By J. Joseph MD, DSc, FRCOG (auth.)
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Extra info for A Textbook of Regional Anatomy
X-rays relevant to the lungs are described at the end of the section on the heart. The Heart The pericardium The heart is surrounded by a double fold of serous membrane, the serous pericardium, which is inside a dense connective tissue sac, the fibrous pericardium. The fibrous pericardium can be compared with a bag in which the heart lies. The mouth of the bag is superior and fuses with the walls of the large vessels emerging from and entering the upper part of the heart (figure 21). The fibrous pericardium is attached below to the central tendon of the diaphragm, anteriorly to the sternum, and above to the pretracheal fascia.
This may be seen in spontaneous and artificial pneumothorax (air in the pleural cavity). Quiet expiration is largely a passive act and is due to elastic recoil of the lungs. In some diseases of the lungs their elasticity is lost and the result is that deep breathing is impossible because the lungs cannot be stretched and compressed sufficiently in deep inspiration and expiration. The terms thoraco-abdominal and abdominathoracic were used to describe two types of respiration. In the former the chest wall moved more than the abdominal wall, that is the diaphragm, and in the latter the reverse occurred.
From the sixth costal cartilage, the lower and posterior borders of the left lung and pleura have the same surface markings as those of the right. The oblique fissure of both lungs begins posteriorly at about the spinous process of the third thoracic vertebra (at the level of the spine of the scapula) and follows the sixth rib round the chest wall to the costal margin. The transverse fissure of the right lung is indicated by a horizontal line corresponding with the fourth right costal cartilage and rib from the sternum to where it meets the oblique fissure, usually about the midaxillary line.