Semishrubs height 8-15 cm with thickish stem, ending buds, and short creeping sterile shoots, flowering shoots under inflorescence covered with short appressed hairs, down direction. The leaves are thick, hard, with very prominent veins on the lower side, linear, 8-15 mm long and 0.7-2.5 mm wide, sessile, dotted with glands and cilia on the edge of the base to the middle of the plate. In the axils of stem leaves are usually well-developed axillary tufts of leaves. Flowers in capitate compact inflorescences. Calyx purplish, uzkokolokolchataya, 3.5-4 mm long, bilabiate, with three small teeth Read more [...]
Fig. 5. Longitudinal section through the armpit. 1 - the neurovascular bundle, 2 - fiber axilla, 3 - fascia muscle; 4 - fascia axillaris; 5 - fascia clavipectoralis; 6 - fascia pectoralis.
Fascia cut through the middle of the width of the axillary cavity and otpreparovyvayut longitudinal cut to the front and rear boundaries of the region, without passing them (Fig. 5).
Separation from the underlying fascia fat pad performing axillary basin, meets with difficulties, as fascia closely connected with it. Therefore, the separation of the fascia should be much delay and dissect, strictly adhering Read more [...]
Fig. 4. Incision at preparing the axilla
Under the back below the shoulder blades enclose roller - of course assign a position at right angles or up. The cuts are but the lateral and medial borders of the field, should pay attention to the fact that section on the lateral border was not held too low, that is, not out on the shoulder (Fig. 4). Both are connected to longitudinal cross section in the middle of the width of the axillary basin. Otpreparovyvayut skin flaps in two wings: anterior - to the edge of the pectoralis major muscle, and posterior - to the edge of a broad back muscles. The Read more [...]
Large vessels are deep in trigonum clavipectoralis and can be shown after the penetration through the closing of its fascia coracoclavicostalis. A guide to find them is the upper edge of the small chest muscle.
Following the course of the saphenous vein beam, cut fascia clavipectoralis and a medial portion of the upper edge of the small chest muscle is the place where it flows into the axillary vein (v. axillaris). After exposure of the axillary vein revealed that it intersects the sterno-clavicular triangle in an oblique direction, coming out from under the clavicle, down and laterally under Read more [...]
Lateral to the long head of the triceps are quadrilateral hole, which by the armpit is limited: the edge of the subscapularis muscle - top, tendon broad back muscles - bottom, the tendon of the long head of triceps - palpated medial and surgical neck shoulder - laterally. In this gap are the axillary nerve and the posterior shoulder envelope artery.
A guide for finding the axillary nerve, directly above shows intermuscular interval is head shoulder, clearly palpated through the subscapularis muscle. Here the nerve trunk is well defined by touch in the form of strands, leaving the direction of Read more [...]
Fig. 8 Levels ligation axillary and brachial arteries.
Radiation nerve (N. radialis) in the axillary region is behind and somewhat medial to the axillary artery in the tissue behind the ulnar nerve, if the latter, along with the medial cutaneous nerve of the arm pull up. It can also be distinguished from other nerves, not only in position, but also by the relatively greater thickness and round shape. Radiation nerve easily detected ahead subscapular artery, if the side and pull up all the neurovascular bundle.
The main trunk of the axillary artery collateral - subscapular artery (a. suhscapularis) Read more [...]
Armpit (axillary) area (Regio axillaris)
In the study of the axillary region are guided by the following boundaries: Front - Lower edge pectoralis major muscle, behind - the bottom edge broad back muscles and a large circular muscle, medial - an imaginary line that runs along the edge and IV connecting edges of the muscles on chest cage, laterally conventional transverse line connecting the edges of the same muscles in the shoulder.
Inspection, palpation, and projection Deepening axillary Depression is caused by the presence of the suspensory ligament armpits (lig. suspensorium axillae). On examination, Read more [...]
Indirect scintigraphy parasternal lymph collectors in recent years is widely used for preoperative diagnosis of lymphatic spread of breast cancer, since the direct administration of the isotope in parasternal lymph vessels impossible, and brandy through the skin of the breast is not possible. Specially made in our clinic study (Dymarsky L. Yu, N. Fadeev, 1976) demonstrated the possibility of using this technique to image not only the parasternal, and axillary (and even supraclavicular) nodes on both sides.
Technology research. 100-150 mCi colloidal 198Au, diluted with 0.5% novocaine solution Read more [...]
