Golovna - home lіkuvannya
Anatomy of the thoracic clitina people. Ribs and sternum. Breast cell in the whole chest cell in the whole anatomy

For its shape, the breast cage is nagadu ovoid with the upper high school and the lower wider, moreover, the offense of the child is obliquely. In addition, the chest wall is shaped from the front to the back.

Breast cell, compages thoracis, open two or two apertures: upper, apertura throracis superior, i bottom, apertura thoracis inferior, tightened with myazovoy partition - diaphragm. Ribs, flanking the lower aperture, fixing the costal arch, arcus costalis.

The front edge of the lower aperture can be printed in the form of a kut, angulus infrastemalis, under-chest kut; at the top of the yogo lie a sword-like sprout. The spinal stop along the middle line protrudes into the chest emptying, and on all sides from the side, between them and the ribs, go through the wide Legendary furrows, sulci pulmonales, in which to take revenge on the back edge of the lungs. The space between the ribs is called the mid-ribs, spatia intercostalia.

In savts, who, due to the horizontal position of the chest gut, fix a vice on the lower wall, the chest wall of the dovga and vuzka, moreover, the Ventra-dorsal size overturns the transverse one, because of what the chest wall is shaped like a side bias (keel-shaped form). At the mavp in zyazyazy z, podіkіntsіvok on the hands and feet and start-


with a transition to an erect-nya chest cell becomes wider and shorter, however, the ventral-dorsal size is more widespread over the transverse one (mavpyacha form). Nareshti, in a people, in a connection with a reverse transition to an upright passage, the hand is ringing through the function of oversupply and a grasping organ of pratsi, in the event that the breast tissue has a tendency to attach itself to some of the upper limbs; inside, to squeeze mute on the ventral wall, which has now become anterior, and on the lower one, set with a diaphragm, as long as the line of gravity is carried nearer to the spinal stop when the vertical position is placed. Everything should be done until the breast cell becomes flat and wide, so the transverse size changes to the anteroposterior one (human shape; Fig. 24).

Transforming the process of phylogenesis, and in ontogenesis, the breast cell of the form. In the world of that child, the child has begun to get up, walk and creep with his pictures, as well as in the world of growth and development of all equipment and the inside of the breast cage, in a step-by-step manner, the shape of a person is characterized by an overwhelming transverse shape.

The shape and size of the breast cancer is also up to significant individual variations, we will summarize the development of the muscles and the lungs with a step, which in its own way is tied with the way of life and the professional of the given people. So, as it is to avenge such vital organisms, as in the heart and in the legends, then the options may be of great importance for the assessment of the physical development of the individual and the diagnosis of internal ailments. Name the three forms of the breast plate: flat, cylindrical and final. People have good muscles and chest lungs the clina grows wide, a little bit short and swelling of the final form, that is, the lower part is shirsh, lower the upper one, the ribs are not very strong, angulus infrasternalis is great. Such a breast cage perebu nіbi at the camp vidihu, from whom I call inspiratory. Navpaki, in people with poorly developed muscles and lungs, the chest cell is old and full, swelling flat in shape, when the chest cell is strongly flattened in the anterior-posterior diameter, so the front wall of the rib, the ribs are very vertical. The breast plate is perebuva nibi at the vidihu camp, which is called expiratory. The cylindrical form of the loan is in the middle of the two described. In females, the breast cage is shorter and even more in the lower half, lower in the choloviks, and more round. Social factors on the form of the breast cage are recognized in the fact that, for example, in the capitalist and lands, which develop among the children of the exploited vernaculars of the population, as they live in dark donkeys, when there is a shortage of joyful sleep the breast tissue swells in the form of "chicken breasts": overloading the anterior-posterior size, and the sternum abnormally sticking forward, yak in chickens. The pre-revolution

New Russia in Shevtsy, as all the lives were sitting on a low stool in a bent position, and they were holding their breasts as a support for the heel when the flowers were hammered into the foot, on the front side of the breast. In children with flat and flat breasts, there is a weak development of muscles in case of improper sitting on the part, the breast cage is overwritten in the sleeping area, so that it is possible to find the heart and the legends. Children need physical culture

rukhs breast cancer. Dykhalny collapse collapses in the alternate raised and lowered ribs, at the same time the sternum collapses. When inhaled, the wrapping of the rear edges of the ribs is shown near the guess at the description of the half of the ribs of the wasp, and the front ends are designed so that the breast cell expands in the anterior-posterior size. The heads of the oblique straight axis wrap around immediately and the spreading of the ribs to the sides, as a result of which the transverse size of the chest wall grows. When the ribs of the cartilage cords are lifted, they straighten, collapse in the slopes between them and the sternum, and then the cartilage itself stretches and curls. When the breath is over, it’s like a wicked act, the ribs go down, and now it’s vidikh.

SKELETON HEADS

scull(Cranium) is only partially carried to the support-arm apparatus. Win persh for everything to serve as a substitute for the brain and the connected organs of the remains; In addition, I will drain the cob part of the herbal and dical tracts, which will be called. According to the cranium, the skull of all spinal parts is divided into two parts: the cerebral skull, neurocranium and visceral skull, cranium viscerale. V to the cerebral skull to develop stars, calvaria,і edstav, basis.

Before the warehouse of the cerebral skull in humans, there are: unpaired, wedge-like, lobova and mesh parts and paired skrone and tim'yana cysts. Before the warehouse of the visceral skull, there are parni - the upper slit, the lower nasal concha, pidnebinna, wilichna, nasal, slips of the bristle and unpaired - the opener, the lower slit and the lower nasal bristle.

Skull rosette. The skull, like the skeleton of the head, of the articulation in its own development is called the organs of the creature and the growing life.

The cranial skull develops into a link with the brain and organs of the senses. In twins, which do not faint the brain, there is no cerebral skull. In chordates (lancelet), in yak brains, the brain is located in the embryonic stage, in the effusion with a semi-tissue sheath (cross-section of the skull).

With the development of the brain in the ribs, near the rest, there is a closed box, the yak in the cartilaginous ribs (sharks) swells the cartilaginous tissue (cartilaginous skull), and in the bony - cystkovu (the ear of the cystic skull).

With the entry of the creatures from the water to the land (amphibians), there is a substitute for replacing the cartilaginous tissue with the cyst, which is necessary for the captor, the support-roche apparatus in the minds of the ground-based sinking.

In the middle of the spine classes, the cartilaginous tissue is less likely to turn into cysts, and the cystic skull to form, so that it becomes more fun. The development of around the cranial cysts is also due to these factors. Tsim will explain in a somewhat simpler way.


The cistok of the crypt of the skull (for example, temporal) and velmy folding the base of the cistok, for example, early, like taking care of the fate in all functions of the skull and as a style for the organs of hearing and gravitation. In terrestrial creatures, the number of cysts is decreasing, while a number of cysts are a product of growth earlier than self-made cyst solutions.

In ssavts_cranial skull and visceral it is easy to grow between themselves. In humans, the connection with the greatest development of the brain and organs is sensitive to neurocranium of a significant magnitude and overlapping over the visceral skull.

The visceral skull develops from the material of the young chypar arches, which are laid down in the mucous membranes of the head viddil of the primary intestine. In the lower ridge, which live near the water, the arches of the chickweed are covered meta-worldly with the chinch-chilines, through the water to pass up to the chilli, which are water-type organs.

In I and II chypar arches, the dorsal and ventral parts are seen. Behind the dorsal part of the I arch, the upper slit develops (partly), and the ventral part of the I arch takes the fate of the development bottom slit... In addition, the processus maxillaris and processus mandibularis are developed in the first time.

When the creatures enter from the water to the land, the lungs gradually develop, that is, the organization of the spirit is of the type, and the zyabra consumes its meaning. At the connection with the cymbs of chaffinch chickens in the terrestrial ridge and human є only in the embryonic period, and the material of the chaffinch arches is used to induce the cysts of the face. By such a rank, by the ruinous forces of evolution of the skeleton of the head є going from aquatic life to terrestrial (amphibious), attaching to the minds of life on land (the class of ridges, especially savtsi) and finding such an organ and developing such a person to the brain - ).

Imagining a line of evolution, the human skull in ontogeny undergoes 3 stages of development: 1) connective tissue, 2) cartilage and 3) cyst. The transition from another stage to the third, i.e., Formation of secondary cysts on the ground of cartilage, trivially stretching out the life of the people. To navigate at an older person, the surplus of cartilage tissue is collected between the cysts in the eyes of the cartilaginous tissues (synchondrosis). The zvid of the skull, the service only for the seizure of the brain, develops without the middle from the recumbent skull, minayuchi stage of the cartilage. Moving from a complete fabric to a copy here can also be seen by stretching out the life of the people. The areas of neo-walled tissue are captured between the cysts of the skull in the vigilance of the dumplings in newborns and in children and adults (div. Nizche). The cranial skull, which is an extension of the spinal stump, develops from the sclerotomes of the head somites, which are laid in the number of 3 - 4 pairs in the capillary area near the front end of the chorda dorsalis.

Mesenchyme of sclerotomes, allowing the bulbs of the brain to develop and developing organisms, setting up the cartilage capsule, cranium primordiale(Pochatkovy), yak on the vidminu from the ridge stop becomes unsegmented. The chord penetrates into the skull to the hypophysis, hypophysis, whereby the skull extends along the extension to the chordi on the chordal and distal part. At the prechordal part, in front of the hypophysis, a pair of cartilages are laid, or cranial beams, trabeculae cranii, which are located in the ligament behind the cartilaginous nasal capsule lying in front of the cartilaginous nasal capsule, which demonstrates the organ of scent. From the sides of the chordi, the cartilage plates of the parachordalia grow. By year, trabeculae cranii grow from parachordalia into one cartilaginous plate, and parachordalia - from cartilaginous auditory capsules, overlying the rudiments of the auditory organ (Fig. 25). Mіzh nasal and rumors


CHAPTERVii

BREAST.

Between: the upper between the breasts pass along the upper edges of the handle of the sternum and collarbone, and at the back - along the horizontal line, drawn through the spine of the 7th ridge.

The lower boundary passes through the sword-like outgrowth of the sternum obliquely down along the costal arches and backward along the XII rib and spinous outgrowth of the XII thoracic ridge.

Let the cordon be clearer, the fragments of the deyaky organ of black emptying would like to lie before the diaphragm, the ale of the lower between the breasts (stove, chastkovo shlunok and іn.); from the side, the dome of the pleura is in large vipads above the upper boundary of the breasts.

The upper opening of the breasts, apertura thoracis superior, is surrounded by the posterior surface of the sternum handle, the inner edges of the first ribs and the anterior surface of the first chest ridge.

The lower opening of the breasts, apertura thoracis inferior, is bordered by the posterior surface of the sword-like outgrowth of the sternum, the lower edge of the costal arch, the anterior surface of the tenth chest ridge.

Breasts walls, parietes thoracis, and chest emptying, cavum thoracis, chest folds, thorax. In the rest of the organization of health and blood circulation, during which in Danish hours, occasional surgical interventions are often held in order to gain knowledge of the topography of the region.

The form. The breast cage, covered with ointments, behind the shape is a cone, before the burns are straightened; Skeletons of the breast cage, navpaki, cone-like expanding to the bottom.

There are three forms of breasts in fallowness from the zalny statue. In wide-bodied people, they have a short and wide breast cage, often with transverse sizes and with a dull epigastric cut; in a narrow-bodied breast cage, navpaki, vuzka and і dovga; vona maє gostry epigastralіy kut. Up to the third form of breasts are carried out in equal measure from the middle epigastric cut.

Rosemary. For judging about the development of a normal breast cancer, there is a practical meaning of special information. In older people in the middle of the breast cancer, the following:

1. Distantia verticalis posterior - posterior vertical r and 8 m e r - seen along the middle line from the spinous ridge I to XII thoracic ridge 27-30 cm.

2. Distantia verticalis anterior - front vertical size - from the upper edge of the sternum handle to the top of the sword-like ridge - 16-19 cm.

3. Distantia axillaris - sub-crestal size - the greatest amount of lateral side of the chest wall along the middle sub-crest line of 30 cm.

4. Distantia transversa - transverse size - a) on the level of the upper chest opening 9-11 cm, b) on the level of the VI ribs 20-23 cm, c) on the level of the lower chest opening 19-20 cm.

5. Distantia sagittalis - antero-posterior size on an equal sword-like outgrowth of 15-19 cm.

6. Perimeter - about 80-85 cm perimeter of breasts above the level of the nipples.

When the projection of the organs of the thoracic empty space is implanted onto the anterior thoracic wall, it should be corroded with clever vertical lines. development:

1. Linea sternalis - sternal line - roztasovana vertically in the middle of the sternum.

2. Linea parasternalis - peri-sternal line - to be designed along the edge of the sternum.

3. Linea medioclavicularis - Sredneclavicular line - is carried out through the middle of the clavicle. (Don't worry about the teat line.)

4. Linea axillaris anterior - the anterior sub-crestal line - is carried out through the anterior edge of the groin fossa.

5. Linea axillaris media - the middle of the sub-crestal line - is carried out through the middle of the groin fossa.

6. Linea axillaris posterior - the posterior sub-crestal line - is carried out through the posterior edge of the groin fossa.

7. Linea scapularis - scapular line - is conducted through the lower cout of the scapula.

8. Linea paravertebralis - navkolokhrebtsevі line - carried out in the middle of the country mіzh margo vertebralis scapulae and spinous processes of the thoracic ridges.

9. Linea vertebralis - linea ridge - forms the growth of spinous outgrowths of the thoracic ridges.

LITTLE BREAST

The cystkova is the basis of the breast plate, thorax, the yak is stored in 12 chest ridges, 12 ribs and sternum.

Thoracic ridges, vertebrae thoracis, are formed by spinous growths straightened to the bottom, processus spinosi, a rounded ridge opening, foramen vertebrale, and apparently special facets - upper ribs and lower ribs The thickness of the pectoral ridges is straight to the bottom to be steadily more massive. The stench is poured into the empty breast tissue at the viglyadi roller. From the sides of the ridge, there are legeny furrows, sulci pulmonales, which are filled with the back of the lungs.

Ribs, costae, are added to the right ribs, costae verae, untrue, costae spuriae. The first, in the number of seven couples, sit with the sternum without the middle, the other (three bets) sit with the emergence of the vische with ribs of cartilage. The lower two ribs bet є vilny and the ribs sound like costae fluctuantes.

The skin rib is a head, caput costae, a collar of a rib, collum costae, only a rib, corpus costae, two knots - ridge, extremitas vertebralis, і sternum, extremitas sternalis, and also two edges - upper, margo superior, і lower., Margo The first edge is on the vidminu from the others in the horizontal area. The spine end of the rib is set with the til of the ribs of the blunt kut, angulus costae. On the upper surface of the I rib of the folds of the humps (Lisfranka), tuberculum scaleni, lateral to the hump, there is a sulcus sulcus, sulcus subclavius ​​is a trace of the same artery.

Topographic and anatomical peculiarities, the shape and position of the I rib may be of great importance for a surgeon-phthisiatrician.

For practical purposes, the I rib is divided into three segments: the posterior segment is the spinal segment, the middle segment is the myasium and the anterior segment is the vertebral nerve. Tse is meaningful in case of different types of thoracoplasty. For example, with the posterior paravertebral thoracoplasty, the posterior segment is seen; in case of upper thoracoplasty, two posterior segments are resected after the Koffi-Antelava method - the spinal and the myasia. When thoracoplasty with decostation of the upper ribs, the I rib is seen rising. Installed, when the upper thoracic aperture is located, the cleft between the clavicle and the I rib of the vuzka; with a wide chest aperture, a gap of great sizes. The first rib is larger than the slope of the cut between shykoyu and til when the sides of the aperture are pressed. When the aperture is flattened from front to back, the I rib is curved more strongly and more bluntly (M.S. Lisitsin).

Along the lower edge of the skin rib, pass the hypochondriac sulcus, sulcus subcostalis;

Puncture of the pleurisy with diagnostic abnormalities is carried out along the upper edge of the ribs of the schobes to unify the injury of the intercostal nerve bundle.

The posterior wall of the thoracic clitine in the whole fixes the sternum of the spinal stump, pars thoracalis columnae vertebralis, as well as the posterior ribs from the head to the vertebral roots.

Dovzhina of the thoracic ridge to the middle 30 cm. The thoracic part of the ridge is flattened backward, setting the thoracic cyphosis, kyphosis thoracis.

In front of the cartilage from VII to X ribs, set the costal arch, arcus costarum. Kut, of the statements of both rib arches, are called the sub-breast kut, angulus infrasternalis, or the epigastric kut, angulus epigastricus.

The sternum, os sternum, is a flat bristle, the yaka occupies the middle part of the anterior breast plate. Vaughn grows on the handle of the sternum, manubrium sterni, tilo sternum, corpus sterni, і sword-like growth, processus xiphoideus. Ostann_y nerіdko buvaє doubled. Inodi in new є openings (foramen Riolani). You can also open it in the breast bone. The sternum can be widespread, and even now it is possible to see heart pulsation and to promote the reduction of soft tissues in case of cutaneous heart rate.

Open the breastbone, it is more practical, so you can lead to the setting of the gryges. internal organs.

M'yazi breasts. M'yazi, which can be carried to the front end of the chest wall, to be divided into two groups: the surface m'yazi, functionally by the m'yazy of the shoulder girdle, and the large or loose m'yazy of the breasts.

Before the first group, lie down in front of the large and small sternum, mm. pectorales, major et minor, roztasovana from the side of the anterior teeth, m. serratus anterior, and the clavicle of the t. subclavius.

Prior to the other group, there should be called and internal interconnections, mm. intercostales externi et interni, transverse m'yaz of the breasts, m. transversus thoracis, і hypochondrium, mm. subcostales.

Superficial m'yazi. 1. M. pectoralis major - great pectoralis - to lie on the surface, to repair in three parts: 1) pars clavicularis - clavicular part - to repair from the lower surface of the inner half of the clavicle; 2) pars sternocostalis - sternum-Rebrova part - to repair from the handle and til of the sternum, as well as from the cartilages of the five upper ribs - from II to VII; 3) pars abdominalis - charevna part - to repair from the front leaf.

All three parts of the mucous membrane converge in a wide flat tendon, which is attached to the crista tuberculi majoris of the brachial cyst.

