Operative surgery, for students and practitioners . om the inner end of this incision another is carriedupward along the posterior edge of the sterno-mastoid for a sufficientdistance to give free access to the space. The incision goes throughthe skin and fat layers down to the deep fascia. The lower endof the external jugular vein, just before it pierces the deep cervicalfascia, may be exposed and may require ligation. Next, the deepfascia is incised when the gland mass is exposed. The gland massmust be enucleated by blunt dissection with the finger or with theblunt-pointed, curved scissors, w
Operative surgery, for students and practitioners . om the inner end of this incision another is carriedupward along the posterior edge of the sterno-mastoid for a sufficientdistance to give free access to the space. The incision goes throughthe skin and fat layers down to the deep fascia. The lower endof the external jugular vein, just before it pierces the deep cervicalfascia, may be exposed and may require ligation. Next, the deepfascia is incised when the gland mass is exposed. The gland massmust be enucleated by blunt dissection with the finger or with theblunt-pointed, curved scissors, working all the time very cose tothe surface of the gland mass, and occasionally snipping connective-tissue strands that show when traction is made on the gland is made on and the adjacent structures slowlyand deliberately peeled away from it. During the course of theenucleation some branches of the transverse cervical and the sub-scapular veins will be seen. These may be pushed aside or they may OPERATIONS UPON THE NECK. 243. Fig. 140.—Incisions for Gaining Access to the Various Triangles of the , cricoid cartilage; U., hyoid bone; , isthmus of the thyroid gland; T.,thyroid cartilage. 1-2, for glands situated along the anterior border of thesterno-mastoid muscle and along the course of the internal jugular vein; 1-3,for opening up the submaxillary triangle; 2, for ligation of the common caro-tid artery, etc.; 4, for glands along the posterior border of the sterno-mastoidmuscle; 4-5, for glands situated in the subclavian triangle; 5, for ligation of thesubclavian artery. 344 NECK AND TONGUE. be divided or torn and will require ligation. After the mass hasbeen removed there will be exposed, in the bottom of the rather deepwound, the cords of the brachial plexus, the subclavian artery restingupon the first rib, and the dome of the pleura. The phrenic nervepasses obliquely across the front of the tendon of the scalenus anticusinto the thorax. Usua
Size: 1362px × 1835px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookauthormcgrathj, bookcentury1900, bookdecade1910, bookyear1913
