DOCSLIB.ORG

Clinical Anatomy a Revision and Applied Anatomy for Clinical Students

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Clinical Anatomy a Revision and Applied Anatomy for Clinical Students Clinical Anatomy A revision and applied anatomy for clinical students HAROLD◊ ELLIS CBE, MA, DM, MCh, FRCS, FRCOG, FACS (Hon) Clinical Anatomist, Guy’s, King’s and St Thomas’ School of Biomedical Sciences; Emeritus Professor of Surgery, Charing Cross and Westminster Medical School, London; Formerly Examiner in Anatomy, Primary FRCS (Eng) TENTH◊ EDITION Blackwell Science To my wife and late parents © 1960, 1962, 1966, 1969, 1971, 1977, 1983, 1992, 1997, 2002 by Blackwell Science Ltd a Blackwell Publishing Company Blackwell Science, Inc., 350 Main Street, Malden, Massachusetts 02148-5018, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Science Asia Pty Ltd, 550 Swanston Street, Carlton South Victoria 3053, Australia Blackwell Wissenschafts Verlag, Kurfürstendamm 57, 10707 Berlin, Germany The right of the Author to be identified as the Author of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First published 1960 Seventh edition 1983 Second edition 1962 Revised reprint 1986 Reprinted 1963 Eighth edition 1992 Third edition 1966 Ninth edition 1997 Fourth edition 1969 Reprinted 2000 Fifth edition 1971 Tenth edition 2002 Sixth edition 1977 Reprinted 2003, 2004 Reprinted 1978, 1980 Greek edition 1969 Library of Congress Cataloging-in-publication Data Ellis, Harold, 1926– Clinical anatomy: a revision and applied anatomy for clinical students/ Harold Ellis—10th ed. p. cm. Includes bibliographical references and index. ISBN 0-632-05195-7 (pbk.) 1. Human anatomy. I. Title. QM23.2 .E43 2002 611—dc21 2001056590 ISBN 0-632-05195-7 A catalogue record for this title is a available from the British Library Set in Hong Kong by SNP Best-set Typesetter Ltd Printed and bound in India by Replika Press PVT Ltd For further information on Blackwell Publishing, visit our website: www.blackwellpublishing.com Contents Preface, xi Acknowledgements, xii Part 1:◊ The Thorax Surface anatomy and surface markings, 3 ◊◊Surface markings of the more important thoracic contents, 4 The thoracic cage, 7 ◊◊The thoracic vertebrae, 8 ◊◊The ribs, 8 ◊◊The costal cartilages, 11 ◊◊The sternum, 11 ◊◊The intercostal spaces, 12 ◊◊The diaphragm, 14 ◊◊The pleurae, 19 The lower respiratory tract, 20 ◊◊The trachea, 20 ◊◊The bronchi, 24 ◊◊The lungs, 24 The mediastinum, 29 ◊◊The pericardium, 29 ◊◊The heart, 31 ◊◊The superior mediastinum, 44 ◊◊The oesophagus, 44 ◊◊The thoracic duct, 48 ◊◊The thoracic sympathetic trunk, 50 On the examination of a chest radiograph, 52 ◊◊Radiographic appearance of the heart, 53 Part 2:◊ The Abdomen and Pelvis Surface anatomy and surface markings, 59 ◊◊Vertebral levels, 59 ◊◊Surface markings, 60 The fasciae and muscles of the abdominal wall, 61 ◊◊Fasciae of the abdominal wall, 61 iv Contents ◊◊The muscles of the anterior abdominal wall, 62 ◊◊The anatomy of abdominal incisions, 64 ◊◊The inguinal canal, 67 Peritoneal cavity, 70 ◊◊Intraperitoneal fossae, 73 ◊◊The subphrenic spaces, 73 The gastrointestinal tract, 74 ◊◊The stomach, 74 ◊◊The duodenum, 80 ◊◊Small intestine, 82 ◊◊Large intestine, 83 ◊◊The appendix, 84 ◊◊The rectum, 86 ◊◊Arterial supply of the intestine, 91 ◊◊The portal system of veins, 93 ◊◊Lymph drainage of the intestine, 94 ◊◊The structure of the alimentary canal, 95 ◊◊The development of the intestine and its congenital abnormalities, 96 The gastrointestinal adnexae: liver, gall-bladder and its ducts, pancreas and spleen, 99 ◊◊The liver, 99 ◊◊The biliary system, 104 ◊◊The gall-bladder, 106 ◊◊The pancreas, 108 ◊◊The spleen, 110 The urinary tract, 112 ◊◊The kidneys, 112 ◊◊The ureter, 116 ◊◊The embryology and congenital