A system of surgery : pathological, diagnostic, therapeutic, and operative . lene muscle towards the first surgeon, standing by the side of thepatient, above the shoulder, stretchesthe integuments of the neck upon theupper part of the chest with the fingersof the left hand, while with the otherhe makes an incision, about two inchesand a half in length, directly along themiddle of the clavicle, commencing atthe sternal origin of the mastoidmuscle and terminating near the ante-rior margin of the trapezius. In thismanner he divides the skin, superficialfascia, and platysma-myoid. Lettingg
A system of surgery : pathological, diagnostic, therapeutic, and operative . lene muscle towards the first surgeon, standing by the side of thepatient, above the shoulder, stretchesthe integuments of the neck upon theupper part of the chest with the fingersof the left hand, while with the otherhe makes an incision, about two inchesand a half in length, directly along themiddle of the clavicle, commencing atthe sternal origin of the mastoidmuscle and terminating near the ante-rior margin of the trapezius. In thismanner he divides the skin, superficialfascia, and platysma-myoid. Lettinggo his hold with his left hand, theparts will be found instantly to resume their natural situation, leaving thus the incision on a level with the superiorborder of the clavicle. The next step of the operation consists in detachingfrom this bone the deep cervical aponeurosis, which may readily be accomplishedby a few gentle strokes of the handle of the scalpel instead of the point of theinstrument, which would greatly endanger the surrounding vessels and I.—48. Ligation of the subclavian artery, in its outer third. 754 DISEASES AND INJUEIES OF AKTERIES. chap. v. The external jugular vein will be found close to the outer edge of the mastoidmuscle, and should be held out of the way with a blunt hook. The supra-scapu-lar artery will also generally appear, at this stage of the proceeding, just aboveand behind the clavicle, or partially covered by it, and should be treated in asimilar manner; or, if divided, it should immediately be tied. The omo-hyoid liesat the outside of the incision, bound down by a process of the cervical aponeu-rosis, which should next be torn through with the knife. Taking the anteriorscalene muscle for his guide, the operator feels for the tubercle of the first rib, alittle to the outside of which the artery will be found pulsating, more or less dis-tinctly, and where it may in general be easily secured by passing the needlefrom before backwards
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Keywords: ., bookcentury1800, booksubjectgeneralsurgery, booksubjectsurgery
