Sternal pleural reflection
The sternal pleural reflection is the junction of costal pleura and anterior margin of mediastinal pleura:
- on the right, sequentially from:
- lung apex to
- deep surface of sternoclavicular joint to
- inner surface of sternum at level of sternal angle to
- right posterolateral margin of xiphisternum
- on the left, sequentially from:
- lung apex to
- deep surface of sternoclavicular joint to
- inner surface of sternum at level of fourth costal cartilage, then passing laterally to
- posterior surface of fourth intercostal space then inferiorly to
- posterior margin of sixth costal cartilage
Hence, the left sternal reflection is displaced laterally by the cardiac margin; this length of the reflection is termed the cardiac notch.
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