. Cunningham's Text-book of anatomy. Anatomy. 1402 SUEFACE AND SUKGICAL ANATOMY On the right side the posterior mediastinal pleura, as it passes from the posterior aspect of the pericardium, backwards, to the front of the vertebral column, sweeps over the ri^ht side of the oesophagus; hence malignant ulcers of the oesophagus are more likely to invade the right pleui-a than the left. On the left side the posterior mediastinal pleura passes from the lateral aspect of the bodies of the vertebrae on to the left side of the aorta. Hence, to evacuate pus from the posterior mediastinum, there is less
. Cunningham's Text-book of anatomy. Anatomy. 1402 SUEFACE AND SUKGICAL ANATOMY On the right side the posterior mediastinal pleura, as it passes from the posterior aspect of the pericardium, backwards, to the front of the vertebral column, sweeps over the ri^ht side of the oesophagus; hence malignant ulcers of the oesophagus are more likely to invade the right pleui-a than the left. On the left side the posterior mediastinal pleura passes from the lateral aspect of the bodies of the vertebrae on to the left side of the aorta. Hence, to evacuate pus from the posterior mediastinum, there is less risk of opening the pleura if the space is entered from the left side of the vertebral column. The seat of election for tapping the pleura {para- centesis pleural) is the sixth or seventh costal interspace, a little in front of the posterior axillary fold. To allow of the introduction of a tube to drain away the pus from the pleural cavity in empyema, a por- tion of one of the ribs (sixth to ninth) is resected. The intercostal vessels and nerves, which lie in the groove at the inferior border of the rib, are avoided by remov- ing the portion of bone subperioste- al^. If the chest is opened in the scapular line, care must be taken not to resect either the seventh or the eighth ribs, which are exposed when the arm is elevated, but are overlapped by the inferior angle of the scapula when the arm is lowered. Anteriorly, the bifurcation of the trachea lies opposite, or a little below, the angulus sterni, while pos- (From Cunningham.) teriorly it lies a little below the level of the root of the spine of the scapula, opposite the fourth thoracic spine. The bifurcation takes place one vertebra higher in the infant than in the adult (Symington). The septum between the right and the left bronchus lies a little to the left of the middle of the trachea, and the right bronchus is wider and more nearly in a line with the trachea than the left bronchus; hence the greater tendency of foreign
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanatomy, bookyear1914