abnormalities of the kidney and ureter, 117 ◊◊The bladder, 120 ◊◊The urethra, 122 The male genital organs, 124 ◊◊The prostate, 124 ◊◊The scrotum, 127 ◊◊Testis and epididymis, 127 ◊◊Vas deferens (ductus deferens), 132 ◊◊The seminal vesicles, 133 The bony and ligamentous pelvis, 133 ◊◊The os innominatum, 133 ◊◊The sacrum, 134 Contents v ◊◊The coccyx, 136 ◊◊The functions of the pelvis, 136 ◊◊Joints and ligamentous connections of the pelvis, 136 ◊◊Differences between the male and female pelvis, 137 ◊◊Obstetrical pelvic measurements, 138 ◊◊Variations of the pelvic shape, 140 The muscles of the pelvic floor and perineum, 142 ◊◊The anterior (urogenital) perineum, 143 ◊◊The posterior (anal) perineum, 145 The female genital organs, 147 ◊◊The vulva, 147 ◊◊The vagina, 148 ◊◊The uterus, 149 ◊◊The Fallopian tubes, 155 ◊◊The ovary, 156 ◊◊The endopelvic fascia and the pelvic ligaments, 157 ◊◊Vaginal examination, 159 ◊◊Embryology of the Fallopian tubes, uterus and vagina, 160 The posterior abdominal wall, 161 ◊◊Clinical features, 162 ◊◊The suprarenal glands, 163 ◊◊Abdominal aorta, 163 ◊◊Inferior vena cava, 165 ◊◊Lumbar sympathetic chain, 165 Part 3:◊ The Upper Limb The female breast, 171 ◊◊Structure, 171 ◊◊Blood supply, 171 ◊◊Lymphatic drainage, 171 ◊◊Development, 173 ◊◊Clinical features, 174 Surface anatomy and surface markings of the upper limb, 175 ◊◊Bones and joints, 175 ◊◊Muscles and tendons, 176 ◊◊Vessels, 178 ◊◊Nerves, 180 The bones and joints of the upper limb, 181 ◊◊The scapula, 181 ◊◊The clavicle, 181 ◊◊The humerus, 182 vi Contents ◊◊The radius and ulna, 184 ◊◊The bones of the hand, 187 ◊◊The shoulder, 189 ◊◊The elbow joints, 194 ◊◊The wrist joint, 197 ◊◊The joints of the hand, 198 The arteries of the upper limb, 201 ◊◊The axillary artery, 201 ◊◊The brachial artery, 201 ◊◊The radial artery, 202 ◊◊The ulnar artery, 203 The brachial plexus, 203 ◊◊The segmental cutaneous supply of the upper limb, 207 The course and distribution of the principal nerves of the upper limb, 207 ◊◊The axillary nerve, 207 ◊◊The radial nerve, 207 ◊◊Branches, 209 ◊◊The musculocutaneous nerve, 209 ◊◊The ulnar nerve, 209 ◊◊The median nerve, 210 The anatomy of upper limb deformities, 212 The spaces of the hand, 216 ◊◊The superficial pulp space of the fingers, 216 ◊◊The ulnar and radial bursae and the synovial tendon sheaths of the fingers, 217 Part 4:◊ The Lower Limb The anatomy and surface markings of the lower limb, 223 ◊◊Bones and joints, 223 ◊◊Bursae of the lower limb, 224 ◊◊Mensuration in the lower limb, 224 ◊◊Muscles and tendons, 227 ◊◊Vessels, 229 ◊◊Nerves, 231 The bones and joints of the lower limb, 233 ◊◊The os innominatum, 233 ◊◊The femur, 233 ◊◊The patella, 239 ◊◊The tibia, 240 Contents vii ◊◊The fibula, 242 ◊◊A note on growing ends and nutrient foramina in the long bones, 242 ◊◊The bones of the foot, 243 ◊◊The hip, 243 ◊◊The knee joint, 247 ◊◊The tibiofibular joints, 251 ◊◊The ankle, 251 ◊◊The joints of the foot, 252 ◊◊The arches of the foot, 253 ◊◊The anatomy of walking, 255 Three important zones of the lower limb— the femoral triangle, adductor canal and popliteal fossa, 256 ◊◊The femoral triangle, 256 ◊◊The fascia lata, 256 ◊◊The femoral sheath and femoral canal, 257 ◊◊Femoral hernia, 258 ◊◊The lymph nodes of the groin and the lymphatic drainage of the lower limb, 259 ◊◊The adductor canal (of Hunter) or subsartorial canal, 260 ◊◊The popliteal fossa, 261 The arteries of the lower limb, 263 ◊◊Femoral artery, 263 ◊◊Popliteal artery, 265 ◊◊Posterior tibial artery, 265 ◊◊Anterior tibial artery, 266 The veins of the lower limb, 267 ◊◊Clinical features, 268 The course and distribution of the principal nerves of the lower limb, 269 ◊◊The lumbar plexus, 269 ◊◊The sacral plexus, 271 ◊◊The sciatic nerve, 273 ◊◊The tibial nerve, 275 ◊◊The