2. M. pectoralis minor - malium pectoralis - tricot form, lie behind the great pectoralis, repair with teeth from II to V rib, and then uphill and stick to the coracoid ridge of the scapula, processus coracoicleus scapulae.

Grievances and bloodshed from breast throats a. thoracoacromialis. Innervated by the anterior pectoral nerves, nn. thoracales anteriores, which is included in the number of two of the brachial gossip.

3. M. subclavius ​​- clavicle muzzle - lie at the bottom of the collarbone in the viglyadi of the clavicle, fix on the first rib, where it is called and attach to the last half of the collarbone. It is innervated by one nerve (n. Subclavius).

4. M. serratus anterior - the anterior dentition - to lie on the bichny surface of the thoracic clit, being covered behind with a scapula, above - with a great pectoral joint and below with a wide mouth of the back. It should be repaired with nine teeth from the outer surface of the eight upper ribs, and two teeth enter from the second rib; attach m'yaz to the entire spinal edge of the scapula. Take care of blood for a. thoracalis lateralis. Innervated by n.thoracalis longus.

Gliboki or vlasny mu'yazi kup i. 1. Mm. intercostales externi - intercostales intercostals - intercostal intercostals from humped ribs to final ends of rib cartilages. Myazovi bundles lie obliquely, outwardly facing the fibers of the last oblique abdominal mass. It should be repaired from the lower edge: overlying ribs and fasten to the upper edge of the lower rib.

The known interdigital mutilations are carried up to the inhalation mucous, as with their fast ribs.

2. Mm. intercostales interni - internal braids of the tongue - lie more in front of the front and stretch out from the rib kutiv to the sternum. In such a rank, in the posterior aspect of the ribs, the inner intercostal ligaments are in the middle and replaced by the tendon plates - the inner intercostal ligaments, ligamenta intercostalia interna.

The straightening of the fibers of the inner mid-ribbed muscles is similar to the fibers of the inner oblique abdominal meat.

Myazov bundles are repaired from the upper edge of the lower rib and are attached to the lower edge of the expanded rib. M'yazi є vidikhal, so yak, when fast, lower the ribs.

3. M. transversus thoracis - the transverse ligament of the breasts - to grow on the inner surface of the sternum and ribs. It should be repaired with teeth from the inner surface of the body and the sword-like outgrowth of the sternum, spreading loosely, to attach to the inner surface of the ribs from II to VI. M'az is perceived to be seen, so yak lowering the ribs. Blood circulation and innervation of the blood vessels are connected by the intercostal vessels and nerves.

Fascia of breasts. 1. Fascia pectoralis superficialis - superficial thoracic fascia - to grow behind the pediatric fat cells. There are two plates - the front plate, lamina anterior, which lies on the anterior surface of the chest cavity, and the posterior plate, lamina posterior, which whistles the back surface of the cavity. In such a rank, the pectoralis is laid between two leaves of the superficial fascias, which enhances the decay and deyakuyness of the present.

2. Fascia pectoralis propria - the fascia of the breasts - in the viglyad of the chohl I am going to have a great breast muzzle in front and behind. Otzhe, and the fascias are divided into two plates - anterior, lamina anterior, and posterior, lamina posterior.

3. Fascia coracoclavipectoralis - beak-and-clavi-pectoral fascia - roztasovana behind the great breast and set the chokhol for the small pectoral and clavicular muscles. It is especially narrow in the mountains below the collarbone and in the area of ​​the coracoid ridge. Qia fascia to recover from the clavicle and the beak-shaped appendage, go down, step by step get angry from the back leaf of the vascular thoracic fascia. Directly named, fascia coracoclavipectoralis pass into fascia axillaris.

Fascia pierces with a great number of judges and nerves.

4. Fascia endothoracica - intrathoracic fascia - whistling the inner surface of the breast tissue and at the bottom to go to the diaphragm, transforming into the fascia diaphragmatica.

Tricutae of the anterior chest wall. 1. Trigonum deltoideoclavipectorale - deltoid-clavicular-thoracic tricuspid - unstitching without anterior clavicle. Vіn obmezhenii: vgorі - collarbone; medially - m. pectoralis major - і laterally - m. deltoideus.

The bottom of the tricycle є fascia coracoclavipectoralis, through the yak pass the judgment and the nerves: the call to the ice v. cephalica, in sulcus deltoideopectoralis, and nn in the middle. thoracici anteriores і gіlki a. thoracoacromialis-rami pectorales, ramus deltoideus ramus acromialis with the same veins.

2. Trigonum pectorale - thoracic tricycle - type of growth of the small breast meat. Yogo cordon: вгорі - upper edge of the small breast meat; below - the lower edge of the small breast meat; medially - a small breast meat.

Trikutnik with his own way of straightening down.

3. Trigonum subpectorale - the chest tricycle is open to the spaciousness, spread between the lower edges of the small and great chest muscles. Tricot bottom є m. serratus anterior. The basis of the yogo is directed uphill and called.

Judge and nerve. The scars and nerves of the anterior thoracic wall develop on the surface and gliboki.

To the superficial vessels, the skirts of the intercostal arteries, rami cutanei aa, are carried. intercostalium, which go through the intercostals, gilts a. mammaria interna, also perforating flesh of fabrics, mid-ribbed prominence and gilts a. thoracalis lateralis (s. mammaria externa).

With a whole lot of a. mammaria interna blood circulation in the middle of the anterior breast cell, and the blood cells a. thoracalis lateralis - call. Venous vidtik - along the same veins.

The superficial nerves of the anterior thoracic wall are drawn from the intercostal nerves, which give the anterior cranial nerves, rami cutanei anteriores, and basic cranial nerves, rami cutanei laterales.

To large boats, carry out:

1. A. thoracoacromialis - the artery of the thoracic cell and brachial appendix - grows in the upper viddle of the breast cell. From a. axillaris, a. thoracoacromialis penetrates the fascia coracoclavipectoralis and on the anterior thoracic point to spread on its own small spines: a) rami pectorales - thoracic spines - enter at the large and small sternum; b) ramus deltoideus - deltoid gilka - pass on the cordon between the breasts and the deltoid region of the shoulder in the sulcus deltoideopectoralis; c) ramus acromialis - the shoulder of the brachial ridge - straight up the edge of the chest wall into the area of ​​the upper layer.

2. A. thoracalis lateralis - the appearance of the thoracic artery - anywhere on the surface of the m. serratus anterior down at once z n. thoracicus longus.

3. A. thoracodorsalis - strong artery of the mammary cell - є bezposrednim advances a. subscapularis; blood supply to callings m. serratus anterior і mucus of the scapular region.

4. Aa. intercostales - intercostal arteries - in the number of 9-10 pairs of rosettes in the superconductors of the same veins and nerves in the mid-ribs from III to XI ribs. The entire fore-nerve intercostal bundle is in the sulcus subcostalis, i.e., without the middle at the lower edge of the rib.

The nerves of the glibular balls of the anterior thoracic wall are represented by the intercostal nerves, nn. intercostales. With their muscular jugs, rami musculares, the stench invokes interstitial musculature.

When I go out from the foramen intervertebrale, the skin nerve comes out with a good head, ramus communicans, it’s like a pretty close-up stovbur, truncus sympathicus, in order to last for a long head, ramus dorsalis, ventralis, ramus Persha іnnervuє m'yazi and shkіru back; another spatku yde, prlyagayuchi bezposeredno to parietal pleura, and distant lyagє to the pidrebral groin, sulcus subcostalis.

The closure of the intercostal nerves from the pleura will explain to us not often in case of pleurisy of intercostal neuralgia.

Behind the bichn_y surface m. serratus anterior straight downwards the chest nerve, n. thoracicus, longus, innervating myaz.

From the glibini deltoid-clavicular-thoracic tricut, trigonum deltoideoclavipectorale go out, piercing the fascia coracoclavipectoralis, anterior pectoral nerves, nn. thoracici anteriores, to enter into a comrade of great and small breasts.

DAIRY CASTLE.

The young milky zolosa, mamma muliebris, is growing in size and shape in terms of fallowness according to the individual anatomy. Vona roztashovana on the anterior thoracic point on the edge from III to VI rib.

Medially, milky zloza with its own sternum reach. Laterally, descend from the great breast meat to the bichnuyu surface of the chest wall, lyagayuchi to m. serratus anterior. In the middle of the puffiness, there is a growth of pigmentation of the naval nipple, areola mammae, in the center of the breast nipple, papilla mammae.

Falsely from the step to the development of the milky zolozi rіven roztashuvannya navkoloskogo rim і nipple rіzniy. In young females, the V ribs are most often brought up to the level of the V rib.

In the presence of milky vines, it is possible to prevent death - sinus, sinus mammarum.

Small. 87. Variation of nipples.

A - cone-like shape; B - cylindrical; B - pear-shaped.

Small. 88. Variation of dairyduct.

A - s sinus statements; B - with separate ducts.

Zalozista part of the body is approved by milky zalozi, corpus mammae. It is stored in 15-20 parcels, lobi mammae, dermal lactic acid duct, ductus lactiferus. Skin 2-3 ducts, angry at once, emerge at the tops of the nipple with a milk solution, porus lactiferus. In total, there are 8 to 15 such milk openings in the nipple.

There are three forms of the breast nipple (Fig. 87): cylindrical, pear-shaped and endless (D. N. Fedorovich). If the baby's life with a cylindrical and pear-like form of the nipple is completely normal, then the final form for a year old is unpleasant, since a baby cannot get a small terminal nipple. It’s even more difficult for you to need to prepare the breast nipples for the hour of your vagina, for which women are welcome in the women’s consultations.

The milk ducts open up either without the middle at the top of the breast nipple, or in the middle of the nipple they get angry at the milk sinuses, sinus lactiferus, in the back of the Chumatsky sinus, sinus lactiferus in the vicinity of the communis, where Tse maє suttєve meaning in the development of lactogenic mastitis: with the presence of such a zagalny sinus, the fiery burning of the surrounding areas is more frequent, less when the milk ducts are separated at the apex of the breast nipple (D. N. Fedorovich).

In nipples and nipples of nipples, sebaceous salmon, glandulae sebaceae, potato zalosi, glandulae sudoriferae, and especially rudimentary milkweed, glandulae areolares.

The rudimentary cholovic dairy zalosa, mamma virilis, can be stored with a full cloth, with traces of zalizy elements, a trick for clientele, in the same time, as it is not very common in the summer. The increase in the number of dairy products is often malignant to degenerate, which is necessary to see.

There are also irregularities, if women have a milk ball, mammae accessoriae, or a milk ball growing lower than a honey mushroom.

Small. 89. Scheme of lymph flow from the breast.

I - l-di axillares; II - l-di infraclaviculares; III - l-di retrosternales; IV - l-di supraelaviculares.

Blood posture of a milky zalosy can be found in three dzherel: 1) A. mammaria interim - internal nipple artery - seemingly piercing beads, rami perforantes, in the third, fourth and fifth mid-ribs, in the middle of the molar. 2) A. thoracalis lateralis - bichna thoracic artery - go down m. serratus anterior and forward grips, supplying blood to the outer edges of the chest cavity. 3) Aa. intercostales - intercostal arteries - provide for the blood supply of milky arteries from the third, fourth, fourth, second, second and third arteries. Tsi piercing throats, rami perforantes, pierce the great breast muzzle and enter the river of zalozi.

Venous vidtik - along the same veins.

The lymphatic system of milky zolozi is represented by the lithic lymph vessels that are roasted in three surfaces. Most of the surface underneath the breast nipple is tattered with lymphatic gossip, plexus lymphaticus subpapillaris.

Glibsche in the fringes of the navkososkovogo gurk zalyagaє surface near-circle gossip, plexus areolaris superficialis. It is more common to develop more peri-circular gossip, plexus areolaris profundus.

From the lymph gossip, the lymph goes straight to the glybin in the plexus areolaris superficialis. (N.) (N.) (N.) (N.) (N.) (N.)

It can be seen from the induced diagram that the most unfriendly localization of cancerous swelling є internal forms of swelling, so as lymphogenous metastases of swelling go right in the middle of the university, that is, E. From the retrosternal lymphatic higher education institutions, the lymphatic organ goes straight up the truncus lymphaticus mammarius directly into the thoracic duct system (zliva) or into the right lymphatic duct (right-handed).

Pidclavicular lymphatic universities are tightly tied with supraclavicular universities. That is, with metastases of malignant fluffs in polyclinic lymphatic universities, such ailments develop as inoperable ones, and they are deprived of exchange therapy.

BREASTING EMPTY.

Cavum thoracis - sternum - bordered from the sides by the pectorals, from the back - by the ridge, from the bottom - by the diaphragm and from the top - by the upper chest opening, apertura thoracis superior.

At the top of the empty chest, there are three gray, isolated bears in the empty breast cells. The number of mice has evolved from the backward coelomic emptying of the body, evidently in the English period.

At the same time, it is clear: topography of pleurisy and pleural emptying, topography of lungs and spinal paths, topography of the heart and natal sac and topography of the middle.

Topography of pleurisy and empty pleura.

Serous membrane of the lungs-pleura - is divided into two sheets: parietal pleura, pleura parietalis, and internal pleura, pleura visceralis. The remaining leaf whistled on the surface of the lung and in the area of ​​the root of the leg during the transition to the adipose leaf, the lig. pulmonale, which is a duplication of the serous membrane. Vona roztashovana under the legacy veins and stretched in a vertical straight line down to the lower edge of the leg. Vuzka smuzhka of a light mіzh leaves of a legendary link, lig. pulmonale, visceral pleural leaf is not covered.

The pristinkova pleura extends to the cube of the dilyanok:

1. Pleura costalis - Pleura ribs - curling the inner surface of the thoracic wart and extending to the inner-thoracic fascia, fascia endothoracica.

2. Cupula pleurae - the dome of the pleura - to rise above the first rib, protruding, out into the area of ​​the shia. Behind the apex of the dome of the pleura is located on the ryvnі of the shyki of the 1st rib, and in front of the collarbone it will spread out by 2-3 cm. Up in the anterior view to the dome of the pleura, the artery is attached to the clavicular artery, as seen on the serous leaf there is a view - the groove of the clavicular artery, sulcus a. subclaviae.

The dome of the pleurisy with a high chest aperture and a thoracic cavity of growth of the appendix, lower with a wide chest aperture. The first one has a dome of the pleura of a cone, the other one has a wide bowl turned downward. The dome of the pleurisy of the reinforcement behind the additional intrathoracic fascia, fascia endothoracica, and a special sound apparatus. The following links are available:

1) Lig. transversopleurale - transverse pleural ligament - stretching towards the transverse ridge of the VII neck ridge and adhering to the dome of the pleura.

2) Lig. vertebropleurale - spinal-pleural ligament - to repair from the anterior surface of the first thoracic ridge and attach to the anterior aspect of the dome of the pleurisy.

3) Lig. costopleurale - costal-pleural ligament - retouched behind the anterior ligaments; stretch from the spinal end of the I rib to the back of the dome of the pleura.

Small. 90. Costal-diaphragmatic-mediastinal sinuses (according to NV Antelava).

1 - aorta; 2 - n. phrenicus; 3 - sinus costomediastinalis; 4 - sternum; 5 - oesophagus; 6 - sinus phrenicomediastinalis; 7 - sinus phrenicocostalis; 8 - diaphragma.

3) Lig. costopleurale - costal-pleural ligament - retractable behind the anterior ligaments; stretch from the spinal end of the 1st rib to the back of the dome of the pleura.

Peretin of the values ​​\ u200b \ u200bare carried out with upper thoracoplasty with the method of immobilization of the upper part of the leg.

4. Pleura mediastinalis - mediastinal pleura - serve as biches of the middle.

The projection of the costal pleura onto the anterior chest wall is visible (div. Fig. 91).

In the area of ​​the jugular sternal viralis, incisura juguli sterni, as well as behind the handle of the thymus, manubrium sterni, the upper interpleural field, area interpleurica superior, is called the thymus tricute, trigonum of the thymicum hallucis, so I In such a rank, in the whole region, the leaves of the parietal costal pleura are located at the meaning of one type of one.

The lower offense of the transition pleural folds converge and in 51% they stick one to one; in 49% of vipadkіv stench does not reach one іnshy (Tsanava, 1951).

By fixing the IV ribs of the left front, the anterior pleural fold goes to the left, fixing the heart virus, incisura cardiaca. The branches of the transitional folds at the bottom are established as the lower Interpleural field, area interpleurica inferior, which is called Voynich-Syanozhentsky's "tricycle safe". Tsei trikutnik good turns in 85%. Vin obmezheniya from the sides by the transitional folds of the parietal pleura, and below - by the diaphragm. The postpleural access to the heart and puncture of the empty pericardium is vibrated in the boundaries of the tricycle.

The rights are crossed by the fold with greater displacement, lower left. Children are seen with more transitional folds, in other words, "tricycle safety" their turns are more beautiful (Tsanava, 1951).

The lower boundary of the parietal pleura, near the middle line, stretches down to the lower base of the sword-like outgrowth.

Spread out to the sides, the lower edge of the costal pleurisy to expand:

along linea medioclavicularis - on the івnі of the VII rib,

along linea axillaris anterior - on the edge of the VIII rib,

by linea axillaris media - at rіvnі IX or X ribs,

along the linea axillaris posterior - on the equal X ribs,

on linea scapularis - on the edge of the XI rib,

descend along the linea vertebralis to the level of the lower edge of the XII thoracic ridge.

Conducted with a robotic scheme: it is necessary to remember, how often variations in the growth of the lower edge of the pleura can be observed. Behind the linea axillaris media, for example, yak means a whisker, it often grows on the edge of the X rib.

When the parietal pleurisy passes from the costal to the diaphragmatic or the mediastinal pleura, a special loss occurs - pleural sinuses, sinus pleurale. Razr_znyayut such sinuses (Fig. 90):

1. Sinus phrenicocostalis - phrenic-costal sinus - is most important in a practical sinus. Vaughn was approved by the transition of the parietal diaphragmatic pleura into the costal pleura. The whole sinus is especially glibky on the right і stretch along the linea axillaris dextra down to 9 cm (V. N. Vorobjov) ..

2. Sinus costomediastinalis anterior - anterior costal-mediastinal sinus - retouching between the anterior mediastinal and costal pleura. Vin, then, roztasovaniye near the anterior edge of the lung at the point of transition of the costal surface of the lung into the mediastinal surface of the lung.

