Surgical anatomy : a treatise on human anatomy in its application to the practice of medicine and surgery / by John B. Deaver.

  • Deaver, John B. (John Blair), 1855-1931.
Date:
1899-1903
Catalogue details

Licence: In copyright

Credit: Surgical anatomy : a treatise on human anatomy in its application to the practice of medicine and surgery / by John B. Deaver. Source: Wellcome Collection.

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    branch of the aorta) the artery of the vas deferens (a branch of the superior vesical), and the cremasteric artery (a Itrancli of the deep epigastric artery) ; (3) the « spermatic veins surrounding the artery and forming a plexus (pampiniform plexus); (4) lymphatics accompanying the vessels and emptjdng into the luml)ar glands; (5) sympathetic nerves, which arc branches of the renal, aortic, and hypo- gastric plexuses ; (6) remains of the processus vaginalis in the form of a small fibrous cord ; (7) Henle's internal cremaster, consisting of longitudinal fibers of pale muscle tissue ; (8) fat and connective tissue derived from, and continuous with, the subserous areolar tissue. The constituents of the spermatic cord diverge as they are followed internally from the internal abdominal ring. The spermatic cord passes through the inguinal canal to reach the scrotum and it is sometimes abnormally followed by an indirect inguinal hernia. Varicocele is an enlarged or varicose condition of the spermatic veins or pampiniform plexus. The fact that these veins are but j^oorly supported by the lax tissues of the scrotum, and the slight degree of compression to which they are subjected in the inguinal canal, help to explain the frecpiency of varicosity of these veins. Tliis condition may cause atro])hy of the testicle. The varicose plexus of veins eventually, or even at the beginning, may sag at the bottom of the scrotum upon the affected side (most often the left), so that on inspection and palpation the scrotum resembles a bag of worms. The condition is devoid of danger, except that it often begets morbid fears on the part of the patient, usually the result of suggestion. If large and associated with relaxation of the scrotuni, varicocele causes a dull, heav}^ dragging sensation in the external genitals. In the radical operation for varicocele a longitudinal incision is made over the mass of veins; the skin, the dartos, the external spermatic fascia, the cremasteric fascia, and the internal spermatic fascia are divided and the mass of veins is separated from the spermatic duct. Two ligatures, preferal)ly catgut, are then thrown around the mass of veins and the spermatic artery and securely tied, the ligatures being about one inch apart. The intervening portions of the veins and the spermatic artery are removed and the ends of the ligatures tied together. Subsequently, the blood sui)])ly of the testicles is derived from the artery of the vas def(;rens and the cremasteric artery. The wound is closed in tlie oi'dinary manner. The Hydatids of Morgagni are two small Ixxlics attached to the up])er part of tlie testicle and the g]()l)us major. Tliev each measure from one-half to one centimetei' in length and contain clear fluid. One is i)ediculattHl and the other is sessile. Tlicy are the remains of the embiTonic structin-e called Miiller's duct. The Paradidymis, or Organ of Giraldes, is an irregular yellowish patch, about one centimeter in breadth, situated in the lower part of the spermatic cord above the hea<l of the epididymis, and covered by the vi.sceral ])ortion of the tunica