Diseases of the chest, throat and nasal cavities : including physical diagnosis and diseases of the lungs, heart and aorta, laryngology and diseases of the pharynx, larynx, nose, thyroid gland, and œsophagus / by E. Fletcher Ingals.

  • Ingals, E. Fletcher (Ephraim Fletcher), 1848-1918.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the chest, throat and nasal cavities : including physical diagnosis and diseases of the lungs, heart and aorta, laryngology and diseases of the pharynx, larynx, nose, thyroid gland, and œsophagus / by E. Fletcher Ingals. Source: Wellcome Collection.

    35/710 (page 7)
    erally by the borders of the bone. This region contains lung tissue. Superficially, the inner or anterior margin of each lung reaches the median line. Deeper, we find the descending vena cava, the ascending, the transverse, and a part of the descending portion of the arch of the aorta, and at the left a portion of the pulmonary artery. At a point opposite the second costo-sternal junction is the bifurcation of the trachea. The inferiok-steenal region, known also as the sternal region, has for its boundaries the borders of all that portion of the sternum lying below the third rib. In it the anterior margin of the right lung corresponds to the median line, and is superficially situated. But the corresponding margin of the left lung recedes from the median line at the level of the fourth rib, passing outward and downward, leaving a triangular space between it and the margin of the right lung. In this space the right ventricle of the heart is superficial. In the upper part of this region we find a large portion of the right auricle and the origin of both the aorta and the pulmonary artery. The portions of the left side of the heart which present anteriorly lie to the left of this region. In this region we find portions of the four sets of valves which guard the orifices of the heart (Fig. 1). At the left edge of the sternum, under the third rib, are the pulmonary valves ; a trifle lower, beneath the centre of the sternum, are located the aortic valves; lower yet, at its left border in the third intercostal space, we find the mitral valves. We locate the tricuspid valves beneath the middle of the sternum on a line with the fourth costo-sternal articulation. These valves lie so closely that a circle scarcely more than an inch in diameter will include all of them, and a circle of half that diameter will embrace a portion of each. At the lower part of this region we have a portion of the liver and of the attachment of the pericardium to the diaphragm. The mesosternal line is an imaginary line passing down the centre of the sternum. The parasternal lines correspond on each side to the borders of the sternum. Posteriorly are the supra-scapular and the scapular regions on each side, extending from the second to the seventh rib and corresponding very nearly to the outlines of the scapula when the patient's arms are hanging loosely by his sides (Fig. 2). The supra-scapular region corresponds to the supra-spinous fossa. It is occupied by lung tissue. The scapular region corresponds to the infra-spinous fossa. It is occupied by Iting tissue. The inter-scapular region lies between the borders of the scapulae divided by the spinous processes of the vertebrae, and extends from the level of the second dorsal vertebra to the level of the seventh. It con- tains lung substance, the main bronchi, and the bronchial glands. The