common peroneal nerve, 275 ◊◊Segmental cutaneous supply of the lower limb, 277 Part 5:◊ The Head and Neck The surface anatomy of the neck, 281 ◊◊The fascial compartments of the neck, 282 The thyroid gland, 284 ◊◊The parathyroid glands, 288 viii Contents The palate, 290 ◊◊The development of the face, lips and palate with special reference to their congenital deformities, 291 The tongue and floor of the mouth, 293 ◊◊The tongue, 293 ◊◊The floor of the mouth, 297 The pharynx, 298 ◊◊The nasopharynx, 298 ◊◊The oropharynx, 300 ◊◊The palatine tonsils, 300 ◊◊The laryngopharynx, 302 ◊◊The mechanism of deglutition, 303 The larynx, 306 ◊◊Blood supply, 308 ◊◊Lymph drainage, 309 ◊◊Nerve supply, 309 ◊◊Clinical features, 309 The salivary glands, 311 ◊◊The parotid gland, 311 ◊◊The submandibular gland, 314 ◊◊The sublingual gland, 315 The major arteries of the head and neck, 316 ◊◊The common carotid arteries, 316 ◊◊The external carotid artery, 316 ◊◊The internal carotid artery, 318 ◊◊The subclavian arteries, 321 The veins of the head and neck, 323 ◊◊The cerebral venous system, 323 ◊◊The venous sinuses of the dura, 324 ◊◊The internal jugular vein, 326 ◊◊The subclavian vein, 328 The lymph nodes of the neck, 330 ◊◊Clinical features, 331 The cervical sympathetic trunk, 332 ◊◊Clinical features, 333 The branchial system and its derivatives, 333 ◊◊Branchial cyst and fistula, 334 Contents ix The surface anatomy and surface markings of the head, 335 The scalp, 336 The skull, 338 ◊◊Development, 340 ◊◊Clinical features, 341 The accessory nasal sinuses, 342 ◊◊The frontal sinuses, 342 ◊◊The maxillary sinus (antrum of Highmore), 343 ◊◊The ethmoid sinuses, 345 ◊◊The sphenoid sinuses, 345 The mandible, 346 ◊◊The temporomandibular joint, 347 ◊◊The teeth, 348 The vertebral column, 349 ◊◊The cervical vertebrae, 350 ◊◊The thoracic vertebrae, 352 ◊◊The lumbar vertebrae, 352 ◊◊The
Load more

Recommended publications
  • METHODICAL GUIDANCE for the Lecture Academic Subject Human
    Ministry of Public Health of Ukraine Ukrainian Medical Stomatological Academy "Approved" at the meeting of the Department of Human Anatomy «29» 08 2020 Minutes № Head of the Department Professor O.O. Sherstjuk ________________________ METHODICAL GUIDANCE for the lecture Academic subject Human Anatomy Module No 3 "The heart. Vessels and nerves of the head, the neck, the trunk, extremities" Lecture No 15 Review of the autonomic nervous system, its central departments. The principles of the autonomic innervation of the organs Year of study ІI Faculty Foreign students' training faculty, specialty «Medicine» Number of 2 academic hours Poltava – 2020 1. Educational basis of the topic The autonomic division of peripheral nervous system regulates physiological processes of the human organism like blood circulation, respiration, digestion, excretion and general metabolism; also, it regulates tissue trophic processes. The autonomic division acts relatively independently from the cerebral cortex and the organs supplied act involuntarily as well. It is quite clear that that distinguishing of the somatic and the autonomic compartments is conditional and exact delimitation is not possible. Such impossibility appears due to common regulatory centers for both divisions and tight morphological and functional associations featured by them. The somatic neurons and the interneurons of PNS like those of CNS feature topographical and synaptic associations so a reflex arc may comprise both somatic (e.g. afferent) and autonomic neurons. Summarizing the aforesaid, the term ’autonomic nervous system’ will be applied to a specific compartment of PNS but not for a separate nervous system. 2. Learning objectives of the lecture: . to familiarize students with the autonomic division of CNS; .