3. Sinus costomediastinalis posterior - posterior costal-mediastinal sinus - retractable posteriorly at the point of transition of the costal pleura into the mediastinal. The offense of the remaining sinus lies in a vertical straight line.

4. Sinus phrenicomediastinalis - the diaphragmatic-mediastinal sinus - is a vuzky space, rostasovan horizontally in the sagittal right at the point of transition of the diaphragmatic pleura into the mediastinal one.

I will describe yak viplyaє, sinus phrenicocostalis є on a horizontal opening, a horseshoe-shaped slit; sinus phrenicomediastinalis on such a level of growth in a sagittal straight line. Rashta two sines lie vertically.

Here it is especially admirable, but in normal minds a vozhninupleuria, cavum pleurae, is a microscopic capillary slit: there is 7μ, that is, I don’t change the diameter of one erithrocyte. On top of it, it’s a serous age, and it’s a bit of an insult to a leaf; In the cich minds, the emptying of the pleurisy is not practical: won’t, as it is said, є microscopic schilina, before the viconan rіdinoyu.

When inhaling, the leaves of sinus phrenicocostalis rossuvayutsya go to the lower edge of the lung; at the sight of an offense of a leaf, it is innocuous to wake up, and that and the width of the costal-diaphragmatic sinus at the sight of an insult of its permanent size, that is, 7 mіkroskopіchnih rozmіrіv scho not vіdsunuvshi svoїm vіstryam vіstseralnoї pleura, scho zavzhdi predstavlyaє Pevnyi nebezpeku povіtryanoї embolії on legenevih veins in lіvogo sericite abo rozvitku spontaneous pneumothorax when poranennі vіstryam Golka legenevoї tkanini i Especially drіbnih bronhіol. in Tsikh vipadkah povіtrya light through poshkodzhenu dіlyanku legenevoї tkanini Penetrates into the pleural cleft, which leads to an overall decrease in the legacy and the appearance of a spirited badness in a sick person.

With exudative pleurisy, with emptying of the pleurisy, the sinus is filled with exudate.

Topography of Legends and Dyhal nobles.

Lungs, pulmones, grow out in the middle of the chest empty, they are called out of the middle. The skin is lighter, we have a cone shape with a base, we rotate to the diaphragm, and three surfaces: the diaphragmatic surface, fades diaphragmatica, the yak represents the lung, basis pulmonis, rib surface, fades costalis, furrow to the inner rib cage, and the mediastinal surface, fades mediastinalis, is straightened to the middle. In the middle, in the cutaneous lung є apex, apex pulmonis, a yak in 3-4 cm above the collarbone (Fig. 91).

On the costal surface of the lung, ribs are seen. The anterior viddili tops may be on the clavicular groove, sulcus subclavius, next to the adjacent artery (a. Subclavia).

The diaphragmatic surface of the lungs is excluded and oblamated by the lower edge, margo inferior. Before the medial mediastinal surface of the legends, there are a number of organs, which are covered on the surfaces of the visuals. Tom here should be talking about the skin lung okremo.

On the medial surface of the right legend, pulmo dexter, the back of the root on the whole stretch from the top downwards stretches at the viglyadi of the groin pressed into the stravohode, impressio oesophagi. Behind the depression in the lower half of the lung is indicated in the later direct depression of the unpaired vein impressio v. azygos, the right bronchus will drain off in an arcuate manner. In front of the root of the lung, the heart surface, facies cardiaca, grows. At the upper vesicle on the mediastinal surface, the sulcus of the clavicular artery, sulcus a. subclaviae, the yak in the mountains go to the costal surface of the lung.

On the medial surface of the legends, pulmo sinister, there is also a number of impressions. So, behind the root, the aortic sulcus, sulcus aorticus, aortic sulcus, aortic-bronchial bundle arcuate from front to back, is well-rotated behind the root. It grows one after one two furrows: front - furrowed without change, sulcus v. anonymae, and hind - borodenal artery, sulcus a. subclaviae, turns more beautifully, lower on the right leg. Anterior lower views of the medial surface of the legends can be warmly depressed, impressio cardiaca. When looking over the legends in front on the front edge, margo anterior, є sertseva virizka, incisura cardiaca. In the lower part of the history of the legacy tissue, I will call it the testicle of the lung, lingula pulmonis.

Small. 91. Between leg and pleurisy (according to V. N. Vorobyov).

I - rear view. 1 - apex pulmonis; 2 - lobus superior pulmonis; 3 - incisura interlobaris obliqua; 4 - lobus inferior pulmonalis; 5 - lower edge of the right legend; 6 - sinus phrenicocoslalis; 1 - lower boundary of the right pleura. II. 1 - apex pulmonis; 2 - area interpleurica superior; 3 - front between the left pleura; 4 - front edge of the left leg; 5 - mice of the lung pericardium adhesion to the anterior thoracic wall; 6 - lower edge of the left legend; 7 - lower pleural interface; 8 - sinus phrenicocostalis; 9 - lobus inferior pulmonis; 10 - lobus medius pulmonis.

The median surface of the lungs can be rotated well - the gates, hilus pulmonis, the roots of the lung are destroyed, radix pulmonis.

The number of legends in choloviks reaches 3700 cm 3, in females up to 2800 cm 3 (Vorobyov, 1939).

Yak right, so it is lighter with the interlobar gap, fissura interlobaris, spread into parts, lobi pulmonis. In the right legend, the dodatkov interlobar cleft, fissura interlobaris accessoria, is promoted. There are three parts to the right in the lung: upper, middle and lower, and in the left two: upper and lower.

Anatomical description of a part of legends on the basis of specific morphological signs appeared before the appearance of robots Ebi, which began to formulate specific morphological signs of the structure of the bronchial tree. For the last two ten years, Ebi was given a glance by the radians' glances. B. Ye. Linberg (1933) at the presentation of anatomical dosages and clinical signs showing that in the cutaneous lung the primary bronchus is divided into a number of secondary bronchus, which called for a visit about two-lobe and four-zonal morbidity. Podalshі doslіdzhennya (E. V. Surov, I. O. Lerner, A. N. Bakulev, A. V. Gerasimova, N. N. Petrov and іn.) lungs. Behind the tsimi danimi, the shape of the legends on the right and the evil is completely symmetrical. Skin is stored from chotiroh parts: upper, lobus superior, lower, lobus inferior, front, lobus anterior (for the old middle term) and rear, lobus posterior.

The head (aka legenevium) bronchus on the right stretches from the bifurcation of the trachea to the point of opening of the supraortic bronchus, and on the left, to the left side to the upper and lower limbs. Zvidsey repair bronchi of a different order. Only the upper part of the right leg will eliminate the bronchial throat without the middle of the head bronchus. All parts of the bronchi are bronchi of a different order.

The gates of the lungs are opened lower than the bifurcation of the trachea, so that the bronchi go obliquely downwards. However, the right bronchus descends more steeply, less livy, and even better trachea. We will explain those who in the right bronchus of the alien body use it more often; it is significant for bronchoscopic examination, not livy.

A. Upper parts. The upper between the tops of the clavicle pass 3-4 cm apart. To the back of the wagon there is a spinous outgrowth of the VII shinny ridge. The lower intercostal space is designed along the paravertebral line on the V rib, on the shoulder blades of the line - on the fourth-fifth intercostal space, along the middle groin line - on the fourth-fifth intercostal space, along the nipple line on the V rib. The upper part of both the legends for their internal structure is entirely symmetrical.

The upper part of the cutaneous lung has three segments: anterior, posterior and lateral, and, as a matter of fact, it is susceptible to the development of an upper lobe bronchus. For its own sizes and obsyag all the upper lobe segment may be equal. Anterior segment of the upper part of its anterior surface of the bed up to the inner surface of the anterior wall of the breast plate; the posterior segment will fill the upper part of the pleural dome. The newest segment of laying between them and calls from them.

B. Front parts. The anterior part of the lung, lobus anterior, has a triangular-prismatic shape in front of the upper and lower parts. The front part is designed on the front sternum in such a rank. The upper boundary anterior lobe є describes the vische of the lower boundary of the upper part. The lower boundary is located along the line of the scapula on the level of the high-som intercostal space, along the middle groin line on the same line, and along the nipple line on the level of the VI rib. The front parts do not reach the ridge line. The front part of the left legend for its internal structure is closer to that of the front part of the right legend. The growth of the glade is that the upper surface of the left front lobe, as a rule, is intimally grown from the lower surface of the upper part (Fig. 92).

The cutaneous anterior part extends into three segments: upper, middle and lower.

D. Back parts. Similar to the front lobe, the rear part can also be composed of three segments: upper, middle and lower. The upper boundary of the posterior lobe begins along the paravertebral line along the fourth and fifth intercostal spaces, on the shoulder blades of the line on the level of the V rib, along the middle groin line along the upper edge of the VII rib. The posterior and anterior parts of the lungs are nasharovyutsya in an oblique right on top of each other.

C. Lower parts. The debridement of the lower portion of the cutaneous lung will significantly overturn the debridement of all portions of the skin. From the point of view of a truncated cone, until the appearance of a light wondered. On the top of these parts of the skin, the lower part is stored in the following segments: anterior, posterior, outer and inner. For the authors' deeds, in niy є 3, for those 4-5 segments.

Small. 92. Projection of lung zones onto the chest wall.

A - upper zone; B - front zone; D - back zone; C - lower zone (according to Bodulin).

With such a rank, behind the casual glances, it is easier to see the four-field Budova and most often 13 segments. As far as the head of the trachea bronchus is concerned, the main or general bronchi; Secondary bronchi є Pai bronchi і bronchi of the third order є segmental bronchi.

Lung projection. Zagalny mezhі legeny when vivchennі on the living for additional percussion and fluoroscopy, or on the corpses of the offensive: the upper lungs, as it is said, stand 3-4 cm in the collarbone, and the upper right leg is in the appearance of trocha in the lower. Behind the apex of the lungs, reach only the level of the VII shyny ridge.

The lower boundary of the right of the legend is projecting when the view is done (div. Fig. 91):

on linea parasternalis - on the half of the VI rib,

along linea medioclavicularis - on the edge of the VII rib, along linea axillaris media - on the edge of the VIII rib,

on linea scapularis - on the edge of the X ribs, on linea paravertebralis - on the edge of the XI thoracic ridge.

At maximum inhalation, the lower inter- face descends anteriorly along the linea parasternalis to the VII rib, and posteriorly along the linea paravertebralis to the XII rib.

The lower border of the left leg grows lower (by 1.5-2 cm).

The inter-lobe of the line is designed on the chest with an offensive rank:

1. Fissura interlobaris - interlobar fissure - on the right and left legends to project on the anterior chest wall in the same way. The projection of the line operates the thorax from the spinous ridge of the III thoracic ridge back to the point of attachment of the VI to the sternum.

2. Fissura interlobaris accessoria - dodatkova interlobar fissure - to be projected at the perpendicular viglyad, lowered from the middle sub-crestal line along the IV rib to the sternum.

In such a rank, the front (for the old terminology middle) part

the right legends zalyagaє between the described slits, that is, between IV and VI with an edge on the right.

Wild throat. The trachea, trachea, or the throat is dizzy, is a cylindrical tube that stretches from the ridge of the VII ridge on the shoulder right up to the bottom of the bronchi in the chest empty. It is stored in 18-20 forms of tracheal cartilages, cartilagines tracheae. Behind the yogi, fasten the ring-shaped ligaments, ligamenta annularia. The ligaments of their sukupnistyu fix the overturning of the trachea wall, paries membranaceus tracheae.

At the bottom, on the level IV-V of the thoracic ridge, the trachea extends to the right and left bronchi bronchus dexter et bronchus sinister. Misce podilu trachea is called bifurcatio tracheae, bifurcatio tracheae.

On the cob, the trachea is shattered on the sheath, so the trachea grows into two parts of the shin, pars cervicalis, and chest, pars thoracalis.

Small. 93. Dedicated trachea with oozing organs

1 - n. recurrens; 2 - n. vagus; 3 - a. carotis communis sinistra; 4 - a. subclavia sinistra; 5 - a. anonyma; 6 - arcus aortae: 7 - bifurcatio tracheae; 8 - l-di tracheobronchiales inferiores.

The sternum of the trachea is otochened by such organs: back to back, lying down stravohid; in the front - on the level of the IV thoracic ridge, secretly over the bifurcation of the trachea, before it the aortic arch is lying. At the same time, the artery is unchanged from the aorta, a. anonyma, attaching the front to the right of the trachea and obliquely to the uphill and to the right; up above the aortic arch to the anterior surface of the trachea, the thymus is prone; right-handed - close to the trachea lie the bloating nerve; zlіva - lіviy pivotal nerve, and vishche - lіva zagalnaya sleep artery (Fig. 93).

Trachea with the head bronchi є the drain boundary between the anterior and posterior middle.

Bifurcation of the trachea. Rozpodil of the trachea on the bronchi (bifurcatio tracheae) is seen on the level IV-V of the thoracic ridge. In front there is a subdivision of the second rib.

Right bronchus, bronchus dexter, shorter and shorter than the left; wines are stored from 6-8 cartilaginous cells and in the middle in the diameter of 2 cm.

Livy bronchus even more; 9-12 cartilages are included in the warehouse. Average diameter - 1.2 cm (M.O. Fridlyand).

We were already crushed, but in the right bronchus, which was removed by a smaller cut, in part, below in the left, the side was stuck.

With its own growth on the bronchi, the trachea forms three kuti - right, left and lower tracheobronchial kuti.

The root of the legend. Up to the root of the lung, there is a bronchus, a legene artery, two legene veins, bronchial arteries and veins, lymphatic judges and nerves.

On the right, going from top to bottom, lay down: bronchus dexter - right bronchus; ramus dexter a. pulmonalis - rights of the legendary artery; vv. pulmonales - legends of veni.

Zliva vische roztashovutsya: ramus sinister a. pulmonalis - liva gilka of the legacy artery; lower - bronchus sinister - livy bronchus; even lower - vv. pulmonales - legeny veni (anatomical code for the right legend - Bavaria; for the left legend - the order of the alphabet - A, B, C).

The right root of the lung is hunted backwards by an unpaired vein, v. azygos, lіviy - from front to back - with an aortic arch.

Innervation of the lungs. The vegetative nerves of the lungs are drawn from a pretty near-cordon stubbur - a nice innervation and from bloody nerves - a parasympathetic innervation.

Nice girls come from two lower ones. ganglia and five upper pectorals.

З n. vagus in the legends comes from the root of the lung with bloody nerves. Tі and іnshі nerves straight up to the leg tissue, supravolume bronchi, and form two vegetative legene gossip, plexus pulmonalis anterior et posterior.

The blood posture of the legacy tissue is going to get involved in the bronchial arteries, aa. bronchiales, in the number of two to one, most often two and one right. The decision to go to the anterior periphery of the thoracic aorta on the third intercostal arteries and along the bronchial tubes to go to the lungs. Bronchial arteries supply blood to the bronchi, legenev tissue and peribronchial lymph nodes, in a great number supervise bronchi. Krym tsyogo, Leheneva fabrics to gnaw for the rakhunok of the sack blood of the system of coils vv. pulmonales. In bronchial tubes and alveoli, anastomoses between the aa system. bronchiales i system vv. pulmonales, besides, it is easier to take revenge on those who are called vasa derivatoria, є anastomotic vessels of the type of arterioles and great in diameter rosette between the systems of the air valves aa. pulmonales et a. bronchiales. In the experiment with the inking suspension of carcasses aa. bronchiales won’t wiggle through the list of main tubes a. pulmonalis, and in case of ін'єкції in the education of the rest of the carcasses, they wedge through aa. bronchiales. In patients with bronchiectasis, and in lung cancer, in some cases, dressing is indicated a. pulmonalis, easier to wrinkle, ale gangrene yogo, which usually does not come. In the minds of pathology, great adhesions between the visceral and parietal pleura and in adhesions to the easy way of ordinary arterial paths from vasa vasorum aortae descendentis, aa. intercostales, aa. phrenici inferiores, aa. mammariae internae, a. subclavia, aa. pericardiacophrenicae.

In such a rank, it is easier to manage blood circulation in the minds of pathology, both for the brain of vlast vessels, as well as for all pre-existing ones, for the life of the parietal pleura, for the failure of such and establishment of adhesions of the tissue in the mind of the pathological of the pleural space.

Another group of Sudin is able to provide diversified functionality. So the yak itself is a legendary artery a. pulmonalis, which comes from the right slug and the shape of a stovbur up to 3-4 cm. According to the legendary arteries, there is venous blood in the lung from the heart. View of arterial blood from capillary hedge to flow through the leg veins, vv. pulmonales, which in the gates of the lungs cover the bronchus in front.

View of venous blood from the leg tissue and go behind the anterior bronchial veins, vv. bronchiales anteriores, into the system of permanent veins, vv. anonymae, і along the posterior bronchial veins, vv. bronchiales posteriores in an unpaired vein.

Lіmfovіdtіkannya. Lymphatic legends, vasa lymphatica pulmonum, grow on the surface and on the surface. The superficial judges set up a dense border under the visceral pleura. Glibokі lymphatic vessels go out from the alveoli and supervise the gіlky veins. In the course of the cob throats of the legene veins, the stench confirms the number of legene lymph nodes, 1-di pulmonales. Dal, followed by bronchial tubes, stench molds without bronchial lymph nodes, 1-di bronchiales. Having passed the roots of the lung, lymphatic judgments wriggle into the system of bronchogenic lymphatic universities, 1-di bronchopulmonales, which represent the first bar on the way to direct the lymphatic from the lung. Visceral lymphatic vessels enter the lower tracheobronchial lymphatic institutes, 1-di tracheobronchiales inferiores, distant, following up the hill, passing the upper right or other tracheobronchial lymphoma Visceral lymphatic judges pass the rest of the bar - right and left tracheal lymphatic vuzli, 1-di tracheales, dextri et sinistri. The sound of a lymph is already leaving the chest empty and wagging in the lower lymph universities, 1-di cervicles profundi inferiores s. supraclaviculares (Sukennik, 1903).

prompt access

A. Access to the latest legends for thoracoplasty

1. Fridrikh-Brauer's Rose for General Extrapleural Thoracoplasty; It is carried out from the spinous outgrowth of the II thoracic ridge down the linea paravertebralis in the course of the dorsal joints of the back to the IX thoracic ridge, then arcuately zagorteє in front, the subrillation of the line is intertwined.

