Aneurysms of the aorta : being an exercise for an act for the degree of M.D. in the University of Cambridge / by Oswald A. Browne.
- Browne, Oswald A.
- Date:
- 1897
Licence: Public Domain Mark
Credit: Aneurysms of the aorta : being an exercise for an act for the degree of M.D. in the University of Cambridge / by Oswald A. Browne. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
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![The aneurysm arose most often (and in about the same number of cases) from the Position, commencement ^ or from the middle -^ of this portion of the arch, having origm more often from the posterior^ than from the anterior^ or u2)per'' surface of the vesseL In four cases the aneurysm arose near to the point of origin of the left subclavian artery, and in three instances involved the whole of the transverse arch ;' in three cases it involved both the transverse and descending portions of the arch.^ Tlic innentinate artery iras ijicolrcd in six cases,''' the sac being in one case (Table II., Great vessels. Case 9) formed by great distension of the posterior v^bXI of the artery at its origin. In three instances the right carotid and subclavian arteries sprang directly from the sac of the aneurysm.^*' It was very rare for either the left carotid or subclavian artery to be mvolved. These arteries were each so involved in one case only. There had been more than one aneurysm in seven instances.^- In Case 4 three distinct aneurysms had occurred. The first arose from the posterior part of the arch where the aorta is in closest relation with the trachea ; a second arose from the anterior wall just l)elow the origin of the innominate artery; whilst a third had its origin below and to the left of the larger aneurysm. In Case 21 an aneurysm projected from the arch anteriorly and slightly to the right, just below the origin of the innominate artery ; a second projected backwards from the arch below, just above the origin of the left subclavian artery. The direction most commonly taken appears to have been directhj iiacl ivanh, and in Direction 13 cases there had occurred a greater or less degree of pressure upon the trachea,attended often by erosion of its cartilaginous rings.In a large number of cases the direction taken was iqncards and to tlie ri(j]t.t toirards tlie surface, presenting either above the episternal notch,or lying just behind the first bone of the sternum^'' and eroding it,' and presenting either there^^ or (more commonly) in the first and second right costal interspaces.^'' In four instances only had the aneurysm presented to the left of the sternum.In these Pieseiitatiou the external tumour was situated to the left of the sternum over the second, third or fourth sterimm. left costal cartilages. The trachea was commonly subjected to pressure.-^ The left bronchus was more or less Effects of ' pressuvG. compressed in three instances,- and in three instances the left recurrent laryngeal nerve had I Table II., Cases 1, 6, 7, 8, 20, 23, 24, 25, 31. 34. -' Table II., Cases 4, 5, 10, 11, 12, 13, 18, 26, 27, 28. 3 Table II., Cases 2, 4, 9, 16, 17, 18, 30, 31, 34. ' Tabre II., Cases 1, 23, 26. ■' Table II., Cases 27, 28. « Table II., Cases 2, 3, 15, 16. Table II., Cases 17, 19, 35. « Table II., Cases 14, 22, 32. '■> Table II., Cases 8 to 18 inclusive. 10 Table II., Cases 8, 10, 11. II Table II., Cases 29 and 33. 12 Table II., Cases 1, 4, 13, 20, 21, 30, 34. 13 Table II., Cases 4, 9, 10, 11, 13, 14, 16, 21, 23, 25, 28, 31, 35. » Table II., Cases 4, 10, 11, 13, 14, 16, 21, 25, 3o I' Table II., Cases 11, 24, 27. 1 Table II., Cases 5, 23, 30. 1' Table II., Cases 1, 12, 19, 24, 26. 18 Table II., Case 19. 13 Table II., Ca'ses 17, 19, 24, 26, 31. 2 Table II., Cases 1, 19, 26, 33. 21 See Note 13 above. 22 Table II., Cases 14, 15, 20. 2](https://iiif.wellcomecollection.org/image/b21456525_0009.jp2/full/800%2C/0/default.jpg)
