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Sternal pleural reflection

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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