. Manual of operative surgery. er the most favorable circum-stances is no triviality. The bronchoscope has made a great difference in the treatment of foreignbodies in the trachea and ought to be employed but only by an expert. 243 2 44 FOREIGN BODIES IN TRACHEA OR BRONCHUS POSTERIOR BRONCHOTOMY (SCHWARTZS OPERATION) Anatomy.—The bronchi may be reached through the posterior medias-tinum, and as this region is full of vitally important structures it is necessaryto review its anatomy in a practical manner. If one excises the third to theninth dorsal vertebrae inclusive, the posterior mediastinum
. Manual of operative surgery. er the most favorable circum-stances is no triviality. The bronchoscope has made a great difference in the treatment of foreignbodies in the trachea and ought to be employed but only by an expert. 243 2 44 FOREIGN BODIES IN TRACHEA OR BRONCHUS POSTERIOR BRONCHOTOMY (SCHWARTZS OPERATION) Anatomy.—The bronchi may be reached through the posterior medias-tinum, and as this region is full of vitally important structures it is necessaryto review its anatomy in a practical manner. If one excises the third to theninth dorsal vertebrae inclusive, the posterior mediastinum will be sufficientlyexposed for study. The most superficial (posterior) structures which pre-sent are vascular, viz., to the left the aorta, to the right the azygos vein. Atthe lower part of the exposed area these vessels lie alongside each other andhide all subjacent structures. As these vessels ascend they separate, the Thyroid Com. car A Sup. lar. n. Vagus Int. jug. Inf. thyroid lar. ?-ubclav. V. Fig. 365.—(Poirier and Charpy.) aorta going to the left where at the level of the fourth dorsal vertebra it passesforwards (as the aortic arch) into the anterior mediastinum; the azygos veinascends towards the right until it bends forwards at the level of the fourth dorsalvertebra to enter the anterior mediastinum. The aorta and azygos thus form atriangle with base above, and the floor of which is formed by the apex (lower end) of the triangle is about two inches below the bifurcationof the trachea. The thoracic duct follows the inner side of the aorta and laterthe subclavian artery. The right and left pleurae approach each other betweenthe aorta and azygos behind, and the oesophagus in front. The right pleurapasses behind the oesophagus in front of the azygos so as to form a sort ofcul-de-sac (Quenu). The two pleurae are loosely connected by areolar position of the pneumogastric nerves is well seen in Fig. 365. T
Size: 1627px × 1535px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookpublisherphila, bookyear1921
