. Journal - American Medical Association. n the humerus. At the lower point of this incision,where it curves along the under border of the pectoralismajor, the index finger of one hand is now shoved u]iunderneath the pectoralis major muscle and brouglit outagain at its upper border, so that the entire pectoralismuscle is thus hooked up on the index finger, and byblunt dissection separated out to its tendinous , however, one wishes to follow the suggestion of H. Mayo and leave the clavicular portion of the pecto- ralis muscle, this can easily be accomplished by bringingthe fin
. Journal - American Medical Association. n the humerus. At the lower point of this incision,where it curves along the under border of the pectoralismajor, the index finger of one hand is now shoved u]iunderneath the pectoralis major muscle and brouglit outagain at its upper border, so that the entire pectoralismuscle is thus hooked up on the index finger, and byblunt dissection separated out to its tendinous , however, one wishes to follow the suggestion of H. Mayo and leave the clavicular portion of the pecto- ralis muscle, this can easily be accomplished by bringingthe finger up through the interval, usually well marked,between the clavicular and sternal portions of the muscle,and thus the clavicular portion can be separated and leftin place. With the tendon of the pectoralis muscle thuslifted up, as shown in Figure 3, it is now divided by thescalpel very close to its insertion into the liumerus. Themuscle immediately retracts toward the chest and ex-poses, underneath, the pectoralis minor muscle invested. wing formation of in its fascia, which above runs to the clavicle and belowspreads out over the chest walls. Tiiis can easily be ex-posed by blunt dissection by the finger, which is nowlikewiseinserted under the fibers of this muscle, which isnow isolated as was the pectoralis major. It is alsoilivided (Figure 3) close to its attachment to the cora-coid process of the scapula. As to the pectoralis minor,like the pectoralis major, also retracts toward the chest, G28 /;/?/?;. I ST . I Miirr, \ iton—.i. \(kson. .T(uii{. A. M. A. the wound is held apart byretractors or by the fingersof an assistant, and the axil-lary space is now widely ex-posed to view from thefront. As a rule this expo-sure can be made withoutencountering any bleedingvessels which will requireclamp or ligature. Likewisewe now have a wide expo-sure of the axilla for thor-ough dissection, without inany way having touchedtlie breast or made any ex-tensive division of tissues. The
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Keywords: ., bookcentury1800, bookdecade188, booksubjectmedicine, bookyear1883