2. Access for anterosuperior thoracoplasty according to NV Antelava; two razrizi are carried out: the first - in the supraclavicular hole parallel to the clavicle with a further phrenic-alcoholization, scalotomy and bite of three upper ribs in the spinal cord; other growth (after 10-12 days) arcuate towards the anterior edge of the groin fossa of the bridle of the posterior edge of the great breast meatus, flaring the chest cavity (the upper three ribs are not visible and the chest is visible through the VI and 6-8 ribs) IV, V

3. Access to the upper part of the lung along Koffi-Antelava goes through the supraclavicular fossa. The growth is carried out along the bisectrix of the cut between the clavicle and the sternocleidomastoid nipple joint. Pislya peretinu with ligatures v. transversa scapulae, v. jugularis externa, v. transversa colli to grow fat cells from lymph nodes, to get to the top a. transversa colli і from bottom a. transversa scapulae and vibrate phrenicalcoholization, scalotomy, resection of three upper ribs and extra-fascial apicolis, i.e. sounding of the pleural dome from adhesions. The head of the operation is the collapse and immobilization of the upper caverns.

4. Access for the subscapular paravertebral pedicle thoracoplasty according to the Brower transmission is two dimensions: the first one - from the II thoracic ridge downwards, paravertebrally, and the other way - parallel to the edge of the thoracic cyst, also at the vertical edge of the chest. The operation is carried out in two moments. The first moment: resection of the II-V ribs and another moment - resection of the I rib with the opening of the trapezoidal bone marrow (carried out after 2 weeks of the first operation).

5. Access for the posterior-upper thoracoplasty should be carried out vertically in the middle of the wall between the spinous outgrowths and the backbone edges of the scapula from the edge of the back and arching along the edge of the back to the shovels. At the same time, the trapezoidal muff is intertwined, and the rhomboid muff and the wide muff of the back (most often seen are the upper seven ribs; sizes are seen in steps, going from the top to the bottom) 5 to

B. Access to the root of the legacy

1. Access to the upper lobe vein according to L.K.Bogush with the mark of the її ligation should be built up in a transverse straight line up to 9-11 cm from the middle of the breast bone above the III rib on the right (for the right leg) and above the II ridge of evil (for the legion) ); the great pectoralis develops along the fibers.

2. Access for dressing the legacy artery along Bakuliv-Uglov is carried out by the same rozrizami, as in the forefront. Ligation of the main legs of the leg artery to prevent bronchiectasis as an anterior stage before the operation of pulmonectomy and as an independent operation.

B. Access for lobectomy and pulmonectomy

In a given hour, two access points should be provided for the visualization of an easy part - posterolateral and anterior. Most of the surgeries vvazayut for a dye posterolateral opening, as it opens up a greater access to the organ. A part of the surgery has an anterior approach, and because of the anatomical elements of the root of the leg, it is more beautifully exposed in front.

1. Posterior-lateral approach according to N.V. Antelava, it is created by transverse development along the VI rib. Remains seen at all costs. In addition, near the ridge, small holes of the V and VII ribs are resected with the help of dilution from the side and the root of the wide access to the organ. The pristinkova pleura is also open along the VI rib.

2.the anterolateral approach according to A.N. Bakulєva, it is formed by kutovym development, which is carried out from the sternoclavicular joint downward to the parasternal one, then from the top of the cuff it is called from the chest cavity to the posterior groin line. M'yakі fabrics re-straighten і resect III and IV ribs. M'yazovy klapot v_dvertayut nazovn_, for whom to open the adipose leaf of the pleura.

On the colorectal bag.

In the number of three closed serous beasts of the coelomic empty space, the heart bag or the pericardium, the pericardium, enter. At the sight of the heart, the bag will burn out on the heart and transform into an epicardium, an epicardium, a shell grown to a heart meat. An empty heart bursa, cavum pericardii, was laid between two leaves in two sheets, and a small amount of ridini was placed on the inner surface of the serous leaves of the heart bursa (Fig. 95). In such a rank, the pericardium is a parietal leaf of the heart bursa, and the epicardium is of the viscera. Ridina in the empty heart bag was called pericardial ridini, liquor pericardii. In pathological minds (with tuberculosis, rheumatism, streptostaphylococcal infections, pneumococcal infections and as a result of injury), the number of days in the form of exudate means growing and growing in between 0.25 to 3 liters (Yu. Yu. Dzhanelidze).

With a great purchase of life, serious damage to the heart cycle occurs very quickly, as it is important for the heart.

The emptying of the heart bag has a cone-like shape. The front of the cone, which is diaphragmatic to the top, fades diaphragmatica, rots at the bottom and extends to the tendon part with diaphragms. Steppingly, the top of the burned out cob viddil aorta sounded.

Razr_znyayut such parts of the heart bag.

1) Pars sternocostalis pericardii - the sterno-rib part of the heart bursa - is straightened forward and down to the lower side of the chest, as well as up to the inner parts of the fourth and fifth mid-ribs.

2) Partes mediastinales pericardii dextra et sinistra - right and left the mediastinal parts of the heart bursa - expand from the sides to the heart and between the mediastinal parts of the pleura. On the ciches of the pericardium, there are diaphragmatic nerves, nn. phrenici і pericardial-abdominal sudini, vasa pericardiacophrenica.

3) Pars vertebralis pericardii - the ridge part of the heart bursa - is straightened back towards the ridge. The posterior surface of the spinal end of the heart bursa є cordon between the anterior and posterior middle. To her lie down stravohid, azygos vein, thoracic duct and thoracic part of the aorta. The spinal part of the heart bursa of the stravohid is depressed on the surface of the spine.

4) Pars diaphragmatica - the abdominal surface of the heart bursa - mintly extends to the tendon center and partly to the mucous part of the diaphragms.

The prismatic leaf of the heart bursa is the base of the heart in the boundaries of the great yogh Sudin, I set the line to the pendulum and go over to the visceral, visceral leaf of the bursa, epicardium. The whole leaf grows up to the heart meat. The ears of the visceral aorta and the legendary artery are covered with a visceral pericardial leaf and protrude into the empty heart bag. The price is great for practical purposes, since in this hour, in case of poured lesions of the lung, with bronchiectasis, a ligation of the head of the leg artery is carried out. From the descriptions of the anatomical minds, such a dressing can be performed in both intrapericardial and extracardial. In the first one, the proximal shape of the court is bandaged, in the other - the distal one.

The dressing of the head head of the legacy artery is carried out in an hour before the operation of the pulmonectomy, for it is an independent operation, because of which it is often necessary to see the legacy.

At the time of turning over one sheet of paper in the first place, they pretend to be a good turn of destruction - a turn. Razrіznyayut chotiri vyvorotu: anterior-upper, posterior-upper, anterior-lower and posterior-lower.

In pathological minds, the purchase of birth due to its severity is found in the lower vivoritis of the heart bag.

The most practical value from the descriptions of the five cases of the heart bag may be pars sternocostalis pars diaphragmatica pericardii, so as through the center of the bag they pierce the punctures to see pathological vipotus.

The heart bag is strengthened in its own setting: 1) The diaphragmatic surface of the heart bag is mintly enlarged with the tendon part of the diaphragm. Here the bed of the heart is called so.

2) The heart bag in the mountain grows to the aorta, the leg artery and the upper empty vein.

3) Take care of the fate of a special ringing device in the replacement bags:

a) lig. sternocardiacum superius - upper sternocardial ligament - stretch from the handle of the sternum to the heart;

b) lig. sternocardiacus inferius - the lower sternocardial ligament - stretched across the back surface of the sword-like outgrowth and the front surface of the heart bag.

Bloodstending. The blood posture of the heart bursa zd_ysnyuєtsya for the rakhunok of the offensive Sudins.

1. A. pericardiacophrenica - pericardial-diaphragmatic artery - є gilkoyu a. mammaria interna, supervujuє n. phrenicus and grow in the heart and diaphragms, preventing blood from the blood and the front side.

2. Rami pericardiaci - pericardial veins - pass without the middle out of the thoracic aorta and supply blood to the back wall of the heart bag.

Venous vidtik goes through the pericardial veins, vv. pericardiacae, bezposredno into the system of the upper empty vein.

Innervation. Innervation of the heart bag, go to the heart of the heart, gossip from the bloody and phrenic nerves, as well as the cute little heart to see the gossip of the heart.

Lіmfovіdtіkannya. The view of the lymph from the heart bag is located in the main in two directions: forward - in the sternum of the lymph nodes 1-di sternales, as well as in the anterior mediastinal lymph nodes, 1-di mediastinales - anteriores backward

1) L-di sternales - the sternum of the lymphatic vuzli - to expand from the side of the sternum along the vasa mammaria interna.

They have lymphatic judgments, which go from the milky zone, the anterior pericardium, and from the mid-ribs.

2) L-di mediastinales anteriores - anterior mediastinal lymph nodes - lay on the anterior surface of the aortic arch. Starts a lymph by vasa lymphatica mediastinalia anteriora head to truncus mammarius on the same side.

3) L-di phrenici anteriores - anterior diaphragmatic lymph nodes - for the name of the name, the anterior mediastinal lymph nodes are seen, so they fill the diaphragm on the floor of the sword-like vid.

4) L-di mediastinales posteriores - posterior mediastinal lymphatic vuzli - grow on the upper, lagging on the trachea and trachea, and lower - supraphragmatic, rosette in the rear overhead Suddenly and lymph from the posterior pericardium.

Lymphatic judges of the first three groups - sternum, anterior mediastinal and anterior diaphragmatic - according to truncus mammarius, fall into ductus thoracicus, and right-handed - into ductus lymphaticus dexter.

Lymphatic vessels from the posterior mediastinal nodes flow into the truncus bronchomediastinalis, behind which the limph of evil reaches the thoracic duct, and the right-handed person - the right lymph duct.

puncture

With the help of proponated methods of puncturing the pericardium with the help of visualization of the line from the emptying of the heart bag, we shorten the step.

1) Marfan's method - the puncture is carried out with a gostry kut at the top of the sword-like protrusion. The head penetrates into the upper lip through the lower surface of the pericardium. Pleural leaves are not punctured with any method. Not without a wound with a bare heart is mute, so if you have a meaningful heart, you burn it out.

2) The way of Larrey - the puncture is carried out in the cuff between the sword-like spine and with the rib cartilage. The yak і in the forward direction of the head then penetrates through the lower surface of the pericardium.

The best ways to injure especially sensitive reflexogenic zones of the pericardium, such as: Shaposhnikov's way - puncture right-handed, beat the edge of the sternum in the third mid-rib, A.G. Voynich-Syanozhentsky - on the right , N. I. Pirogova - in the fourth mezhreber'i evil and іn. recommend not slid.

TOPOGRAPHY HEART.

To the blood circulation system, it is delivered to the heart, blood vessels and to reach the folding nerve apparatus, which regulates the whole activity of the heart-vascular system.

The heart is the main motor for blood circulation, for the purpose of pumping blood through the vessels. It is a great addition to the arterial and venous vessels of the myaz type, with their active fast-paced people they drink the blood on the vessels. In the whole aspect, the entire system of judgment is recognized by the authors as “peripheral heart”.

Morphologically and functionally, the heart is divided into two halves: the right - the venous heart and the left - the arterial heart.

Holotopia. The heart of its healthy growth is to be in half of the breast plate in the boundaries of the front middle. The sides are surrounded by leaves of the mediastinal pleura. Only about 1/3 of the heart will be rocked to the right of the middle line and to go into the right half of the breast tissue.

The form. The heart behind its shape is close to the cone. At the newest base of the heart, basis cordis, the part is rounded down to the bottom - the top of the heart, apex cordis, and two surfaces: the bottom, lay down to the diaphragms - the diaphragmatic surface, fades diaphragmatica, and the antero-upper, rebound-back fades sternocostalis.

In front of the zovnіshnyaya side of the viddіlenі from the shlunochki in the transversely vintsevoy sulcus, sulcus coronarius, in the yak ridge one venous sinus, sinus coronarius cordis. Anterior lateral borozenkoyu, sulcus longitudinalis anterior, lіviy slunochku is seen from the right. To the back, the back is bored, sulcus longitudinalis posterior.

Variation of morphology. A normally functional heart in the presence of its own sizes is

1. Wide і short heart, in a yaky transverse size is greater than the length.

2. Vuzke and dovge heart, in which dovge is larger than th's diameter.

3. Droplet heart - more heart is much larger than the diameter.

4. The shape of the heart is zvychana; in the case of a dozhin it is close to a transverse size.

Rosemary. Dovzhina heart from asleep to the top of the door 12-13 cm. The diameter of the reach is 9-10 cm. The anteroposterior size is 6-7 cm.

Waga. Vaga of the heart in new-born women is 23-27 m In mature hearts, in the middle one is important: in choloviks - 297 g, in females - 220 g (in women from 20 to 30 years).

The position. The heart is spread behind the lower half of the thoracic cyst in the boundaries of the lower Interpleural field, area interpleurica inferior.

In the whole region, as it has already begun, it is established that the size of the trike is more spacious, do not cover the pleurora and see the name of Voynich-Syanozhentsky, a trikutnik of safety.

It is necessary to creep, so that the position of the heart changes in the fallowness of the position of the dust, mental debris, phases of heart activity and vіku. When it is put on the head of the heart, it will be changed, when the highest postage is changed, it will be named. When nahila forward, the heart is lying close to the breast.

Behind the upper half of the sternum, the great heart of the heart grows.

Variation of the situation. At the presentation of X-ray dosages in Danish hour, there are three main options in the position of the heart: vertical, horizontal and diagonal. Tsi variatsії position tied with constitutional features to organism. In wide-bodied specialties, the heart is more often placed horizontally, in the narrow-bodied heart it is in a vertical position. In some industrial constitutions, the heart is rostered in an oblique straight line.

Heart projection. On the anterior chest wall, the heart is designed in such a rank: the upper border passes along the cartilage of the third ribs. The lower boundary of the edge is obliquely from the point of attachment of the cartilage of the V rib through the edge of the sword-like outgrowth to the fifth intermediate edge of the left side.

The right border, going from top to bottom, fix up to the upper edge of the third rib by 1.5-2 cm. Named from the edge of the chest wrist, then a thin line with an opaque line to the point of fastening the right right fifth rib to the sternum.

Liva between the edema is called a line at the height of 3-3.5 cm called from the edge of the thoracic cyst, and at the bottom 1.5 cm to the middle of the midclavicular line.

The top of the line is seen in the fifth half of the edge.

Projection of heart openings. 1) Ostium venosum sinistrum - lithium venous opening - opening in the third interstitial gap at the sternum itself The robot of the two-stalk valve hangs on the top of the heart.

2) Ostium venosum dextrum - to the right venous opening - to project in an oblique straight back behind the lower third of the sternum. The sound from the closure of the tricular valve is heard in the fourth intercostal gap to the right of the edge of the sternum.

3) Ostium arteriosum sinistrum - lіve arterial or aortic opening - lie behind the sternum on the іvnі cartilage of the III rib. Tony's aorta is visible at the other intercostal space on the right, along the edge of the sternum.

4) Ostium arteriosum dextrum - the right arterial opening or the opening of the legacy artery - also grows on the ryvny cartilage of the third rib, ale lіvіshe - at the left edge of the chest cyst. Tony sees half a thousand valves in the leg artery to be heard at another mid-ribbed gap of evil on the edge of the sternum.

The heart in its own camp is strengthened. 1. Vono to be seen from below by diaphragm - it is especially possible to be spared with the so-called recumbent heart.

2. The heart "pidvishene" on its great vessels - aorta, the legacy of the artery and the upper empty vein. The time is important for the so-called hanging heart.

3. Deyake means a great deal of grip on the heart from the side of the legends, to the heart of the heart to squeeze from the sides, to the bottom of the deyakiy world.

Skeletotopia. The heart is rounded behind the sternum and stretched from the II to the VI rib. Outside of the anatomical anatomy, I may approach the skeleton.

1) Auricula dextra - right vushko - is located behind another, mid-ribbed prominence on the right side of the breastbone itself.

2) Atrium dextrum - to the right of the anterior - to move the right-handed along the linea mediana anterior between the third five costal cartilages, with 1/3 of them lying behind the sternum and 2/3 - behind the right costal cartilages.

3) Ventriculus dexter - the right slit - the lagging between the third rib cartilage, and the sword-shaped spine, and the right of 1/3 of the th is to lie behind the sternum, and 2/3 - behind the other rib cartilages.

4) Auricula sinistra - liva vushko - roztashovane behind the third left costal cartilage at the sternum itself.

5) Atrium sinistrum in front of the heart - directed backwards, so that the anterior chest wall does not appear on the screen. The raztashuvannya of the left front of the eye leads to the other costal cartilage and the other intercostal gorge.

Small. 94. organbreastempty.

1 -. v. anonyma sinistra; 2 - a. carotis communis sinistra; 3 - n. vagus; 4 - v. subclavia; 5 - pericardium; 6 - cor; 7 - diaphragma.

6) Ventriculus sinister - lіviy slunochok - in the viglyadі vuzkoy smuggle project on the anterior chest wall, named as vіd. the sternum goes from the other mid-ribs to the cartilage of the IV ribs.

Syntopy heart. The heart is in the offensive in the throes with the oozing organs (Fig. 94, 95).

In front - in the risnogo step, covered with leaves of the mediastinal pleura.

Most often, the heart appears from the side of the lungs, so that the anterior costal-mediastinal sinuses are closed. If you are wounded in front of the most recent appearances of the heart, you can be a little bit of a genius and a parenchyma of the legacy. As soon as the injury is caused by the edge of the sternum, call to the pleura, which is more difficult for the development of pneumothorax. Nareshty, if the injury is caused by the "tricycle of safety", it is not supervised by pneumothorax.

Small. 95. organbreastempty.

1 - a. carotis communis dextra; 2 - v. jugularis interims; 3 - v. jugularis externus; 4 - aorta ascendens; 5 - a. pulmonalis; 6 - v. cava superior; 7 - cor.

In such a rank, it is possible to develop three later zones from the sides to the linea sternalis - call, in which a wounded pleurisy, a legend and a heart, a middle one, can be seen, and a pleura may appear in a heart, and one inside, a wounded one.

Behind the ridge, the back of the ridge is folded to the heart: stravochid with bloody nerves, thoracic aorta, right-handed - an unpaired vein, malice - a semi-unpaired vein in the unpaired-aortic thoracicus ductus, sulcus ductus

From the sides to the heart, lay the walls of the mediastinal pleura, and behind them - the lungs, cover the visceral pleura.