Advanced sectoral resection (Removal of the sector in one block with axillary fiber) followed by irradiation of the breast and the area of regional collectors in recent years have been used widely as an alternative to radical operations (Veronesi et al., 1977). Aiming for cosmetic results, the notion of significant performance followed by radiation therapy, is able to kill any remaining tumor in the wound elements, though unlikely to be sufficient as possible counterarguments multicentric primary cancer and high susceptibility of metastatic axillary-subclavian nodes are hard to reach muscles and Read more [...]
In recent years, these techniques have become part of the arsenal of diagnostic measures to clarify the lymphatic spread of the tumor.
The value of lymph node aspiration is not in doubt, especially when considering the defeat supraclavicular node metastases, as the increase of nodes apparent metastatic lesions on palpation, often associated with inflammatory changes caused by edema or after irradiation. Equally important is the cytological diagnosis in isolated axillary nodes without increasing the defined tumor nodule in the breast. In these cases, the differentiation between the "occult" Read more [...]
Simple breast amputation cancer with or without removal of the fascia covering the pectoralis major muscle, is used not only as a palliative intervention in decaying ulcerated tumors or contraindications to mastectomy for Halstead, but as fundamentally adequate and surgery with additional radiotherapy technique McWhirter (1955). Left lymph collectors, according to the author of the method, which has many supporters, despite losing their metastases are biological barriers to tumor cells. Applied after amputation of the breast irradiation (gamma-therapy) and axillary regions nadpodklyuchichnoy Read more [...]
Estrogenoretseptory. It follows from the above characteristics of the biological activity of the primary tumor, the most important quality of the living tumor cell is its ability to unrestrained cell division. It remains unclear what stimulates the steady multiplication of cancer cells, the mechanism, the switching cells of normal tissue on the path enhanced DNA synthesis and mitosis. At the same time show that many hormones play a significant role in the division and in counting them in the period of DNA synthesis (S phase of the cell cycle) can cause genetic defects that violate the cell viability. Read more [...]
Axillary fossa (Axilla) - area bounded by the front of the pectoralis major muscle, the back - wide back muscles inside - serratus anterior muscle and the outside - the inner surface of the arm (Figure). Axillary fossa skin is thin, mobile, covered with hair, with a lot of sweat and sebaceous glands. For the subcutaneous fat layer of the superficial fascia and the remnants of the fascia, and then the fatty tissue, which lie axillary artery a vein, nerves, lymph nodes.
Inflammatory diseases of the axillary fossa gidradenity most frequent (see), there are boils. In the propagation of the inflammatory Read more [...]
The volume of surgery on the lungs depends on the type of disease. When choosing an operation should always seek to maximize the preservation of healthy lung tissue, but not at the expense of radical intervention. These principles are especially important in children. The most common operations in the lung are: removal of segment share, delete whole L., lung tissue dissection, dissection of adhesions L.
To perform radical surgery on the lung pleural cavity can be opened from the anterior-lateral, lateral or posterolateral access. Line anterior-lateral access starts at the edge III, some distance Read more [...]
Temperature body in healthy preterm infants measured two times a day - morning and evening, about 18 hours more frequent measurement is shown when overheating and febrile patients. With a significant overheating of the child (over 38 ° C) body temperature was measured every hour until it is its apparent decline. If you experience that child hot, or, with a marked malaise, sister once should measure his temperature.
Place temperature measurement are axillary and inguinal region and the rectum. Rectal measurement temperature is rarely used. The indications for this method are common diaper rash Read more [...]
Dairy gland - Paired organ located on the front of the chest wall, producing milk intended for feeding infants.
Fig. 1. The structure and topography of the breast: 1 - lateral axillary lymph node; 2 and 3 - axillary artery and Vienna; 4 - bundles of brachial plexus; 5 - central axillary lymph node; 6 - apical axillary lymph nodes; 7 - supraclavicular lymph nodes; 8 - Lateral thoracic artery and Vienna; 9 - sternal lymph nodes; 10 - plexus of blood and lymphatic vessels;11 - a branch of the internal thoracic artery to the breast; 12 - areola; 13 - milk ducts; 14 - lateral arterial branches of the Read more [...]
Axillary fossa (fossa axillaris) is bounded in front m. pectoralis major, behind - m. latissimus dorsi, medially - chest wall laterally shoulder. After removal of fat, blood vessels, nerves and lymph nodes exposed large-size cavity (cavum axillaris) Having a lower wide opening (apertura inferior cavi axillaris), Up axillary cavity narrows and reported to the neck through the aperture (apertura superior cavi axillaris) Bounded by the clavicle, I rib and the upper edge of the blade. Through the top opening in the axillary cavity penetrates the neurovascular bundle to upper extremity. On the Read more [...]