Practical anatomy: a manual of dissections / by Christopher Heath.

  • Christopher Heath
Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Practical anatomy: a manual of dissections / by Christopher Heath. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    third nerve usually accompanies and joins this. These last must be found at once, and are to be carefully preserved. ^\-ll the fat is to be removed from the axilla, and the muscles cleaned, so far as they are exposed, care being taken not to injure the axillary vessels (particularly the vein) and nerves, which are to the outer side of the space; nor the posterior thoracic nerve (Fig. 2, 12), which runs vertically upon the serratus magnus, about three inches from the edge of the pectoralis; nor the subscapular vessels and nerves at the edge of the subscapularis. The Axilla is a conical space between the chest and upper arm, and has the following boundaries: In front is the pectoralis major muscle, with the minor beneath it; behind are the subscapularis, latissimus dorsi, and teres major muscles; to i\xQ inner side is the serratus magnus, with the upper ribs and intercostal muscles; and to the outer side the upper part of the humerus and the coi'aco- brachialis muscle. The base of the cone has already been seen to be the axillary fascia stretched between the anterior and posterior boundaries, and the ajjex mvUI now be found with the finger in a triangular interval between the clavicle, the upper border of the scapula, and the first rib. The great vessels and nerves lie along the outer boundary of the space, the artery being between the nervous cords and the vein to their inner side, whilst the branches of the artery take a general direction towards the thorax. On the inner side of the space, and imbedded in fat, are the glands, ten or twelve in number, which receive the lympha- tics from the mamma and arm, and which may therefore be extirpated when diseased, or incised when suppurating, without danger to the large vessels. Opportunity^ is to be taken, before any further dissection is made, to expose the lower part of the axillary artery thoroughl}^, as that is the portion of the vessel to which a ligature may be applied. Surgery.— To tie the axillary artery: the arm being drawn away from the trunk, an incision, [two to] three inches long, is to be made in the length of the limb, at a distance behind the edge of the pectoral muscle equal to one-third of the whole width of the axilla. On dividing the deep fascia, the large axillary vein will come into view, which must be drawn down and held aside, when the large nervous cords will be seen, and a little dissection will ex- 3