    [Show full text]
  • Human Physiology/The Male Reproductive System 1 Human Physiology/The Male Reproductive System
    Human Physiology/The male reproductive system 1 Human Physiology/The male reproductive system ← The endocrine system — Human Physiology — The female reproductive system → Homeostasis — Cells — Integumentary — Nervous — Senses — Muscular — Blood — Cardiovascular — Immune — Urinary — Respiratory — Gastrointestinal — Nutrition — Endocrine — Reproduction (male) — Reproduction (female) — Pregnancy — Genetics — Development — Answers Introduction In simple terms, reproduction is the process by which organisms create descendants. This miracle is a characteristic that all living things have in common and sets them apart from nonliving things. But even though the reproductive system is essential to keeping a species alive, it is not essential to keeping an individual alive. In human reproduction, two kinds of sex cells or gametes are involved. Sperm, the male gamete, and an egg or ovum, the female gamete must meet in the female reproductive system to create a new individual. For reproduction to occur, both the female and male reproductive systems are essential. While both the female and male reproductive systems are involved with producing, nourishing and transporting either the egg or sperm, they are different in shape and structure. The male has reproductive organs, or genitals, that are both inside and outside the pelvis, while the female has reproductive organs entirely within the pelvis. The male reproductive system consists of the testes and a series of ducts and glands. Sperm are produced in the testes and are transported through the reproductive ducts. These ducts include the epididymis, ductus deferens, ejaculatory duct and urethra. The reproductive glands produce secretions that become part of semen, the fluid that is ejaculated from the urethra. These glands include the seminal vesicles, prostate gland, and bulbourethral glands.
    [Show full text]
  • Developmental Venous Anomaly: MR and Angiographic ­Features
    JBR–BTR, 2014, 97: 17-20. DEVELOPMENTAL VENOUS ANOMALY: MR AND ANGIOGRAPHIC FEATURES M. Faure1, M. Voormolen1, T. Van der Zijden1, P.M. Parizel1 Developmental venous anomaly (DVA) is probably the most common anomaly of the intracranial vasculature. DVAs consist of multiple, radially oriented dilated medullary veins that converge into a transcerebral vein. We describe the imaging findings of this vascular anomaly in different patients and the role of different imaging modalities. Key-words: Cerebral blood vessels, abnormalities – Cerebral blood vessels, MR – Cerebral angiography. Developmental venous anomaly (DVA) was first considered a rare vascular malformation (1, 2). Nowa- days, with the advent of Computed Tomography (CT) and especially Magnetic Resonance Imaging (MRI), DVAs are seen every week to month by radiologists (3, 4). Most DVAs are solitary, asymptomatic lesions and are discovered incidentally. They have a relatively benign nature with a low incidence of hemorrhage. When they do bleed, this is thought to be due to associated vascular mal- formations, like cavernous angiomas. The typical angiographic appearance of a DVA is a caput medusae appear- ance in the venous phase. MRI com- bined with MR angiography (MRA) replaces angiography in most un- A B complicated cases as a non-invasive alternative (3, 5). Case reports Case 1 A 32-year-old woman presented with headache, with no particular location and no neurological deficit. MRI of the brain was made in another hospital that showed a flow void running transcerebral, suggestive for a vascular malformation (Fig. 1A,B). Initially, there was no gadolinium contrast given and an arterial feeder could thus not be excluded with MRI.