Above, in the heart, the great judges enter into the air. In the anterior viddilia to the new pristine, there is also the thymus, glandula thymus, in the grown-ups - the surplus.

Small. 96. Organize breast emptying.

1 - n. vagus; 2 - n. phrenicus; 3 - a. carotis; 4 - n. laryngeus inferior; S - v. anonyma sinistra; c - arcus aortae; 1 - pleura; 8 - pericardium; 9 - v. anonyma dextra; 10 - clavicula; 11 - n, vagus.

At the bottom, the heart is rosted on the anterior arch of the tendinous center with diaphragms folium anterius diaphragmatis (Fig. 96).

Bloodstending. The system of vintsevic arteries and venous vessels of the heart form the third stake for blood circulation in humans.

The managers of the more frequent anastomoses with the vessels of the great and small blood circulation of the arteriosclerotic viper of the heart, for example, of the nature, lead to the strong and often nonvolatile breakdowns of the heart meat.

Rise of the following:

1. A. coronaria cordis dextra - rights of the vintseva artery of the heart - to repair from the form of the right aorta sinus, sinus aortae (Valsalvae), frog in the groove between the arterial cone, conus arteriosus, and rule the vushkom. The artery is placed in a circular direction, lagging, and we are ruling in front of the eyes and we are ruling the duck. On its way out to develop and anastomoses with the main trunk of the wine artery.

On the posterior surface of the heart, from the right vintsevo artery, enter the posterior slump, ramus descendens posterior, yak frog in the posterior lateral groin, sulcus longitudinalis posterior.

Small. 97. Gilki vintsevyh arteries. Judge all orders, for a vignette

capillary

2.A. Coronaria cordis sinistra - liva vintseva artery of the heart - protects the ear from the left sinus of the aorta between the leg artery and livim vushk and unbarredly dwells on its two prints: ramus circumflexus - vintsevoy artery heart; ramus descendens anterior - anterior lower head - lyagaє in the anterior lateral boron, sulcus longitudinalis anterior.

An important key picture, as it is insisted in the case of a third cola, the blood circulation should be set in front of the current surgery, and for the development of ordinary court nobles from the system great stake blood circulation. Before the experimental advances on the creatures in the whole direct from the days of the great omentum to the epicardium (omentopexy) from the applications to finish the tip on the pericardium (fenestration of the pericardium), you will be able to cleanse the pericardium (fenestration of the pericardium). Ognev, 1952).

Venous appearance from the heart is drawn through other veins into the larger vein of the heart, v. magna cordis, yak, expanding, transforming into a large vessel - the heart's sinus sinus, sinus coronarius cordis; The rest is seen in the right front of the heart.

Small. 98. Judge the pericardium.

Obhіdnі judges of the third stake blood circulation. Before the warehouse of the third stake, blood circulation should enter aa. coronariae, dextra et sinistra і in some types of buvaє a. coronaria tertia (Fig. 97 and 98).

With the blockade of one of the meanings of arteries in the minds of the experiment, so even the clinics insist on death from the ischemia of the great part of the heart meat. With victories okremikh gilok aa. coronariae is especially problematic є outside of the general rule of thumb rami descendentis a. coronariae cordis sinistri, rami circumflexus aa. coronariae cordis sinistri et rami descendentis posterioris a. coronariae cordis dextri.

Vymknennya dermal arteries increase the veda until the destruction of the food of provincial nobles of the heart - the bundle of Gis, the institutes of Ashoff-Tavar and Kissa-Flak. Investigation of giloks of a different order do not depend on death until death, but to lie down in the zone of inclusion, and are not safe for the third order. If there is an infarction of the heart, right out of the order of the heart, if death does not come, if you step into the zone of aneurysm of the heart. In general, the pericardium often grows up to the epicardium and the heart will be removed from the pericardium (aa. Pericardiacophrenicae - aa. Mammariae internae). In everyday blood circulation, the heart also takes on the fate of vasa vasorum aortae descendentis, vasa vasorum aa. coronariae cordis et vasa vasorum vv. cavae inferioris et superioris.

Lіmfovіdtіkannya. Lymphatic heart deaths spread on the surface and gliboks. The first ones are in your myocardium, others are in your myocardium.

The streams of lymphs follow along the vintsevic arteries from bottom to top and go to the first bar - heart lymph nodes, l-di cardiaci, rosetto on the anterior or biches of the upper aorta. Looks like a lymph along the anterior mediastinal zone of the court m, vasa mediastinalia anteriora, coming to truncus mammarius on the same side.

Innervation. Development of non-cardiac and inner-cardiac innervations. Prior to the first, it is introduced by the parasympathetic fibers of the bloating nerve, as well as by the sympathetic jugs from the heart nerves from the system of the cordon sympathetic stovbur; to the other - a special nerve unit of the apparatus.

Parasympathetic innervation:

1) Kami cardiaci superiores - the upper heart of the head - going to the outer part of the blukular nerve and going to the heart.

2) Kami cardiaci inferiores - the lower heart of the throat - coming out of the blistering nerve above the bifurcation of the trachea.

3) N. depressor - to enter from the bloating nerve and enter into the heart, the strength of what is trusting.

4) Pavlov's "strong" nerve - the strength of the heart is very fast.

Nice energy:

1. N. cardiacus superior - the superior cervical nerve - to enter the lower pole of the ganglion cervicale superius, anastomoses to the way with the bladder nerve, the upper laryngeal and rotary nerve and the lower entry into the heart of gossip.

2. N. cardiacus medius - the middle cervical nerve - comes from the ganglion cervicale medium - and also enters into the heart gossip.

3. N. cardiacus inferior - lower cervical nerve - to enter the lower cervical nerve, ganglion cervicale inferius, or from the vascular node, ganglion stellatum;

Fibers of the pretty and bloody nerves in the heart area take on the fate of the six nerve heart gossips.

1) і 2) Plexus cardiacus anterior (dexter et sinister) - anterior heart gossip (right or left) - rosters on the great vessels and front sides of the heart.

3) і 4) Plexus cardiacus posterior (dexter et sinister) - posterior heart gossip (right or left) - mostly on the back surface of the licks.

5) і 6) Plexus atriorum (dexter et sinister) - atrial gossip (right or left) - rots in the atrium.

The inner-core nerves of the device zoom in on the "autonomy" of the robot heart. Up to these foldable apparatuses, the universities Kissa-Flak, Ashoff-Tavara and a bunch of Gis are presented, which are described in the books of physiology.

prompt access

1. lingual growth of Janelidze - carried out in an arc-like manner along another mid-ribbed line, repaired along the middle clavicular line, then along the middle of the sternum downwards and turned again on the half of the 6th left rib before the new Further, III, IV, V and VI ribs are resected at once from the sides, carefully going through the pleural fold to the left (and if the right to cross the pleural fold on it, then I’ll stop going to the right), go out to the right. Pospleural access.

Small. 99. Access to the heart.

1A - Dzhanelidze's tongue-shaped rosters; 1B - stolkovy rosris Kocher; 2A - Ren's access through the sternum. 2B - T-podbniy rozriz Lefort.

2. T-shaped transpleural access of Lefort - stagnates in case of injured heart with pleural effusion with pneumothorax. Razrіz is carried out along the middle of the sternum from the level of the II rib down to the middle of the xiphoid ridge. On the fourth intercostal space, from the designated development, another growth is carried out up to the midclavicular line of evil. Then the ribs of the cartilage in the bones are attached to the breastbone obliquely. The ribs are pulled out with blunt jigs (two - uphill and two - down) and the heart shirt is exposed.

3. The stool part of Kocher is carried out along the III rib of the sinus horizontally to the right edge of the sternum, then along the right edge of the sternum vertically downward and further along the edge of the costal arch. For the whole cartilage of the III, IV, V and VI ribs, the ribs are slanted at the sternum itself, and the ribs are broken and hinged at the look of the stool. Distant pleural folds appear to the sides and expose the "tricycle safety".

4. through the sternum Ren's approach - it is carried out along the middle of the sternum towards the level of the second rib downwards by 1-2 cm below the sword-like ridge. The sternum later grows out along the middle line, and on the level of the II ribs to overturn transversely. The edge of the sternum opens and opens up a great and manual access to the heart. Transitional pleural folds expand to the sides, causing the pericardium to be exposed.

TOPOGRAPHY middle

The space, laid between the inner surfaces of the lungs from the curvature of the pleurora, is called mediastinum, mediastinum. The middle middle, mediastinum commune, cleverly frontal area, should pass through the root of the lung (along the trachea and bronchi), go into two parts: the anterior middle, mediastinum anterior, and the posterior middle, posterior

The front middle for its size is larger and borrowed approximately 2/3 of the back middle.

The front middle, in its turn, grows to the front-upper and front-lower middle.

The posterior middle of the same rank extends to the posterior-upper and posterior-lower middle.

front middle

In the anterior middle of the thymus rosette, the heart with the pins, as well as the abdominal nerves and the pins.

Vilochkova zalosa. Goiter abo thymus zolosis glandula thymus, zalyag in the upper Interpleural abo thymus field, area interpleurica superior s. thymica, behind the sternum handle. It’s reachable for the child to develop 2-3 times, and the distance is "conceived" in the process of rapid development. fatty degeneration and swelling of fatty degeneration.

Above, on the deyak_y vіdstanі from the thymus gullet, the thyroid gallbladder grows; below - the anterosuperior surface of the heart bursa; from the sides of the border between the mediastinal pleura.

Near the circumference, the anterior mediastinal lymph nodes, l-di mediastinales anteriores, in the number of 10-12, grow out in front of the fatty cells, more in front. During pathological processes, it is not easy for the lymphatic universities to significantly increase in their sizes and to build up deep-lying veins. The onset of blood circulation problems in the blood circulation in the blood circulation in the blood vessels is in the hands of the patient.

With hyperfunction of the thymus in childish vinikaє especially pathological stance- status thymicolymphaticus.

Visible aorta. Aorta ascendens to be repaired for the first time in the heart on the level of the third mid-ribbed industry. Vona roztashovuutsya behind the chest and for their sizes it is more difficult to act on the width. Dovzhina її 5-6 cm. On the pivot of the other right sternocostal joint, the won is turned left and back, passing into the arch of the aorta, arcus aortae.

The three great Sudins are the basis of the heart of the visible aorta є in order by another vessel: the right-handed person from her to lie v. cava superior а zlіva - a. pulmonalis.

In such a rank, the viscous aorta is zalyagє in the middle between the two meanings.

Aortic arch. Arcus aortae spread from front to back through the root of the legends, on which yak bi "sit tops". Yak zgaduvalosya, through the root of the right legend, an unpaired vein is spread backwards.

The arch of the aorta is repaired on the ryvn of the other sternocostal joint and will fix the lower part of the arch, the upper part of which is pointed at the center of the handle of the sternum. Vona is otochennye such assertedness: from above to her lying down, a vein is unchanged, v. anonyma sinistra, from below pass the transverse sinus of the heart, sinus transversus pericardii, bifurcation of the legacy artery, livy rotary nerve n. recurrens sinister, і obliteration of the arterial duct, ductus arteriosus (Botalli).

Small. 101. Scheme of rostašuvannya botallova ducts.

A - the upper empty vein; B - botall duct: 1 - right vushko; 2 - aortic arch; 3 pulmonary artery; 4 - liva vushko.

Arterial duct. Ductus arteriosus (Botalli), aka botal duct, is an anastomosis between the aortic arch and the legacy artery, which is of great importance in uterine blood circulation. For a child up to 3-6 months of life, the child's life is deserted and transformed into an obliterated arterial ring, lig. arteriosum (Botalli) (Fig. 101). Legeneva artery. A. pulmonalis emerge from the arterial cone, conus arteriosus, the right duck. There lie evil from the viscid aorta. The ear of the ear is indicative of another mid-ribbed advance of evil. Similar to the aorta, the cob saw the legendary artery go into the empty heart bag. It is more important than practical meaning, as it is permissible in case of gnar processes in the legends, for example, in case of bronchiectasis, the ligation of the main head of the Legend artery through the empty heart bag. Such a dressing in the Danish hour is not often carried out as an anterior stage before pulmonectomy, for it is an independent operation, so as for dressing in a large number of cases, it is often necessary for N. G. Uglov).

Upper empty Vienna. V. cava superior to pretend to be angry with two unchanged veins on the edge of the attachment of the first costal cartilage to the sternum. Vaughn is a wide vessel, almost 4-5 cm long. On the edge of the third costal cartilage, it flows into the right anterior. Lower її ії ідділ "to be thrown into the empty heart bag.

As a result of the muscle attachment to the right mediastinal pleura, in case of a wounded lower empty stage, the disease does not subside, and often leads to an endemic embolism.

Lower empty Vienna. V. cava inferior perforates the diaphragm, passing through the opening of the lower empty vein or chotiricutne openings, foramen venae cavae inferioris s. quadrilaterum, and penetrates into the empty heart bag. Here you can see the letter of heart for the top. Dovzhina of the supraphrenic part of the lower empty vein reaches 2-3 cm. The viscera falls into the lower viddil of the right atrium.

Legendary veni. Vv. pulmonales, in the number of chotiers, go through two doors of the cutaneous lung and go to the left atrium, fall into the yak and fall. The rules of the legend are better than the ones. Mayzhe, with all its stripes, the legenevia veni vdajutsya into the empty heart bag.

Transverse sinus. Sinus transversus pericardii grows crosswise between the heart and the arch of the aorta. Її between: in front - aorta ascendens і a. pulmonalis; behind - v. cava superior; above - arcus aortae; below - basis cordis.

The transverse sinus is of practical importance for operations on the heart in case of any injury. With such operations, wind a gauze servet through the transverse sinus, - gently pulling for it, close the heart forward. I am bleeding from the wound of the heart and to the singing world at the moment when the seams are applied.

Abdominal nerves and nerves. N. phrenicus - enter the gossip, along the anterior surface of the anterior descent, go down and penetrate through the upper sternum opening into the sternum emptying. Here the right and left abdominal nerves show three different topography.

The right abdominal nerve, lagging behind a.pericardiacophrenica, passes through the right mediastinal pleura and the lateral surface of the upper empty vein.

Livy pectoral nerve, supravascularization also a. pericardiacophrenica, penetrating into the thoracic emptying in front of the aortic arch and in the middle of the heart bag.

The offense of the nerve passes in front of the root of the leg, which stench and is carried to the organs of the anterior middle.

The abdominal nerves were simultaneously soldered to the bicar surface of the heart bursa with the supervascular vessels.

A. pericardiacophrenica - pericardial-abdominal artery - є gilkoyu a. mammaria interna, so the yak itself and the myazo-abdominal artery, a. musculophrenica.

Vrodzheni wadi sertsya

In connection with the expansion of surgical involvement in the heart of the region, it is necessary to know the topographic anatomy of the organ in case of congenital wads, as well as in case of severe major sudins, to go and fall into one.

Tinkering about the anomalies of the growth of the heart, then you will respect that in the embryonic stage the heart will move from the area to the breast. In the process of relocation, there can be різні options the growth of the heart yak is carried out to the level of the segments of the ridge in the anterior-posterior direction, as well as by the extension to the middle area of ​​the chest wall. The heart can occupy a very high growth, and the main entrance to the aorta, so that it flows into the upper empty vein of the unchanged vein can stand up to 1 or 2 cm in the form of incisura juguli sterni. Tsi dan, established in the Danish hour of M.M. When there is a lot of low growth, the heart of the blood-bearing judgment is located behind the breastbone. Along the way up to the middle area, it can be drip, we can mow and cross the yak with a serpentine left-sided position, as well as with a severe anomaly, since the heart grows more on the right side with situs total inversis partial. Ectopia of the heart is even more of a ridkisny variation of its development, it is possible to lie down either from the sight of its change, or from the superbly great way of shifting downwards - to move to the level of the navel of the cranial wall. Ectopia of the heart in the row of vipads will be similar to the incomplete sternum, diaphragms and the anterior cervical wall. Call all the anomalies of that organ to accept, as the rule of ordering anomalies and other organs (B.V. Ognev). A late defect of the cyst part of the sternum, incorrect titles in the literature for the stolen sternum, can be referred to such anomalies, if two symmetrically displaced late rudiments of a certain organ do not get angry in the membranous period. Such types have been described in older adults (B.V. Ognev). Relocation of the heart to the empty space only when the ventral or dorsal myotome is under-filled, where the diaphragm develops. Through defects, the remaining organisms in such drops move into the empty chest, most of the slums, the spleen, the transverse colon, the small intestine, and as a great fertility - nirki (Mikulich). Moving the heart into a chapel empty is a superb sweetness, especially if it is found in the grizzly bear of the umbilical grizzly.

We see one thing as caution, since the child of the bull has been crushed by the operation of the umbilical grizzly and into the grizzly mouse known to the heart (Klinika of the child's surgery of the Ivanov State Medical Institute). Obviously, in the child of Bula, there is an abdominal intestinal event due to the failure of the process of the evil of the right and the left myotomy in the anterior cervical wall along the middle area.

With such a rank, the heart, with an ectopia, can occupy the position of the chest cell from the lower view of the shia, as well as, in any dividing line of the anterior cervical wall, in the boundaries of the line and the miraculous lack of symmetry. Suddenly, if the blood is pumped into the heart's ointment, then the stench (aa. Coronariae cordis dextra et sinistra) comes from the cob aorta. Three Vintsev arteries are rare. The rest may come not only from the aorta, but from the legendary artery, with the insistence of the hypoxemia of the same heart, which the vintsevo artery is trying to see, so that we can see the legendary artery.

When you open up the partitions in front of the heart and the mouthfuls of the heart, they often try to finish it. For 1000 corpses, according to the data of E.E. Nikolaevoi, openings in the septum in front of the heart were found in 29.8% of vipads. The size of the opening is varied from decilcaps to 2 cm or more. The shape of the opening is variable. In some cases, it can be closed with a functional valve, but also a chorda tendinea and a special for new papillary mucosa of the atrium. Approximately 0.2% of people (Tolochinov-Roger ailment) develop openings in the school of shlunochkiv. When there is a gap between the anterior and the middle septum, the offense of the atrio-mucous membrane is open to get angry in one. When the atrioventricular valve device is vaccinated, it appears that the podrozdil on two and tristulkovy valves is purely clearer (Shushinsky). One valve is visible only as one ring, and one is one that can be viewed as a number of valves. The papillae can enter the empty slots in a single array, or skin conditions (B.V. Ognev). The defect between the anterior septum and the ulceration of the two-stalk valve-ailment of the Lutembacher is characterized by the hypoplasia of the lone slug, as it will be explained by the fact that the serpentine slug will remove even a little blood, so as to stay through the wide frontal defect. In the right half of the heart, in a small amount of blood circulation in such a fall, there is an excess of blood.

