Operative surgery . Fig. 12G4.—Composite normal interpleuralspace of Voinitch-Sianojentsky. a. Re-sultant line of greatest safety, b. Me-dian line. 5, 6, 7. Fifth, sixth, andseventh costal Fig. —Internal mammary artery lyingon triangularis sterni muscle, a. Muscle. of the interpleural space, while a double jDleurisy with effusion diminishesthe space and presses the pericardium backward. In abdominal distentionthe diaphragm or lower boundary of the interpleural space is pushed upward,so that a puncture of the fifth space might enter the abdominal cavity. Apericardia
Operative surgery . Fig. 12G4.—Composite normal interpleuralspace of Voinitch-Sianojentsky. a. Re-sultant line of greatest safety, b. Me-dian line. 5, 6, 7. Fifth, sixth, andseventh costal Fig. —Internal mammary artery lyingon triangularis sterni muscle, a. Muscle. of the interpleural space, while a double jDleurisy with effusion diminishesthe space and presses the pericardium backward. In abdominal distentionthe diaphragm or lower boundary of the interpleural space is pushed upward,so that a puncture of the fifth space might enter the abdominal cavity. Apericardial effusion, other things being equal, tends to increase the size ofthe interpleural space. The anterior pleural folds are loosely adherent tothe pericardium, from which they can be stripped, but intimately bound tothe triangularis sterni, from which they can not be separated. A ridge ofdense cellulo-adipose tissue designates the line of pleural reflection. The tri-angularis sterni underlies the sternum and costal cartilages. Upon it reststhe internal mammary artery (Fig. 1265), which above lies from one half toone and a half centimetres (two to six tenths of an inch), and below fromone to two
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Keywords: ., bo, bookcentury1800, bookdecade1890, bookidoperativesurgery02brya