    [Show full text]
  • Gross Anatomy
    www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY www.BookOfLinks.com Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the infor- mation contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. www.BookOfLinks.com THE BIG PICTURE GROSS ANATOMY David A. Morton, PhD Associate Professor Anatomy Director Department of Neurobiology and Anatomy University of Utah School of Medicine Salt Lake City, Utah K. Bo Foreman, PhD, PT Assistant Professor Anatomy Director University of Utah College of Health Salt Lake City, Utah Kurt H.
    [Show full text]
  • Autonomic Nervous System
    AUTONOMIC NERVOUS SYSTEM PAGE 1 AUTONOMIC NERVOUS SYSTEM PAGE 2 AUTONOMIC NERVOUS SYSTEM PAGE 3 AUTONOMIC NERVOUS SYSTEM PAGE 4 AUTONOMIC NERVOUS SYSTEM PAGE 5 AUTONOMIC NERVOUS SYSTEM PAGE 6 AUTONOMIC NERVOUS SYSTEM PAGE 7 AUTONOMIC NERVOUS SYSTEM PAGE 8 AUTONOMIC NERVOUS SYSTEM PAGE 9 REVIEW QUESTIONS 1. The autonomic nervous system controls the activity of _?_. (a) smooth muscle (b) cardiac muscle (c) glands (d) all of these (e) none of these 2. All preganglionic and postganglionic autonomic neurons are _?_ neurons. (a) somatic efferent (b) visceral efferent (c) somatic afferent (d) visceral afferent (e) association neurons 3. Which neurotransmitter is released at the synapses between preganglionic and postganglionic autonomic neurons ? (a) epinephrine (b) norepinephrine (c) acetylcholine (d) serotonin (e) oxytocin 4. All preganglionic sympathetic neurons are located in: (a) the lateral horn of the spinal cord of spinal cord segments T1-L2 (b) brainstem nuclei (c) intramural (terminal) ganglia (d) paravertebral ganglia of the sympathetic chains (e) prevertebral ganglia 5. All preganglionic parasympathetic neurons are located in _?_. (a) prevertebral ganglia (b) the lateral horn of spinal cord segments T1-L2 (c) sympathetic chain ganglia (d) intramural ganglia (e) brainstem nuclei and spinal cord segments S2-S4 6. Prevertebral and paravertebral ganglia contain _?_. (a) preganglionic sympathetic neurons (b) preganglionic parasympathetic neurons (c) postganglionic sympathetic neurons (d) postganglionic parasympathetic neurons (e) all of these 7. The otic, ciliary, submandibular and pterygopalatine ganglia are located in the head region and contain _?_. (a) preganglionic sympathetic neurons (b) preganglionic parasympathetic neurons (c) postganglionic sympathetic neurons (d) postganglionic parasympathetic neurons (e) none of these 8.