In case of congenital defects in the anterior septum, due to the ulceration of the tristula valve, the right slunk of the heart is located in the rudimentary stanza, or even out.

Sounding of the aortic valves or the legacy of the artery is very rare. In the aorta, all three valves can be a monolithic dome-like diaphragm, in the center of which there are openings, the sound of the leg artery is localized to the sound of the valve.

In the case of the vivification of the great Suddens, when one comes out of the heart, it leads to anomalies of aortic growth, legacy artery and empty veins. The aorta can grow close to the right lug and move around. The legendary artery can be roasted over the top of the lion's clown, going out of the empty place of the rest. The aorta with the Legendary artery can enter from one be-like dork. Three anomalies in the position of the main heart vessels, as a rule, are tied together with a change in diameter in the ring of the indicated vessels of an abnormal zakritt. The upper empty vein can be transported in one hour in the area of ​​the left front of the heart. Such types are described in vv. cava superior duplex (D. N. Fedorov, A. I. Klaptsova).

Removal of the aorta from the right slug in case of one-hour sounding abnormally atresia of the legacy artery, open aperture in the mid-slung septum, and the hypertrophy of the nodule of the right heart, I will call the tetralogy of the same anomaly of the "phylum".

Eisenmenger's ailment is of its own kind, a kind of tetralogy of Fallot. When the aorta goes out from the right slunk, the Legend's artery is normally open, a high defect of the mid-slit septum and the hypertrophy of the right slut.

Falsely from the growth of the heart there can be a variety of options for the growth of the aorta, the legacy of the artery, the arch of the aorta and the passage from it. Most of the options are observed in the appearance of the main vessels from the aortic arch.

Behind M.M.Polyakovo's caution, with a right-sided aortic arch, it spreads over the right bronchus, when it can go down along the right sides of the ridge and over the diaphragm, approach the middle area. Right-sided aortic growth is not easy to go to the sinus inversus of the organs of the breast and the black empty. The aortic arch can pass behind the stravohode, and then after turning on to the left side ridge stop going down, occupying the middle position on the ridge. With such a rosette, the aortic arches went out from the left, the backward artery, or the clavicular artery, went out from the right half of the arch, and in front of the trachea, or from the back of the trachea, to cross the middle line of the ridge. The irreplaceable artery in such vipadas can be seen, so that the chotiri sudini can enter from the aortic arch. Yaksh є bends lig. arteriosum occurs when the trachea and stravochid are slowed down. When the right side of the clavicle artery is seen from the left side of the aortic arch (A.Ya. Kulinich), a vessel can go behind the trachea, between the trachea and the trachea, or in front of the trachea. Let us go to the right upper kintsivka... Health of the trachea and the trachea can also be found in the subordinate aorta, when the aorta in the cob is divided into two. One head is in front of the trachea, and іnsha is behind the trachea. Tsi gilki, straight forward, to know again. The anterior arch, as a rule, is thinner. One of the arcs is not easily obliterated і mа viglyad іv'yazyаy.

Botallov duct may become overgrown. According to N. Ya. Galkin's tribute, the botal's duct is seen in children in 24.1%, in every month up to one month of life in all children it is seen; from 1 to 6 months of incidence in 39.7%, from 6 months to 1 month - in 8.9%, from 1 month to 10 years - in 2.7%. On the corpses of children who are older than 10 years, and on 250 corpses of grown-up people, the duct botalls are not affected. Topographically, the botal duct in children grows in the anterior middle, and in 92.2% of corpses, during the whole period of repairs in the transitional fold of the cervical bursa, and 7.1% of the cases have a small part of the arthritis before packing. ... Up to the anterior part of the aortic viddil of the Botallov's duct, the bloody nerve is attached to the vein nerve. In 80.2% of the corpses of botalov, the duct is cylindrical, in 19.8% it is cone-like in the legendary artery. Aneurismatic form of it occurs in 7.7%. Topographically, by a permanent bridge, the passage of the duct goes into the antero-external part of the main stovbur of the Legendary artery, it is not safe to say at the ear of the liver. The ligation of the botallov's duct, viroblen after the show, is fraught with traces of innumerable springy stinks of the ligature with further bleeding. We use the method of blocking the Botallov's duct by means of the imposition of an edge suture suture on the aorta and Legenev's artery at the point of the Botallov's duct openings.

If the isthmus of the aorta is sore (coarctation of the aorta), as long as the transition of the arch into the lower form, there may be some variations. In case of an infantile type of ringing, you can reach it with a length of decile centimeters. In older people, the sound is counted in millimeters. Mabut, meaning snakes aorty may also have an innate character. In the presence of a lot of countrymen, the whole court system has been established. In such vipad

small improvement in the diameter of the offense aa. subclaviae to the size of the aorta. Zbіlsheno in the diameter of all bottles aa. subclaviae, especially truncus thyreocervicalis, truncus costocervicalis, a.transversa colli, a. mammaria interno, - spines of the cranial stem, sharply enlarged all the interdigitated and across the artery, as well as the spinal canal and the spinal cord. We have already described the subway of the upper empty vein, but if there is an anomaly of the lower empty vein, then you should respect it, but it can also be subordinate (B.V. Inodі buvає only left-sided lower empty Vienna. two upper empty veni just one side of one go on two sides of the body and carry shelter in the right front of the heart. Some of them are anastomosed at the venous gossip. With the development of the left upper empty vein, the entire venous blood of the entire upper half of the body is consumed through the enlargements of the vintsevian sinus in the right anterior. Sometimes one of the two empty veins is rare, and sometimes and offends can fall into the front of the heart.

When describing the variacy of the legene veins, it should be noted that there is no middle, either behind the additional upper empty vein, or the lower empty vein, or the ventral venous sinus of the inferior veins in the anterior right.

rear middle

In the posterior middle of the onset of the onset: thoracic aorta, unpaired and semi-unpaired veins (so called cardinal veins), thoracic duct, stravochid, bloody nerves and pretty near-cordonny stubs and come from them.

Breast aorta. Aorta descendens is the third form of the aorta. Vaughn will go to the thoracic aorta and the celiac aorta. The thoracic aorta, aorta thoracalis, is close to 17 cm before the genital and stretches from IV to the XII thoracic ridge. On the edge of the XII thoracic ridge, the aorta through the aortic opening of diaphragms, hiatus aorticus, in the space beyond the urethra. The thoracic aorta is right-handed between the thoracic duct and the unpaired vein, the malignant - with the unpaired vein, in front of it adjoins the Sertseva bursa and the bronchus, and behind it is the ridge.

From the thoracic aorta, go through the veins to the organs of the thoracic emptying - internal veins, rami viscerales, and pristinkovy veins, rami parietales.

9-10 pairs of intercostal arteries, aa. intercostales.

Introduce to the internal tubes:

1) Rami bronchiales - bronchial blood vessels - in the number of 2-4, in part 3 to supply blood to the bronchi and lungs.

2) Rami oesophageae - to the stravohode of the artery - in the number 4-7, he will supply blood to the stravohode.

3) Rami pericardiaci - heart bags - blood supply to the back wall.

4) Rami mediastinales - mediastinal spines - supply blood to lymphatic universities and cells of the back middle.

Cardinal veni. Before the cardinal veins of the people, unpaired and semi-unpaired veins are introduced.

The value of the versatility of cardinal veins in humans is mainly manifested: 1) in the growth of the number of unpaired and unpaired veins, 2) in the versatility of venous bursts on the rise to the ridge number 3) ).

Unpaired Vienna, v. azygos, which develop from the proximal side of the right posterior cardinal vein, є unprecedented extensions of the right upper cross vein, v. lumbalis ascendens dextra. Stopping, passing between the inner and middle diaphragms in the posterior middle and turning into an unpaired vein, go up the hill and expand the right-handed person from the aorta, chest flush and tol ridges. On its way, most often there are 9 lower intercostal veins of the right side, as well as veins to the stravohode, vv. oesophagea posterior bronchial veins, vv. bronchiales posteriores, і veins of the back middle, vv. mediastinales posteriores. On the IV-V chest ridges there is an unpaired vein, bending around the right root; light backwards, into the upper empty vein, v.cava superior.

Small. 102. Variation of morphology of unpaired and unpaired veins.

1 - bi-magistralny variant; 2 - transient one-estuarine variant; 3 - transitional two-estuarine variant; 1 - transitional three-mouth variant; 5 - pure monomagistralny version (according to V. Kh. Frauchi).

V. hemiazygos s. hemiazygos inferior - semi-unpaired or lower semi-unpaired vein - є to the continuation of the left overhead transverse vein, v. lumbalis ascendens sinistra, penetrating through the same slit-like opening between the inner and middle diaphragms and heading to the posterior middle. Raztashovuyuchis behind the thoracic aorta, vona Ide up on the left sides of the ridges and on the way to take a large part of the mid-ribbed veins on the left side.

The upper half of the intercostal veins emerge into the predatkovu or the superior semi-unpaired vein, v. hemiazygos accessoria s. superior, yak to flow into an unpaired vein anyway, or even there, in front of the front, having found a lower, unpaired vein. Cross-baptism with a parallel vein of the ridge is found in different variants: at the level of VIII, IX, X or XI chest ridges.

Variation of the unpaired vein in the people in the literature of the description of the offensive: 1) the unpaired vein can fall without the middle in the right anterior; 2) you can fall into the right pidclavicular vein; 3) you can fall into the right unchangeable vein; 4) nareshty, you can fall into an unchanged vein, or into a left upper empty vein with situs inversus (A.A. Tikhomirov, 1924).

Often there is a balanced development of both cardinal veins, which are not tied between themselves by anastomoses. In some cases, as a result of the evil along the middle line of unpaired and unpaired veins, a single venous stubbore is formed, straightening in the middle of the ridge, into which the intercutaneous veins fall symmetrically on the right and left sides. Variations in the development of the cardinal veins are manifested in the development of the number of intercardinal anastomoses.

Visible crosswise veins are far from being seen in all types. Equal development of the viscous transverse veins on the right and left sides grows in 34%. The presence of the right visceral vein in case of an increase in the daytime is 36%. As a result, the visibility of both viscid transverse veins is reduced in 28%. -Naybіlsh rіdkіsny option - only left-sided rosetting of the left sideways vein with increased visibility of the right side (about 2%).

When the viscous transverse veins are open, the organism is in the uncomfortable minds in the development of roundabout blood circulation, as it will go through the system of superficial and glib epicranial veins, vv. epigastricae inferiores superficialis et profunda, as well as through the population system. veins, vv. paraumbilicales.

Small. 103. Scheme of the lymphatic system of people.

I - shiyny widdil; II - chest widdil; III - transverse viddil. 1 - truncus lymphaticus jugularis; 2 і в - ductus thoracicus; 3 - sinus lymphaticus; 4 - truncus lymphaticus subclavius; 5 - truncus mammarius; 7 - truncus bronchomediastinalis; 8 - diaphragm; 9 - cisterna chyli; 10 - v. azygos; 11 - anastomosis cum v. azygos; 12 - truncus lumbalis sinister; 13 - truncus intestinalis; It - v. cava superior.

Breast duct. In the boundaries of the posterior middle, the thoracic part of the thoracic duct, pars thoracalis ductus thoracici (Fig. 103), can be stretched out from the aortic opening with diaphragms to the upper thoracic aperture. Pass the aortic opening, the thoracic duct of the frog into the unpaired aortic groin, sulcus azygoaortalis. Close the diaphragms of the thoracic duct, cover the edge of the aorta with the vein in front of the back surface of the stravohode. At the breast, the right side of the breast falls into the right and the middle of the breast lymphoma, and the lungs of the back of the breast, as well as the broncho-mediated stovbur, truncus bronchomediastinalis, in the middle Drive uphill to the III-IV-V thoracic ridge, the duct is to rob the turn to the left behind the stravohode, the aortic arch and the left clavicular vein and go far to the VII "shy" ridge through the apertura thoracis superior. Dovzhina of the thoracic duct at a mature reach slugs 35-45 cm with a diameter of 0.5-1.7 cm (G.M. Yosipiv, 1914). Thoracic duct of schilny to frequent morphological variations in development. The thoracic ducts are promoted in the view of one stovbur - monomagistral, the paired thoracic ducts are bi-magistral, the thoracic ducts, thoracic ducts are split in a similar manner, so that one or more loops on its own loop are installed. The loops are set for the thoracic duct on two arms with the further back. Single, sub-loop and third-party loops and winding are possible in the vicinity of the chotiri loops (Fig. 104).

Syntopy of the thoracic duct can also be varied. Yaksho vіn seeks out to the left, yogo on a large protrusion curved the right edge of the aorta; navpaki, roztashuvannya thoracic duct right-handed obumovlyu yogo early belly of the right edge of the aorta. When the thoracic duct is bare, it’s easier to go right-handed, then the main one stubbury into the grooves between the unpaired vein and the aorta (sulcus azygoaortalis). On the edge of the aortic arch, the thoracic duct appears to be ill-advised against both the clavicular artery and medially.

Quick access to the thoracic part of the duct can be made through the eighth intercostal space of the right-handed person (according to Rinaldi), or to the lower sides of the thoracic part behind an additional laparotomy and from a further diaphragmotomy (according to D.A. Zhdanov).

Small. 104. Variation of the thoracic duct.

A - looped shape; B - the magistral form.

The need for exposure of the thoracic duct can be traumatic injuries, as a result of which ailments, as a rule, go out of the way of the hiatus, the lymph of the rear middle, the life of important organs of the breast emptying is the heart, the heart. The ligation of the thoracic duct in cich vypadki can vryatuvati sick, so as in Danish hour it was brought, but the experimental ligation of the thoracic duct is not very significant in lymphoid.

Stravohid. Oesophagus stretches from the 6th to the 11th thoracic ridge.

Stravohid - a muff tube with internal ring and lasting latent balls.

Dovzhina stravohodu with the middle position of the head is 25 cm. Close to 15 cm borrowed from the teeth to the cob stravohodu. In this way, when the slurry probe is laid, the end of the penetration into the slurry pipe is carried out for a 40 cm of the probe. If 3-4 cm fall on the strand section, 1-1.5 cm on the strand section, then the middle section of the stravohode in the chest section is approximately 20 cm.

Vigini stravohodu. According to the period until the middle line, the stravochid set up two viginas: the upper viginus, with any stravochid it appears only along the middle line on the edge of the third thoracic ridge.

On the level of the IV chest ridge, the stravohid once again lie strictly in the middle of the ridge, and lower downward to the right until the sixth of the chest ridge, which once again goes straight to the left, and on the level of the X chest ridge, the beginning of the middle test is flat.

Zvuzhennya stravohodu. "Behind" the stroke of the stravohidnoy tube, three ringing sounds are spared: top, abnormal, ringing rosters at the point of transition of the pars laryngea pharyngis to the shiina part of the yogo. It is visible to the lower edge of the cricoid cartilage і one 14-15 mm. Medium or aortic ulceration roztashovane on the level of the IV thoracic ridge and the appearance of crossing over the aortic arch. The middle road is 14 mm in diameter. The lower zvuzhennya lie down towards the passageway through the diaphragm and grow on the level of the XI thoracic ridge. It's about 12 mm in diameter. At the scene of the lower ringing of the rings, the fibers are developed more intensively and the sphinkter Gubarova (D. Zernov) is approved. Between the three constrictions, two extensions are expanded: the upper one - on the level of the III chest ridge and on the level of the VII. The upper extended reach is 19 mm in diameter, the lower one is close to 20 mm.

Educate the stravohod. At the connection with the descriptions of dried and expanded, it will educate the stravohode nervnomirniy. If on the corpses there is a zvuzhen stretching up to 2 cm, then the amount of space between the extension of the stravohode in the living appears to be twisted. The third party is most often caught in the ringing sounds. Malicious new solutions, mabut, can often be seen in the sounds of sounds, especially in the lower yogi. If you do not give in to a side object from the stravohode, then, if it is evident in the upper sound, conduct a rosin rosin to the stravohode, oesophagotomia externa. You can go to the lower zvuzhennya laparotomy.

Syntopy stravohodu. When passing through the stravohode from the shoulder to the chest empty, the trachea will expand in front of the new one. Having penetrated into the rear middle, the stravohid step-by-step started to get better at the level of the 5th chest ridge and in front of it crossed the bronchus. From the thoracic level, the thoracic aorta gradually move to the posterior surface of the stravohode.

In such a rank, up to IV of the chest ridge, the stravohid lie on the ridge, i.e., it lies in front of the trachea. The lower level of the stravohid is pricked up by the jolobok between the unpaired vein and the aorta, sulcus azygoaortalis. In such a rank, syntopy to stravohod in lower view thoracic emptying is as follows: back to the new bed, thoracic duct and ridge; in front of him, to close the heart of the great judge; right yogo supervodzhuє v. azygos; zlyva - chest part of the aorta.

More nerves. N. vagus - blukayuyu nerve - low topography on the right and evil.

Livy bloody nerve penetrates into the thoracic emptying in the gap between the hypogastric sleepy arteries and the lymphatic arteries and reclines the aortic arch anteriorly. On the edge of the lower edge of the aorta, the lions of the Vagus n. Viddaє the pivotal nerve, n. Recurrens sinister, which forms the arch of the aorta behind and turns into the area of ​​the shia. The lower part of the bloody nerve follows along the posterior surface of the left bronchus and distal - along the anterior surface of the tract.

The right bloating nerve enters the sternum emptying, growing into the gap between the right clavicular vessels - the artery and the vein. Having skirted the forward artery, the bloating nerve comes across the Recurrens dexter, which behind the right side of the clavicle artery can also turn on the side. The lower right blokayuyu nerve pass behind the right bronchus, and then lie on the back surface of the stravohode.

In such a rank, the bloody nerve in the connection with the turn of the shutter in the membranous period of the frog to the front surface of the stravohode, and the right one to the back.

Blue nerves to lie on stravohody not near the monolithic strings, but to fix the loops and stretch the strings, called the stravochid strings, chordae oesophageae.

