Atlas And Textbook of Topographic And Applied Anatomy

Cover Atlas And Textbook of Topographic And Applied Anatomy
Atlas And Textbook of Topographic And Applied Anatomy
Oskar Schultze
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) It is at this point that the deposition of a considerable quantity of pericardial exudate may press upon the esophagus and produce dysphagia. By irritation of the vagus nerve (Fig. 51) pericarditis in this situation may also cause vomiting, hiccough, and paralysis of the vocal cords. This practical and important relation will be referred to again when we discuss the esophagus in detail.
THE MEDIASTINUM.
Ill Not less important is the fact that a comparatively small area of the pericardium is i
...n im- mediate contact anteriorly with the inner surface of the thoracic wall. This place is situated where the two anterior pleural limits diverge close to the left sternal border from the fifth to the seventh costal cartilage. In withdrawing fluid from the pericardial cavity it is best to make the puncture in the fifth intercostal space close to the sternal margin. If the puncture is made further to the left, there is danger of injuring the left pleural sac.
A knowledge of the relation of the pericardium to the thoracic wall is also necessary when it is desired to open retrosternal abscesses or to remove tumors from behind the sternum by a partial resection of this bone, since the pleural and pericardial cavities should not be clumsily nor unnecessarily opened.


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