    [Show full text]
  • Scrotal Ultrasound
    Scrotal Ultrasound Bruce R. Gilbert, MD, PhD Associate Clinical Professor of Urology & Reproductive Medicine Weill Cornell Medical College Director, Reproductive and Sexual Medicine Smith Institute For Urology North Shore LIJ Health System 1 Developmental Anatomy" Testis and Kidney Hindgut Allantois In the 3-week-old embryo the Primordial primordial germ cells in the wall of germ cells the yolk sac close to the attachment of the allantois migrate along the Heart wall of the hindgut and the dorsal Genital Ridge mesentery into the genital ridge. Yolk Sac Hindgut At 5-weeks the two excretory organs the pronephros and mesonephros systems regress Primordial Pronephric system leaving only the mesonephric duct. germ cells (regressing) Mesonephric The metanephros (adult kidney) system forms from the metanephric (regressing) diverticulum (ureteric bud) and metanephric mass of mesoderm. The ureteric bud develops as a dorsal bud of the mesonephric duct Cloaca near its insertion into the cloaca. Mesonephric Duct Mesonephric Duct Ureteric Bud Ureteric Bud Metanephric system Metanephric system 2 Developmental Anatomy" Wolffian and Mullerian DuctMesonephric Duct Under the influence of SRY, cells in the primitive sex cords differentiate into Sertoli cells forming the testis cords during week 7. Gonads Mesonephros It is at puberty that these testis cords (in Paramesonephric association with germ cells) undergo (Mullerian) Duct canalization into seminiferous tubules. Mesonephric (Wolffian) Duct At 7 weeks the indifferent embryo also has two parallel pairs of genital ducts: the Mesonephric (Wolffian) and the Paramesonephric (Mullerian) ducts. Bladder Bladder Mullerian By week 8 the developing fetal testis tubercle produces at least two hormones: Metanephros 1. A glycoprotein (MIS) produced by the Ureter Uterovaginal fetal Sertoli cells (in response to SRY) primordium Rectum which suppresses unilateral development of the Paramesonephric (Mullerian) duct 2.
    [Show full text]
  • A Pocket Manual of Percussion And
    r — TC‘ B - •' ■ C T A POCKET MANUAL OF PERCUSSION | AUSCULTATION FOB PHYSICIANS AND STUDENTS. TRANSLATED FROM THE SECOND GERMAN EDITION J. O. HIRSCHFELDER. San Fbancisco: A. L. BANCROFT & COMPANY, PUBLISHEBS, BOOKSELLEBS & STATIONEB3. 1873. Entered according to Act of Congress, in the year 1872, By A. L. BANCROFT & COMPANY, Iii the office of the Librarian of Congress, at Washington. TRAN jLATOR’S PREFACE. However numerou- the works that have been previously published in the Fi 'lish language on the subject of Per- cussion and Auscultation, there has ever existed a lack of a complete yet concise manual, suitable for the pocket. The translation of this work, which is extensively used in the Universities of Germany, is intended to supply this want, and it is hoped will prove a valuable companion to the careful student and practitioner. J. 0. H. San Francisco, November, 1872. PERCUSSION. For the practice of percussion we employ a pleximeter, or a finger, upon which we strike with a hammer, or a finger, producing a sound, the character of which varies according to the condition of the organs lying underneath the spot percussed. In order to determine the extent of the sound produced, we may imagine the following lines to be drawr n upon the chest: (1) the mammary line, which begins at the union of the inner and middle third of the clavicle, and extends downwards through the nipple; (2) the paraster- nal line, which extends midway between the sternum and nipple ; (3) the axillary line, which extends from the centre of the axilla to the end of the 11th rib.
