Operative surgery . its further employment, especially when directed to morbid statesof the anterior and middle mediastina. OPERATIOXS ox THE HEART AND PERICARDIUM. ISTot until quite recently has this field of operative effort been given theconsideration commensurate with its great importance. The Anatomical Points.—The heart corresponds in front to the lowertwo thirds of the sternum, and parts of the adjacent costal cartilages and ofsome of the left ribs. Its upper limit is at about the third costal cartilages, its apex at a point located threequarters of an inch within andone inch and a half
Operative surgery . its further employment, especially when directed to morbid statesof the anterior and middle mediastina. OPERATIOXS ox THE HEART AND PERICARDIUM. ISTot until quite recently has this field of operative effort been given theconsideration commensurate with its great importance. The Anatomical Points.—The heart corresponds in front to the lowertwo thirds of the sternum, and parts of the adjacent costal cartilages and ofsome of the left ribs. Its upper limit is at about the third costal cartilages, its apex at a point located threequarters of an inch within andone inch and a half below thenipple. It extends three inchesto the left, and about one inchand a half to the right of themedian line of the sternum. Be-hind the sternum are situatedmore than two thirds of theright ventricle, the right auricle,a large part of the left auricle. Fig. 1263.—Vertical section showing relations of and a portion of the anteriorthe heart and a considerable pericardial effu-sion to the parietes; a. Cul-de-sac. 7. Seventh costal cartilage. coronary vessels. The base ofthe heart corresponds at the backto the sixth, seventh, and eighthdorsal vertebrae. The anterior portion of the pericardium above, lies fromthree to five centimetres (one and two tenths to two inches), and belowabout one centimetre (four tenths of an inch) behind the sternum. At thebase of the pericardial sac anteriorly there is a cul-de-sac (a) of from one totwo centimetres (four to eight tenths of an inch) in depth, normally col-lapsed, but distended in the event of pericardial effusion, when it corre-sponds to the region of the sixth intercostal space (Fig. 12G3). Towardthis cul-de-sac (a) are the efforts of the operator directed in aspiration andin drainage of the pericardium. The distended pericardium extendsabove to the first space, below to the seventh cartilage, to the right fromtwo to three centimetres (eight tenths to one and two tenths inches)beyond the edge of the sternum, and to th
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
