1. =Thoracic Cavity.= Presence of gas or air (pneumothorax,
infections with colon bacillus, gas-forming bacillus, proteus,
etc.), relative degree of pressure, odor, etc. Measure contents of
each pleural sac; note character of fluid (clear, turbid, bloody,
chyliform, chylous, purulent, fibrino-purulent). Normally the pleuræ
are moist-shining, smooth, grayish, transparent; only a few drops
of fluid found in the cavities. In cases of slowly progressive
cardiac insufficiency large amounts of clear fluid may collect in
the cavities just before death. Non-inflammatory collections of
fluid also occur in general œdema. In these conditions the pleuræ
are not cloudy or dull, while in the case of inflammation the
pleural surfaces are dry, cloudy, dull-shining, injected, rough
or covered with fibrinous or purulent exudate. Examine pleural
surfaces particularly for evidences of inflammation, recent and old
tuberculosis, primary and secondary neoplasms (carcinoma).
2. =Position of Thoracic Organs.= Locate anterior borders of lungs,
apex and borders of heart. The normal lung collapses after the
removal of the sternum. How much of the pericardial sac is left
uncovered by the lungs?
3. =Anterior Mediastinum.= Note character of connective-tissue,
amount and color of fat-tissue, number and size of lymphnodes,
occurrence of œdema or emphysema. An artificial œdema may be caused
by the injection of large quantities of salt solution in the pectoral
region just before death. An artificial emphysema may be produced by
the removal of the sternum. The condition of the large veins in the
upper portion of the mediastinum should be noted before the heart
is removed. Are they lax, moderately full, or distended? Secondary
tumors, hemorrhages, abscesses, œdema and emphysema are the most
common pathologic conditions.
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