    [Show full text]
  • Autologous Unilateral Breast Reconstruction with Venous Supercharged IMAP-Flaps: a Step by Step Guide of the Split Breast Technique
    Journal of Clinical Medicine Article Autologous Unilateral Breast Reconstruction with Venous Supercharged IMAP-Flaps: A Step by Step Guide of the Split Breast Technique , Kathrin Bachleitner * y, Laurenz Weitgasser y, Amro Amr and Thomas Schoeller Department of Hand, Breast, and Reconstructive Microsurgery, Marienhospital Stuttgart, 70199 Stuttgart, Germany; [email protected] (L.W.); [email protected] (A.A.); [email protected] (T.S.) * Correspondence: [email protected]; Tel.: +49-711-6489-7202 Both authors contributed equally to this work. y Received: 13 August 2020; Accepted: 18 September 2020; Published: 20 September 2020 Abstract: Various techniques for breast reconstruction ranging from reconstruction with implants to free tissue transfer, with the disadvantage of either carrying a foreign body or dealing with donor site morbidity, have been described. In patients who had a unilateral mastectomy and offer a contralateral mamma hypertrophy a breast reconstruction can be performed with the excess tissue from the hypertrophic side using the split breast technique. Here a local internal mammary artery perforator (IMAP) flap of the hypertrophic breast can be used for reconstruction avoiding the downsides of implants or a microsurgical reconstruction and simultaneously reducing the enlarged donor breast in order to achieve symmetry. Methods: Between April 2010 and February 2019 the split breast technique was performed in five patients after mastectomy due to breast cancer. Operating time, length of stay, complications and the need for secondary operations were analyzed and the surgical technique including flap supercharging were described in detail. Results: All five IMAP-flaps survived and an aesthetically pleasant result could be achieved using the split breast technique.
    [Show full text]
  • Vocabulario De Morfoloxía, Anatomía E Citoloxía Veterinaria
    Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) Servizo de Normalización Lingüística Universidade de Santiago de Compostela COLECCIÓN VOCABULARIOS TEMÁTICOS N.º 4 SERVIZO DE NORMALIZACIÓN LINGÜÍSTICA Vocabulario de Morfoloxía, anatomía e citoloxía veterinaria (galego-español-inglés) 2008 UNIVERSIDADE DE SANTIAGO DE COMPOSTELA VOCABULARIO de morfoloxía, anatomía e citoloxía veterinaria : (galego-español- inglés) / coordinador Xusto A. Rodríguez Río, Servizo de Normalización Lingüística ; autores Matilde Lombardero Fernández ... [et al.]. – Santiago de Compostela : Universidade de Santiago de Compostela, Servizo de Publicacións e Intercambio Científico, 2008. – 369 p. ; 21 cm. – (Vocabularios temáticos ; 4). - D.L. C 2458-2008. – ISBN 978-84-9887-018-3 1.Medicina �������������������������������������������������������������������������veterinaria-Diccionarios�������������������������������������������������. 2.Galego (Lingua)-Glosarios, vocabularios, etc. políglotas. I.Lombardero Fernández, Matilde. II.Rodríguez Rio, Xusto A. coord. III. Universidade de Santiago de Compostela. Servizo de Normalización Lingüística, coord. IV.Universidade de Santiago de Compostela. Servizo de Publicacións e Intercambio Científico, ed. V.Serie. 591.4(038)=699=60=20 Coordinador Xusto A. Rodríguez Río (Área de Terminoloxía. Servizo de Normalización Lingüística. Universidade de Santiago de Compostela) Autoras/res Matilde Lombardero Fernández (doutora en Veterinaria e profesora do Departamento de Anatomía e Produción Animal.
    [Show full text]
  • Supplementary File 1
    Supplementary File Table S1 Checklist for Documentation of Google Trends research. a) Initial list of pain locations and factors related to pain Name Matched as topic related to pain (not disease diagnosis) Head & Neck Headache / Head Pain Yes, „Headache” Eye pain Yes „Eye pain” Nose pain No Ear pain Yes, „Ear pain” Toothache Yes, „Toothache” Tongue pain No Lip pain No Sore Throat Yes, „Sore Throat” Neck pain Yes, „Neck pain” Trunk Chest pain / Heart pain Yes, „Chest pain” Breast pain Yes, „Breast pain” Abdominal pain / Stomache Yes, „Abdominal pain” Epigastric pain Yes, „Epigastric pain” Umbilical pain No Flank pain Yes, „Abdominal pain” Hypogastrium pain No Groin pain Yes, „Groin