한국인에 있어서 흉곽전벽의 늑골종격흉막이행선에 관한 연구

Abstract

[한글]

Study on the Lines of the Costomediastinal Pleural Reflection to the Anterior Wall

of the Chest in Korean

Don Woo Choi

Department of Anatomy, Yonsei University College of Medicine

(Director : Prof. Soo Yun Pak)

Introduction

It has long been apparent that a considerable discrepancy exists between the

traditional textbook treatment of the lines of both costomediastinal reflections to

the anterior wall of the chest and the usual findings in the dissection of the

region.

This investigation was made to determine the magnitude of this discrepancy and to

establish if possible, the topographic relations of these reflected lines from the

midline by the author's classification. Thisstudy also exhibits the mean distance

from the midline at the level of each sternochondral joint, their corresponding

extreme positions, the distribution of cases grouped around the mean, and the

character of the lines formed by both costomediastinal recesses.

Material and Method

101 Korean adult cadavers(52 male, 49 female) which were given to Department of

Anatomy. Yonsei University College of Medicine for the students from 1967 to 1972,

were used in this investigation. Following removal of the skin, fascia, and

pectoral muscles in routine dissection, both clavicles were removed at both

sterno-clavicular articulations. After the upper nine or ten ribs were cut at the

costochondral junctions on both sides, costal cartilages including the sternum were

separated and removed from the endothoracic fascia.

Then both costal pleurae were opened and the reflected margins of both

costomediastinal recesses were checked. After, the distance fromm the midline to

each reflected point at the level of each costal rib was recorded. This information

was classified into 4 types using the distance from the midline as the criteria.

Results and Conclusion

Type A, in which neither right or left reflection lines cross over the midline,

comprises 51.5%(52/101 cases).

Type B, in which both lines contact each other on the midline regardless of the

level of the costal rib, comprises 26.7%(27/101 cases).

Type C. in which the reflection lines of the right crosses over the midline to

the left side regardless of the level of the costal rib and again crosses the

midline to the right side at lower costal rib level, comprises 19.9%(20/101 cases).

Type D, the reverse of Type C, in which the reflection line of the left crosses

over the midline to the right side regardless of the level of the costal rib and

again crosses the midline to the left side at lower costal rib level, comprises

1.9%(2/101 cases).

[영문]

It has long been apparent that a considerable discrepancy exists between the traditional textbook treatment of the lines of both costomediastinal reflections to the anterior wall of the chest and the usual findings in the dissection of the region.

This investigation was made to determine the magnitude of this discrepancy and to establish if possible, the topographic relations of these reflected lines from the midline by the author's classification. Thisstudy also exhibits the mean distance from the midline at the level of each sternochondral joint, their corresponding extreme positions, the distribution of cases grouped around the mean, and the character of the lines formed by both costomediastinal recesses.

Material and Method

101 Korean adult cadavers(52 male, 49 female) which were given to Department of Anatomy. Yonsei University College of Medicine for the students from 1967 to 1972, were used in this investigation. Following removal of the skin, fascia, and

pectoral muscles in routine dissection, both clavicles were removed at both sterno-clavicular articulations. After the upper nine or ten ribs were cut at the costochondral junctions on both sides, costal cartilages including the sternum were separated and removed from the endothoracic fascia.

Then both costal pleurae were opened and the reflected margins of both costomediastinal recesses were checked. After, the distance fromm the midline to each reflected point at the level of each costal rib was recorded. This information was classified into 4 types using the distance from the midline as the criteria.

Results and Conclusion

Type A, in which neither right or left reflection lines cross over the midline, comprises 51.5%(52/101 cases).

Type B, in which both lines contact each other on the midline regardless of the level of the costal rib, comprises 26.7%(27/101 cases).

Type C. in which the reflection lines of the right crosses over the midline to the left side regardless of the level of the costal rib and again crosses the midline to the right side at lower costal rib level, comprises 19.9%(20/101 cases).

Type D, the reverse of Type C, in which the reflection line of the left crosses over the midline to the right side regardless of the level of the costal rib and again crosses the midline to the left side at lower costal rib level, comprises 1.9%(2/101 cases).