From the thoracic view of the blukus nerve to enter the following veins:

1) Kami bronchiales anteriores - anterior bronchial tubes - are directed along the anterior surface of the bronchus to the lung, and at the same time with the jaws of a pretty near-cordon stovbur to form the anterior Legendary gossip, plexus pulmonalis anterior.

2) Kami bronchiales posteriores - posterior bronchial tubes - they also anastomose with the jaws of a pretty prikordonny stovbur and enter the gates of the leg, deconstruct the posterior Legeneva gossip, plexus pulmonalis posterior.

3) Kami oesophagei - on the anterior surface of the tract, to form the anterior tract of gossip, plexus oesophageus anterior (for the rachun of the left bloating nerve). Analogous gossip - plexus oesophageus posterior (for the rakhunok of the right bloody nerve) - grows on the posterior surface of the stravohode.

4) Kami pericardiaci - heart bag spikes - enter with other spikes and inner bag.

Nice stovbury. Truncus sympathicus From the organs of the posterior middle of the wines, the most lateral and іdpovіdaє to the level of the rib heads.

For the new tributes of the lions, a pretty near-Cordonian stove burrow is an important arterial, that is, an innervating head rank of the aorta and arterial judgment. The right truncus symphaticus is central to the venous system of the sudins (B. U Ognev, 1951). Particularly significant is the third thoracic sympathetic ganglion of evil, which leads to the aortic arch and overwhelmingly settles aortic sympathetic gossip. With an obliterated endorsement, spontaneous gangrene in the Danish hour, the vikorinennya of the aforementioned 3rd sympathetic ganglion of malice is proponated, and good results are obtained with those who are ill (B.V. Ognev, 1951).

A number of cute gangsters of the near-Cordon Stovbur are fed to significant numbers. Often spite the evil around the ganglions of oneself without the knowledge of the ganglion of interganglionary gilk, rami interganglionares. For the preliminaries of N.N. Metalnikov (1938), there are three main variants of morphological buds and near-Cordon sympathetic stovburivs.

1. Segmental form of a sympathetic stovbur, when all ganglia are formed independently and one out of one interganglionary gilkami, rami interganglionares. The number of universities is up to 10-11.

2. A draining form of a near-cordon pretty stovbur, when all the pretty vuzli get angry in one late weight of the sutsilny syroi speech. Okremi nice universities with no bends.

3. The shape of a cute stovbur is changed, when you try to spite the evil around cute universities two or three at a time. With this form, one should be spared, with such a rank, a part of the evil of cute universities in the new branches of the near-cordon stove. Qia form of a loan for the period of the date up to the front two.

Kozhen vuzol near-cordon stove, ganglion trunci sympathici s. vertebrale, seemingly from a well-received gilka, ramus communicans albus and from a well-known gilka, ramus communicans griseus. Bila spoluchna gilka is represented by centered myakushevy nerve fibers, which pass through the anterior cortex, radix anterior, up to the ganglion vertebrale clitin. The cyst fibers from the clitin of the bicorny horn to the clitin of the spinal ganglion sound the prenodal fibers, fibrae praeganglionares.

Sira spoluchna gilka, ramus communicans griseus, carry the serenity of the fibers from the ganglion vertebrale and go to the warehouses of the spinal nerve. Cy fibers are called post-knot fibers, fibrae postganglionares.

From a near-cordon handsome stoovbur, go a number of gilks to the organs of the chest and black empty:

1. N. splanchnicus major - the great internal nerve - to be repaired with five roots from V to IX of the chest node. Having come to one stop, the nerve is straight up to diaphragms and penetrates into the empty space of the abdomen and crus mediale and crus intermedium diaphragmatis and take the fate of the formulated sleepy gossip, plexus Solaris.

2. N. splanchnicus minor - malium internal nerve - to repair from X to XI of the thoracic sympathetic universities and penetrate at once from the item Splanchnicus major into the empty stomach, sometimes enter to the plexus Solaris fold, and the head rank is the form of nirkovy gossip, plex.

3. N. splanchnicus imus, s. minimus, s. tertius - unpaired, malium or the third internal nerve - to be repaired from the XII thoracic pretty university and also joins the plexus renalis.

Krіm tsogo in the upper vіddіlі grudnoї porozhnini od cute prikordonnogo Stovbur vіdhodyat drіbnі gіlochki, SSMSC take fate in formuvannі aortic plexus, plexus aorticus, stravohіdnogo plexus, plexus oesophageus, utvorenogo for rakhunok stravohіdnih gіlok, rami oesophagei, and takozh legenevogo plexus in yak vstupayut legenevі gіlki, rami pulmonales, near-cordon pretty stovbur.

Reflexogenic (Shockogenic) zones. Widely stagnate in surgical practice І. P. Pavlova about the head role of the nervous system in organism allowed the Radiansky surgeons to reach great successes in the surgery of the breast emptying organs until the present hour.

Just as recently, the school of surgical thoracologists in the village of Zauerbrukh has been trying to get rid of the problem of breast surgery in the fight against pneumothorax, for whom folding equipment was created for school children. s S. I. Spasokukotsky, A. N. Bakulova, A. V. Vishnevsky, A. A. Vishnevsky, B. Ye. Linberg, N. V. Antelava and bagatma іnshy. Tsey shlyakh of straightening on the main fight against shock, on sparing measles to the brain. Overwhelmingly nurturing the nervous system, overdeveloping measles in the brain is the axis of the cause of important inheritance of operations in a number of hours.

To this, the most important factor, which will summarize the success of the operation in this hour, is the relational anesthesia, and the reduction of the release of all providers of painful impulses to measles. To achieve a complete interruption of the receptor system, it is necessary to carry out anesthesia of all the main seven reflexogenic (shockogenic) zones of the breast emptying. Zoni ci nasteni:

1) Pristinkova pleura - in the course of development, she was guilty of buttressing and was anesthetized.

2) N. phrenicus - diaphragmatic nerve - to be exposed to the injection of anesthetic pressure in the anterior diaphragm or diaphragm, or by way of a nerve cross.

3) Nn. intercostales - intercostal nerves - the introduction of anesthesia is observed from the ribs, de in the sulcus subcostalis the nerve bundles are covered.

4) N. vagus - blukuyu nerve.

5) N. sympathicus - pretty nerve- offense vimikayutsya one hour by way of carrying out vagosympathetic blockade on the shoulder and in the back middle.

6) Plexus aorticus - aortic gossip - vimicate in the injection of the anesthetic para-aortic bladder.

7) Radix pulmonis - the root of the lung - anterior and posterior legends of gossip are covered in new; vimikayutsya ryasnim vvedennya anesthesia razchinu in the boundaries of the root of the lung.

Gnіyniki i empієmi

At the empty breast cells, there is a growing number of middle cells.

Develop anterior and posterior mediastinitis. With anterior glandular mediastinitis, glandular tissue melting along the course of intercostal prominences, glandular pericarditis, or emptying of the pleurisy, are more likely to occur.

With posterior mediastinitis, it penetrates into the pidpleural cell and can go down into the uterine cell through the opening with diaphragms (spatium lumbocostale), either through the aortic, or stravohidny hole... Inodі gіy penetrate into the trachea abo stravohіd.

BACK

Kistiak spiny є ridge stop with soothing soft fabrics. To the central region, the vii area is carried (the bullet is also described in the section "Shia"), the thoracic area of ​​the back, across, the kryzhovy area. A description of the remaining two examples will be given at once with information about black emptyings and basins. To this, there will be a short view of the layer-by-layer topography of the thoracic side of the back and the sheath of the spinal cord.

Zovnishni obrisi. When looking at the back, the physically kindly rooted head from the sides of the dorsal furrow, sulcus dorsi, especially in the transverse side, note two late m'yazovyh shafts, approved for the rakhunok of the cricke-spinous m'yazi, m. sacrospinalis, abo tensor spin, m. errector trunci. At the transverse dilenka of the back, there is a spine of a lozenge in a diamond-shaped form - Michael's rhombus, - in the configuration of which plays a role in obstetric practice.

shari

At the thoracic form of the back, the following shari are spared:

1. Derma - shkіra.

2. Panniculus adiposus - adipose blood cells.

3. Fascia superficial - superficial fascia.

4. Fascia propria dorsi - hairy fascia of the back - at the viewer of a thin half-tissue plate, a wide muzzle of the back is attached, as well as a small braid from the abdomen.

5. Stratum musculare - muscular ball - representations of three muscular groups: flat, long, short.

To the flat m'yazam admitted: m. trapezius - trapezoidal m'yaz, mm. rhomboidei major et minor - large and small rhomboid m'yazi - і in the upper viddіli - m. levator scapulae - scapula lifter, m. serratus posterior superior - upper posterior teeth m'yaz і mm. splenius capitis et cervicis - reminna of the head and head.

To dovgim m'yazam to be introduced: m. sacrospinalis - kryzhovo-spinous m'yaz, m. iliocostalis - club-ribbed m'yaz, m. longissimus dorsi - found m'az back, mm. semispinales - nap_vostist_ ointment.

Remaining words for the surgeon do not conceal a practical meaning.

Until short messages are introduced, it also does not mean the great value of mm. interspinales - mіzhostistі m'yazi, as well as mm. intertransversarii - intertransversarii.

The blood circulation of the soft tissues of the thoracic viddіlu of the back zdіysnyua behind the rakhunok of the rear hіlok of the interstitial arteries, rami posteriores aa. intercostalium. At the upper viddili there is a significant drop in the transverse artery of the shia, ramus descendens a. transversae colli.

The innervation of the region is looking for the ramps of the back hillocks of the middle nerves - rami posteriores nn. intercostalium.

Ridge canal і yogo vmіst.

Ridgeal stovp, columna vertebralis, the ridge canal, canalis vertebralis.

In normal minds, the ridge stovp has established and transverse lordosis, i.e., the swelling anteriorly, as well as the thoracic and crooked kiphosis, i.e., the swelling in the front. In pathological minds, there is a decrease in the reduction of the spinal stump - scoliosis.

At the spinal canal, the spinal cord is laid with its roots, shells and vessels, as well as venous gossip and fluff of fatty cells.

Similar to the brain, the spinal cord of the discharge of three membranes: pulp, pia mater, pavutinous, tunica arachnoidea, and the last dura mater.

M'yaka of the cerebral membrane is lying down to the spinal cord. Take revenge on the great number of Sudins. The subarachnoid space, spatium subarachnoidale, grows between myaky and pavutin shells. There is a wide range of spinal cord ridges.

The zovnishnya is a solid moss shell, dura mater, which is a place near the bee's viglyad, going down to the II Kryzh ridge. Around the hard cerebral sheath, one pretends to be good in the internal ridge gossip, plexus vertebrales internus. The sound of venous blood is directed along the mid-spinal veins and far - into the system of unpaired and unpaired veins.

The transverse puncture rolls around the IV and V transverse ridges along the projection line (Jacobi). The line is carried out through the combs of both club kistok. Vona forms the IV transverse ridge. Yakscho zrobiti injected golki vische tsієї lines, when you pass through III and IV ridges, if lower - then between IV and V (Fig. 105a).

When the head is penetrated into the depth of the won, pass through the skin, the fatty cell, then three links: nasal, lig. supraspinale, mishostis, lig. interspinale, i zhovtu, lig. flavum (Fig. 105, b).

Small. 105, a, b, p. H-virobnitstvo transverse puncture.

Online access. To expose the spinal cord in case of jogging or swelling, a laminectomy is performed, i.e., the visualization of spinous protuberances and arch of the spines with a rise or along the middle line of the ridge, or at the end of the U-shaped valve.

When the spinous spines and arches of the spines are biting, the sheaths of the spinal cord are exposed.

The spinal cord, medulla spinalis, is located in the middle of the spinal canal, canalis vertebralis.

Small. 106. Lateral growth of the spinal cord (diagram).

1 - substantia gelatinosa; 2 - bichny pіramіdniy shlyakh; 3 - tractus rubrospinalis (Monakov's bundle); 4 - tractus vestibulospinalis; 5 - anterior pyramidal bundle; 6 - formatio reticularis; 7 - Flexig beam; 8 - Burdakh's bundle; 9 - Gaulle beam; 10 - Govers beam.

The heights of the dressings are without the middle with the dovgastim brain, at the bottom the wine ends with a short cerebral cone, conus medullaris, which will be transformed into the endsex thread, filum terminate.

The spinal cord is divided into three parts: shine, pars cervicalis, chest, pars thoracalis, and across, pars lumbalis. The first part of the іdpovid іddіl ridge ridge, the other - the thoracic and the third - the transverse і krizhovy ridge.

The dorsal cerebral spinal cord is made up of two tilings: shiine, intumiscentia cervicalis, yake zalyagє from III shinny to II thoracic ridge, and transverse draining, intumiscentia lumbalis, stacked between IX thoracic and I transverse ridges.

On the anterior surface of the spinal cord, the anterior median slit, fissura mediana anterior; to the back lie the same back slit, fissura mediana posterior. In front of the zalyagє anterior cord, funiculus anterior, laterally outward - bichny cord, funiculus lateralis, and backward - posterior cord, funiculus posterior.

The cords are drawn one out of one by the sulcus lateralis anterior and sulcus lateralis posterior, as well as by the described anterior and posterior middle clefts.

On the growth of the spinal cord, it is formed from the syroe of the speech, substantia grisea, roztashovany in the center, and the white speech, substantia alba, and the spine along the periphery. Sira speech is rosted at the viglyadi letter N. Vono fixes the anterior rig, cornu anterior, posterior rig, cornu posterior, and central Syra Rechovina, Substantia grissea centralis.

At the center of the rest pass the central canal, canalis centralis. The whole channel is in the mountains of dressings from the IV with a duck, at the bottom go into the end of the duck, ventriculus terminalis.

Spinal cord:

1. Pia mater - the beetle of the moss shell - it’s screwing up the tongue to the brain, to take revenge on the richly Sudin.

2. Tunica arachnoidea - sapling sapling - thin with a small number of sapling saplings. Between her and the hard cerebral sheath, she becomes empty - subdural space.

3. Dura mater - a hard mucous membrane - representing a connective tissue lamina, a yak covering the pavutin shell. Named spatium epidurale. In such a rank, in the spinal cord, there is a small space between them: spatium epidurale, spatium subdurale, spatium subarachnoidale and spatium epimedullare.

On the transverse development of the spinal cord, this is indicated (Fig. 106).

Roztashovane centrally, the serpentine grows on the front and rear horns; The middle one is called a gray adhesion, commissura grisea. There was a speech to last for a number of bunches, in which arrangement to carry out a somatic and pretty way.

Small107 Tractus proprioreceptivus spinocerebellaris dorsalis (straightcerebellarwayFleksiga).

1-beam Flexig; 2 - Govers beam; 3 - nucleus dorsalis (Clark's column); 4 - medulla oblongata; 5 - corpus restiforme; 6 - vermis cerebelli; I and II - cells of the first and other neurons.

In front of the sides from the anterior lateral slit, tractus corticospinales anteriores, and tractus vestibulospinales are among them.

Behind on the sides of the rear lateral slit lie the Gaulle beams and the name of the Burdakh beams from them.

The numerous surfaces of the white speech in the spinal cord are occupied in front of the Govers bundle, which includes three outer bundles - tractus spinocerebellaris ventralis, tractus spinothalamicus lateralis and tractus spinotectalis. Behind the Hovers bundle, the Fleksig bundle is a straight line of proprioceptive paths to the cornsus (Fig. 107).

More described two bunches are laid in front of tractus rubrospinales - Monakovsky bunch - and behind - bichny paramidal path - tractus corticospinalis lateralis.

Between the anterior and posterior horns, the substantia (formatio) reticularis is the sympathetic zone of the spinal cord. Here Jacobson's clitini will be sprinkled. When a network-like speech occurs, dystrophic processes of the shlunkovo-intestinal tract with the development of the inferiority of the intestinal tract are detected on the general stage (segment).

Cutting the entire diameter of the spinal cord (injuries, burning) of the wicker will interrupt the conduction of the impulses, which manifests itself as paraplegia (or in the absence of the spinal cord - tetraplegia), para-anesthesia and malfunction of the pelvic organs.

Small. 108. Fig.109

Small... 108. Tractus spinothalamicus ventralis (three-neuronalwaybolovihіtemperatureimpulses).

I, II, III - cells of the first, other and third neurons. 1 - bark of the posterior central zivini; 2 - corona radiata thalami; 3 - capsula taterna (posteriorly); 4 - nucleus lateralis; 6 - mesencephalon; in - nucleus ruber; 7 - medulla oblongata; 8 - tractus spinocerebellaris ventralis.

Small. 109.Tractus spinothalamicus ventralis(A three-neural path of impulses in a vice and a dot).

I, II, III - cells of the first, other and third neurons. I - bark of the posterior central zivini; 2 - radiatio thalami; 3 - capsula interna (posteriorly); 4 - nucleus lateralis; 5 - mesencephalon; 6 - medulla oblongata 7 - pons.

Dissection of one half of the spinal cord of the wicker, spastic parallax of the underlying muscles on the side of the lateral tract during the period of the reduction of the pyramidal bundle, at the expense of the separate sensitivity on the sides of the ear through the reduction of the back side of the back

Exteroreceptual way. They develop phylogenetically more early protopathic sensitivity, so that they can receive more and more temperature impulses and are more differentiated from the point of view of their psychic sensitivity.

1. Protopathic sensitiveness is represented by a three-neural system of guides:

a) tractus radiculospinalis - korintsevo-spinal path - representing the first neuron of the described protopathic bundle; from the back of the spinal cord to the bottom of the back of the spinal cord;

b) tractus spinothalamicus lateralis (Fig. 108) - spinothalamic path - is, at the same time, another neuron of the protopathic conductive system. In the spinal cord, there is a zalyag in the Hovers bundle at once from tractus spinocerebellaris ventralis and tractus spinotectalis. A bunch of straight uphill, passing through the back of the brain, in the bridge of the varolyus, crossing the middle area in the warehouse of the middle loop, lemniscus medialis, far, through the small brain, pedunculi cerebri, in the final nucleus of the green hillock, nucleus lateralis thallus;

c) tractus thalamocorticalis - at the same time with a cell є the third neuron of the protopathic system. Here, more and more temperature pulses pass through the inner capsule, capsula interna, exchange of the wind, corona radiata, to measles of the back central part.

