Landmarks, medical and surgical / by Luther Holden.

  • Luther Holden
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: Landmarks, medical and surgical / by Luther Holden. Source: Wellcome Collection.

    44/116 (page 32)
    vej^sd. Anatomists generally describe the left as a trifle longer than the right; but from an examination of a hundred bodies, I found their average length to be the same. 66. Mr. Abernethy, who in the year 1796 first set the example of tying the external iliac, made his incision in the line of the artery. But the easiest and safest way to reach the vessel is by an incision, recommended in the first instance by Sir Astley Cooper, and now generally adopted, beginning just on the inner side of the artery, a little above the crural arch, and continued upwards and outwards a little beyond the spine of the ilium. The same incision extended farther in the same direction would reach the common iliac. Bony pro- 6/. The anterior superior spine of the ilium, the spine minences. Qf ^j^g pubes, and the line of the crural arch are landmarks with which every surgeon should be thoroughly familiar. Spine of 6^. This spine of the ilium is the spot from which we 1 mm. measure the length of the lower extremity. It is a valuable landmark in determining the nature of injuries to the pelvis and the hip. The thumb easily feels this spine even in fat persons. Its position with regard to the trochanter major should be carefully examined. The best way to do this is to place the thumbs firmly on the opposite spines, and to grasp the trochanters with the fingers. Any abnormal position on one side is thus easily ascertained with the sound side as a guide. Spine of 69. The spine of the pubes is the best guide to the pubes. abdominal ring. It cannot easily be felt by placing the finger directly over it, since it is generally covered by fat. To feel it distinctly, we should push up the skin of the scrotum and get beneath the subcutaneous fat. If there be any difficulty in finding it, abduct the thigh, and the tense tendon of the adductor longus will lead up to it. The position of the spine of the pubes is appealed to as a means of diagnosis in doubt between inguinal and femoral hernia. The spine lies outside an inguinal, inside a femoral.