on the dia-phragm, which separates it from the cardiac end of thestomach and left lobe of the liver. The left ventricleand auricle and the left margin of the right ventricle arecovered by lung and pleura, the lung here being quite thin. The projection of the outline of the heart upon theanterior surface
Physical diagnosis, including diseases of the thoracic and abdominal organs : a manual for students and physicians .. . upward. The first two are given in the directionof the normal blood current and the last two in the direc-tion of a regurgitating current. The under-surface of the heart rests on the dia-phragm, which separates it from the cardiac end of thestomach and left lobe of the liver. The left ventricleand auricle and the left margin of the right ventricle arecovered by lung and pleura, the lung here being quite thin. The projection of the outline of the heart upon theanterior surface of the chest is approximately as fol-lows : A point in the fifth intercostal space three and one-half inches to the left of the median line indicates thesite of the apex. Connect this with a point on the lowerborder of the left second costal cartilage one inch to the 34 ANATOMICAL. left of its sternal end by a line gently curved, with itsconvexity to the left; then connect this last point with apoint on the upper border of the right third costal car-tilage one-half inch from its sternal end by a straight Fig. PulmonicAorticMitralTricuspid Apex Diagram showing the approximate outline of the heart and therelative location of the orifices. line, and connect this point and the apex with the rightseventh costo-sternal articulation by straight lines. The pulmonic orifice is directly behind the upper partof the third left costo-sternal articulation. The aortic orifice is behind the sternum opposite the TOPOGRAPHICAL AND RELATIONAL ANATOMY. 35 lower part of the third left costo-sternal articulation tothe left of the median line. The mitral orifice is behind the sternum opposite thefourth costo-sternal articulation, slightly to the left ofthe median line. The tricuspid orifice is behind the sternum oppositethe fourth intercostal space and in the median line.(Fig. 11.) THE AORTA. The aorta, arising at the aortic orifice, first appearsbetween the pulmonary artery and the apex of the
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