pain” Back pain Yes, „Back pain” Low back pain / Lumbar pain Yes, „Low back pain” Pelvic region Pelvic pain Yes, „Pelvic pain” Penis pain Yes, „Penile pain” Testicular pain / Pain of balls Yes, „Testicular pain” Rectum pain / Anal pain Yes, „Rectum pain” Limbs Shoulder pain Yes, „Shoulder pain” Clavicle pain No Arm pain No Forearm pain No Wrist pain Yes, „Wrist pain” Hand pain / Palm pain No Thigh pain No Buttock pain No Knee pain Yes, „Knee pain” Calf pain / Calf cramps No Podalgia / Feet pain Yes, „Podalgia” Factors Dysmennorhea / Painful Yes, „Dysmenorrhea” mennorhea Dyspareunia / Sex during Yes, „Dyspareunia” intercourse Odynophagia / Pain during Yes, „Odynophagia” swallowing Pain during breathing No Pain during walking No b) Search details Section/Topic Checklist item Search Variables Access Date 22 July 2019 Time Period From January 2004 to date of the
    [Show full text]
  • Head & Neck Surgery Course
    Head & Neck Surgery Course Parapharyngeal space: surgical anatomy Dr Pierfrancesco PELLICCIA Pr Benjamin LALLEMANT Service ORL et CMF CHU de Nîmes CH de Arles Introduction • Potential deep neck space • Shaped as an inverted pyramid • Base of the pyramid: skull base • Apex of the pyramid: greater cornu of the hyoid bone Introduction • 2 compartments – Prestyloid – Poststyloid Anatomy: boundaries • Superior: small portion of temporal bone • Inferior: junction of the posterior belly of the digastric and the hyoid bone Anatomy: boundaries Anatomy: boundaries • Posterior: deep fascia and paravertebral muscle • Anterior: pterygomandibular raphe and medial pterygoid muscle fascia Anatomy: boundaries • Medial: pharynx (pharyngobasilar fascia, pharyngeal wall, buccopharyngeal fascia) • Lateral: superficial layer of deep fascia • Medial pterygoid muscle fascia • Mandibular ramus • Retromandibular portion of the deep lobe of the parotid gland • Posterior belly of digastric muscle • 2 ligaments – Sphenomandibular ligament – Stylomandibular ligament Aponeurosis and ligaments Aponeurosis and ligaments • Stylopharyngeal aponeurosis: separates parapharyngeal spaces to two compartments: – Prestyloid – Poststyloid • Cloison sagittale: separates parapharyngeal and retropharyngeal space Aponeurosis and ligaments Stylopharyngeal aponeurosis Muscles stylohyoidien Stylopharyngeal , And styloglossus muscles Prestyloid compartment Contents: – Retromandibular portion of the deep lobe of the parotid gland – Minor or ectopic salivary gland – CN V branch to tensor
    [Show full text]
  • Venous Angiomas of the Brain A
    - REVIEW ARTICLE systems," Venous angiomas may be Venous angiomas of quite small, draining a limited region of the brain, or may be very large, the brain a sometimes draining an entire hemi- • sphere. They can be single or multi- ple, and even bilateral.P" The com- review monest sites of occurrence are in the frontal and parietal lobes of the cere- venous anomaly' or DVA, pointing bral hemispheres and in the cerebel- Ian C Duncan out that these abnormalities actual- Ium.':" They can also be found in the ly represented an extreme anatomi- FFRad(D)SA occipital and temporal lobes, basal cal variant of the normal venous ganglia and pons." Unitas Interventional Unit POBox 14031 drainage of the brain. Lytlelton Imaging 0140 Pathology The classical radiographic appear- The theory of the development of ance of these abnormalities accurately venous angiomas is that there is fail- reflects the anatomical picture with Introduction ure of regression of normal embryon- multiple enlarged transmedullary Venous angiomas of the brain, also ic transmedullary venous channels. veins radiating in a wedge or radial termed venous malformations or These persistent transmedullary veins pattern toward the larger collecting developmental venous anomalies run axially through the white matter vein producing the pathognomic (DVA) are commonest of the to drain into a single larger calibre col- 'caput medusae' or 'spoke wheel' intracranial vascular malformations lecting venous trunk. The dilated ter- appearance during the venous phase comprising between 50% and 63% of minal collecting vein then penetrates of a cerebral angiogram (Figs 1,2).14,15 all intracranial vascular malforma- the cortex to drain either superficially A similar appearance is often seen on tions.
    [Show full text]