The costomediastinal recess is the potential space in the pleural cavity between the costal pleura and mediastinal pleura at approximately the level of the fifth intercostal space on the left hand side. In this area - the inferior margin of the left sternal reflection - the parietal pleura of the neighbouring surfaces comes to lie slightly anterior to the left anterior surface of the pericardium.
During inspiration, the relatively negative pressure within the pleural cavity forces the lung to expand: the costomedial recess marks the area in which the lingula expands into. During expiration, the relatively raised intrapleural pressure contracts the lung and in the region of the recess, the innermost surfaces of the apposed parietal pleura are drawn together by the surface tension of the intervening pleural fluid film.
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