THE SHOULDER 1149 



Thoracic 



First. Summit of arch of subclavian (Godlee). 



Second. Level of episternal notch. This is usually opposite the fibro-cartilage 

 l)et"\veen the second and third. Bifurcation of innominate (Ciodlee). 



Third. Level of junction between the manubrium and tlie fjladiolus. This is 

 sometimes opposite the tifth. Lowest limit of superior mediastinum. Bifurca- 

 tion of trachea. Beginning of superior cava. Highest part of aortic arch. 



Fourth. Second piece of aortic arch reaches spine. Arch of vena azygos major. 



Fifth. Termination of tiiird piece of aortic arch. 



Fifth to eighth. Base of heart. 



Sixth. Pulmonary and aortic valves. Commencement of aorta and pulmonary 

 artery. End of superior cava. 



Seventh. Mitral orifice. 



Eighth. Tricuspid orifice. 



Ninth. Lower level of manubrium. Openings in diaphragm for inferior vena 

 cava and oesophagus. Upper limit of spleen. 



Tenth. Level of tip of xiphoid cartilage. Lower limit of lung posteriorly. 

 Upper limit of liver comes to the surface posteriorly. (Esophagus passes through 

 diaphragm. Cardiac orifice of stomach. 



ICleventh. Lower border of spleen. Suprarenal capsule. 



Twelfth. Lowest part of pleura. Aorta passes through diaphragm (upper 

 border). Coeliac axis (lower border). Pylorus. Upper border of kidney. 



LUMB.\R 



First. Pancreas. Pelvis of kidney. Renal arteries (ending). 



Second. Spinal cord ends at junction of first and second. Third piece of 

 duodenum. Receptaculum chyli. Lower end of left kidney. 



Third. L^mbilicus, opposite fibro-cartilage, between this and fourth. Lower 

 end of right kidney. Lower limit of liver on right side. 



Fourth. Bifurcation of aortic arch. Highest part of iliac crest. 



Fifth. Commencement of superior vena cava. 



Sacral 



Third. End of first piece of rectum. Lower limit of spinal membranes. 

 Coccyx (tip). End of second piece of rectum. 



SUPERFICIAL AXATOMY OF THE UPPER LIMB 



THE SHOULDER 



The following surface-marks, of the greatest importance in determining the 

 nature of shoulder injuries, can be made out \\vi\- : — The clavicle in its whole 

 extent, the acromion process, the great tuberosity, and upper part of the 

 shaft of the humerus. Much h'ss distinctly, the position of the coracoid 

 process and tlif head of the humerus can be made out. The anterior margin 

 of the clavicle, convex internally and concave externally, can be made out in its 

 whole extent, the bone, if traced outwards, being found not to be horizontal, but 

 rising somewhat to its junction with the acromion. The tip of this process, when 

 the arm hangs by the side, is in the same line as the external condyle and the 

 styloid process of the radius. On the inner side, the head and internal condyle of 

 the humerus and the styloid process of the ulna are in the same line. Thus the 