2. Those of epicritical sensitivity, which carry out impulses and vise, are also represented by three neurons one after another. The first neuron here is also є tractus ceptivus spinocerebellaris radiculospinalis. Another neuron is tractus spinothalamicus anterior - the anterior dorsal thalamic bundle. It grows in the anterior feet of the spinal cord (Fig. 109)

Small. 110.Tractus proprioreceptivus spinocerebellaris ventralis(Some of the intersections of the paths in the surface view of the Govers beam).

1 - vermis cerebelli; 2 - brachlum conjunctivum; 3 - medulla oblongala; 4 - Govers beam; 5 - Flexig beam; I and II - cells of the first and other neurons.

It is important to note that the anterior dorsal-thalamic bundle, the fibers that conduct the pulses and the vise, are laid in the back of the spinal cord. Behind it, impulses go uphill through the dovgastia brain, and the visceral bundle is pressed down to the lasting back-thalamic tract,

In such a rank, є two beams, such as to conduct an impulse vise and dota. The first bundle, laying in the anterior feet of the spinal cord, is crossed, the other - in the posterior feet - straight. The presence of two nobles of impulses in the dots and in the vice will explain, the spine, with the affected spino-thalamic tract, and more often lose the provocation of pain sensitivity to preserve the dots, for example, with syringomyelia.

Proprioceptive way. 1. Tractus spinocerebellaris dorsalis - spinal cerebellar dorsal path - straight, not crossed; lag in the spinal cord in the Flexig's bundle. Stretch down to the II transverse ridge. Nese impulses from the tendon, muscle and joint to measles, vermis. To reach the Flexig's bundle up to the big brain and distance through the rope body, corpus restiforme, entering the cortex of the hrobak. Reflexively, through the system of rukhovyh shlakhіv pіdtrimuє rіvnovagu tila.

Small. 111.Tractus proprioreceptivusspinocorticalis(Vidchuttya posi, orієntuvannya in the open space).

1 - bark of the posterior central zivini; 2 - nerve fibers to close the inner capsule with the bark; 3 - posterior blockage of the internal capsule; 4 - nucleus lateralis thalami optici; 5 - mesencephalon; 6 - lemniscus medialis; 7 - nucleus cuneatus; 8 - nucleus gracilis; 9 - fasciculus gracilis; 10 - fasciculus cuneatus; 11 - pons. I, II, III - cells of the first, other and third neurons.

Small. 112. two-neural rukhovy pіramіdniy shlyakh.

1 - corpus caudatum; 2 - thalamus; 3 - globus pallidus; 4 - putamen; 5 - anterior view of the posterior quilting of the inner capsule; 6 - mesencephalon; 7 - spinal cord; 8 - gyrus praecentralis; 9 - corona radiata; 10 - pons Varolii; 11 - pyramis; 12 - decussatio pyramidum; 13 - Flexig beam; 14 - bichny stoovp; 15 - Govers beam.

2. Tractus spinocerebellaris ventralis (Fig. 110) - a ventral cerebellar path - a bed in the spinal cord in the Hovers bundle, in the warehouse where tractus spinothalamicus lateralis and tractus spinotectalis can also pass. Raztashovuyuchis in the superficial viddili of the Hovers bundle, the fibers of tractus spinocerebellaris ventralis grow up, pass through the back of the brain and through the brachium conjunctivum reach the cortex of the cerebral. Part of the fibers of the road cross over to the opposite side, and in this order of the way є we cross frequently. The function is the same as in the anterior spinocerebellar path.

3. Tractus spinocorticalis (Fig. 111) - spinal proprioceptive paths to measles, which gives a clear sense of position and organization in space. Pass in bunches of Gaul and Burdakh, rosted in the back of the spinal cord. Dyyshovshi to a large brain, the fibers of the path enter the nucleus gracilis and nucleus cuneatus. Starts through the middle loop, lemniscus medians, scho zalyagє in the Varoli bridge, impulses reach the green hillock and end in the bark of the rear central part.

Rukhovi shlakhi. 1. Tractus corticospinalis (Fig. 112) is a long way, which does not have a lot of impulses up to the muses of the tulub and kintzivok. Repair in the upper 3/4 of the precentral zivini. Sounds through the middle of the wind, corona radiata, and the middle of the back to the brain, pedunculi cerebri, the impulses to pass through the middle of the brain, the middle of the big brain (the beginning of the middle way) and in this part of the decidal stage Then there are two paramount paths - bichny, tractus corticospinalis lateralis and cherevnoy, tractus corticospinalis ventralis. The first zalyagє to the middle of the Flexig bundle. The other is located in the anterior feet of the spinal cord. Tsey shlyakh also overlap, ale lower - in the spinal cord. Moving up to the anterior horns of the spinal cord, the pulses follow the distance in the storage of the peripheral nerve to the junction of this segment.

Small... 113. Tractus cerebellorubrospinalis (controlrukhovikhneuronsdorsalbrain).

1 - decussatio dorsalis tegmenti; 2 - decussatio ventralis tegmenti; 3 - every step of the spinal cord; 4 - nucleus dentalis; 5 - clitini Purkin; 6 - nucleus ruber.

I, II, III, IV - klіtinnі tila chotiroh lanok.

2. Tractus tectospinalis - rukhovy path from the middle brain (quadruple) to the anterior horns of the spinal cord. Healthy reflexive reactions of healthy and auditory character. The first ones pass through the upper humps of the quadruple, the others - through the lower ones. In case of an unsupported buzzy sound, or a light-filled sound, the pulses reach the receptors up to the quadruple, and the sound goes for all the ruffled segments along the tractus tectospinalis, for the reason that it seems to be good.

3. Tractus vestibulospinalis - analogous rukhovy path from the lateral nucleus of Deiters' vestibular nerve to the anterior horns of the spinal cord. Zdіysnyu reflexi, how to admit rіvnovagu.

Kryzhovy view of the parasympathetic system of folds in the spinal cord at the levels of the II, III and IV kryzhovy segments. Pulses to enter the warehouse n. pelvicus.

A lot of parasympathetic systems are caused by the release of the pelvic organs: the uterus, the cuticle, rectum.

4. Tractus cerebellorubrospinalis (Fig. 113).

The system is nice. The sympathetic nervous system is stimulated by the segmental principle. The central neurons lag in the thoracic cavity (from the VII to the I-IV transverse segment) of the spinal cord. Sounds of preganglionic fibers through rami communicantes albi are sent to the pretty universities near the Cordonians. The rest are stored in a number of universities, tied between themselves by interganglionary gilkami, rami interganglionares. The number of universities in the shoulder, chest and transverse areas is not permanent. The universities of the near-cordon stovbur give numerical gilki, which take part in the formulated gossip: dormouse, plexus Solaris, brijovykh, plexus mesentericus, nirkovy, plexus renalis, and in.

More sympathetic to the lecture system is described in the course of the course.

The demolition of the sympathetic system is pulling the vasomotor and pilomotor breakdowns, the destruction of the functions of the empty organs, the destruction of the secretory efficiency, in the first place - the perspiration.

Vegetative path to Sudin. Behind the casual glances, the head of the university center of the innervation of the arterial system є III of the chest sympathetic ganglion of evil (B.V. Ognev). The arterial system will negate the innervations for the rakhunok of the livy pretty prikordonny stovp; The venous system is nervous with the head rank from the right prikordonnogo pretty stoop.

The central Sudinorukhovy zone is zoosered in the dovhasty brain. Sudin receptors are represented by freshbred nerves, nn. pressores, і depressive nerves, nn. depressores.

Rukhovy nerves of the musculature of the vasoconstrictor і vasoconstrictor (zbudzhuyuchi) and vasodilators (attracting).

The vasoconstrictor can get a nice innervation from the transverse-thoracic spinal cord and through the rami communicantes albi to reach the universities of the cordon stop. Sounds in the warehouses of Adventitial gossip and impulses reach the circular fibers of the Sudin.

Vegetative to heart. The parasympathetic path to the heart is repaired in the dorsal nucleus of the bloating nerve. Sounds of impulses on the item Vagus reach the inner-heart nodes, which end in the heart-throat. Fibers will trust the power of the heart.

A nice way to my heart is to repair in the nuclei of the upper thoracic cavity of the spinal cord. Sounds of impulses through rami communicantes albi, and then through the near-storm storms to reach the upper high schools. Dal to accelerate the fibers, rami accelerantes, reach the heart's muzzle along the heart nerves. Fibers to the way will speed up the robot's heart.

Vegetative path to the sectional mikhura. Parasympathetic fibers from the edge of the spinal cord are straight up to m. detrusor vesicae in the warehouse of item pelvicus. To produce an impulse to the speed of the detrusor and the relaxation of the internal sphincter of the mikhur.

Sympathetic (perceptible) fibers from the lower nuclei of the lower end of the spinal cord through rami communicantes albi are sent to the ganglion mesentericum inferius, the pulses follow the system of hypogastric nerves, nn. hypogastrici, up to the musculature of the michura. The growth of the nerve of the wicker is the speed of the internal sphincter and the relaxation of the detrusor, i.e.

Short version

BREAST KLITINAEstablish itself with a sternum and 12 pairs of ribs with protruding pectoral ridges. Ribs - cysts, z'ednani in pairs with pectoral ridges (12 pairs). At the dermal rib, there is a posterior, large dovga, - a cyst part and anterior, more short, - a cartilage (costal cartilage). Seven pairs of upper ribs with cartilaginous parts sit with the sternum - the right ribs. The cartilage of 8-10 pairs of ribs sits behind the cartilage of the vischerozhennogo ribs, fixing the ribs. 11 and 12 ribs bet may be short cartilaginous parts, which end in the joints of the cartilage - sharp ribs. In the cyst part of the ribs you see the head, the neck and the thin. The head of the rib is located behind the til of the ridge. Behind the head, the back end of the ribs sound, making the ribs shine, yak pass into the found viddil - tilo. There is a hump, which serves for the connection of the transverse protuberance of the thoracic vertebra, between 2-12 pairs of ribs. The bodies of 2-12 pairs of ribs are bent forward; The rib should bend at right angles to the front, making the cut of the rib. Behind the lower edge of the lower edge, there are grooved ribs for the sudins and nerves. 1 edge is on the upper and lower surface, the medial and lateral edge. On the upper surface of the ripping of the humps for attaching the front descent joint. In front of the hump, there is a boring pidclavicular vein, behind it is a boring pidclavicular artery.
The sternum (lat. Sternum) is a flat brush, rostered around the frontal area. Vona is stored in 3 parts: upper - sternum handles, middle - tila; lower - sword-like sprout. On the upper edge of the handle of the sternum, there are 3 vias: in the middle - the jar, from the sides - the pair of clavicles (for connection with the collarbones); In the lower end, on the edge of the land, there is a loss of cartilage for 1-2 ribs - ribs virizka. Tilo sternum along the edges of the canopy for cartilage 3-7 pairs of ribs. Sword-like sprout means more and more thinner, the shape of its growth: from the bottom to the bottom, call out fires, and sometimes it’s a little bit more or less doubled.
The collection of breast cells.
With their hind knots, the ribs sit behind the pectoral ridges behind the additional slopes. The heads of the ribs are segmented with the tines of the ridges, and the humps of the ribs with the transverse ridges. Slopes are combined, in them there is a decrease in the ribs. Seven pairs of upper ribs, with their anterior edges, get from the sternum. The first ribs with the sternum cause synchondrosis, and 6 pairs are sutured behind the additional help of the sterno-costal slopes. Central ribs. The onset of 5 pairs are called grave, VII, VIII, IX, X bets of the ribs, one with one of their own cartilages - the underlying vyshche, the stink of the costal arch. The front ends of the XI and XII pairs of ribs can lie in soft tissues, which are called ribs.
Chest function. 1. Protected2. Take part in the act of dichannya. When the ribs are dimmed, they lower and lower the ribs.
When 1 rib is inactive, the ventilation in the upper part of the breast cell is not very mobile, often igniting processes occur.
The sternum is generally approved by two thoracic ridges, ribs and sternum. The upper aperture її is flanked backward by the I pectoral ridge, from the sides - by the I rib and in front by the handle of the sternum. The lower aperture of the chest wall is significantly wider. Cordon її store XII chest ridge, XII і XI ribs, costal arch and sword-like spine. The ribs of the arch and the sword-like protuberance form the underbearing kut. Between the ribs and the middle of the breast, from the sides of the ridge, there are the legendary furrows. The back and side walls of the chest wall are significantly higher, lower than the front. In a lively people, the cysts of the thoracic clitine are supplemented with m'wings: the lower aperture is closed with a diaphragm, and the middle edges - with the same m'wings. In the middle of the breast, in the breast, in the heart, in the heart, in the thymus, in the great judges and in the nerves.

The shape of the breast cancer is of great importance and visibility. At the choloviks, it expands from the bottom to the bottom, cone-like, great size. The breast plate of women is of a smaller size, egg-like: at the top of the vuzka, in the middle part, it is wide, and from the bottom it sounds again. In newborns, the thorax is squeezed from the sides and pulled forward.

original

The sternum is made up of the sternum and 12 pairs of ribs with protruding pectoral ridges. Ribs (lat.Costae) - cysts, z'udnani in pairs with pectoral ridges (12 pairs). At the dermal rib, there is a posterior, large dovga, - a cyst part and anterior, more short, - a cartilage (costal cartilage). Seven pairs of upper ribs with cartilaginous parts sit with the sternum - the right ribs. The cartilage of 8-10 pairs of ribs sits behind the cartilage of the viscous rib, fixing the ribs. 11 and 12 ribs bet may be short cartilaginous parts, which end in the joints of the cartilaginous wall - hitky ribs.
At the cyst part of the ribs, there is a head, a collar and a thin. The head of the rib is located behind the til of the ridge. Behind the head, the back end of the ribs sound, making the ribs shine, yak pass into the found viddil - tilo. There is a hump between the shy and til, which serves to connect with the transverse ridge of the ridge of the thoracic ridge.
Tila 2-12 pairs of ribs are bent forward, lining the inner and outer surfaces, upper and lower edges. The rib should bend at right angles to the front, making the cut of the rib. Behind its lower edge there are bordered ribs for the sudins and nerves.
1 rib is on the upper and lower surface, medial and lateral edge. On the upper surface of the seaming of the humps for attaching the front descent joint. In front of the hump, there is a boring pidclavicular vein, behind it is a boring pidclavicular artery.
The sternum (lat. Sternum) is a flat brush, rostered around the frontal area. Vona is stored in 3 parts: upper - sternum handles, middle - tila; lower - sword-like sprout. On the upper edge of the handle of the sternum, there are 3 vias: in the middle - the jar, from the sides - the pair of clavicles (for connection with the collarbones); In the lower end, on the edge of the land, there is a loss of cartilage for 1-2 ribs - ribs virizka. Tilo sternum along the edges of the canopy for cartilage 3-7 pairs of ribs. Sword-like sprout means more and more thinner, the shape of its growth: from the bottom to the bottom, call out fires, and sometimes it’s a little bit more or less doubled.
The collection of breast cells.
With their hind knots, the ribs sit behind the pectoral ridges behind the additional slopes. The heads of the ribs are segmented with the tines of the ridges, and the humps of the ribs with the transverse ridges. Slopes are combined, in them there is a decrease in the ribs. Seven pairs of upper ribs, with their anterior edges, get from the sternum. The first ribs with the sternum cause synchondrosis, and 6 pairs are sutured behind the additional help of the sterno-costal slopes. Central ribs. The onset of 5 pairs are called grave, VII, VIII, IX, X bets of the ribs, one with one of their own cartilages - the underlying vyshche, the stink of the costal arch. The front ends of the XI and XII pairs of ribs can lie in soft tissues, which are called ribs.
Breast cell function.
1. Zakhisna
2. Take the fate of the act
When the ribs are dimmed, they lower and lower the ribs.
When 1 rib is inactive, the ventilation in the upper part of the breast cell is not very mobile, often igniting processes occur.
Breast cell as a whole(Compages thoracis, thorax) is fixed by two twelve pectoral ridges, ribs and sternum. The upper aperture її is flanked backward by the I pectoral ridge, from the sides - by the I rib and in front by the handle of the sternum. The lower aperture of the chest wall is significantly wider. Cordon її store XII chest ridge, XII і XI ribs, costal arch and sword-like spine. The ribs of the arch and the sword-like protuberance form the underbearing kut. Between the ribs and the middle of the chest, from the sides of the ridge, there are the legendary furrows. The back and side walls of the chest wall are significantly higher, lower than the front. In a lively people, the cysts of the thoracic clit are supplemented with meats: the lower aperture is closed with a diaphragm, and the mid-ribs - with the same meats. In the middle of the breast, in the breast, in the heart, in the heart, in the thymus, in the great judges and in the nerves.

The shape of the breast cancer is of great importance and visibility. At the choloviks, it expands from the bottom, it is cone-like, there is a lot of great size. The breast plate of women is of a smaller size, egg-like: at the top of the vuzka, in the middle part, it is wide, and from the bottom it sounds again. In newborns, the breast cage is pressed from the sides and pulled forward.

Small. 25. The development of the skull (diagram).

/ - nasal capsule; 2 - Zorova capsule; 3 - hearing capsule; 4 - parachordal cartilage; 5 - chorda dorsalis; b - trabeculae cranii.

capsules from the dermal side of the skull to go to the body.

Imagining evil in the process of evolu- tion in a larger setting, the bones of the base of the skull emerge from the outermost cysts (earlier, they are self-sufficient), as they get angry at once and make the snares. It will be said about the description of the bones of the base of the skull.

The cartilages of the chimney arches are being re-formed (Fig. 26, Table 2): the upper part (the first chimney or slit arches) take the fate of the formed upper slit. On the ventral cartilage of these arches, the lower slit is established, yak to come down to the skrone cyst behind the additional skrone-lower slit slope.

The reshta of a part of the cartilage of the chypre arch is transformed into the hearing of the brush: a hammer and a cowadlo. The upper view of the other chimney arch (hyoid) is used to cover the third hearing of the brush - the stirrups. All three rumors of the brush do not mean anything to the brush of accusation and are accommodated in a drum empty, so that they develop from the first chickweed and warehouse middle vukho (div. "Organ for hearing"). The first part of the pid'yazikovy arc is seen to induce the pid'yazikovy brush (small horns and partly tila) and the awl-shaped protuberances of the rim brush at once in lig. stylohyoideum.

The third branchial arch is also the part of the sub-ligamentous cyst and the great horns. The cartilage of the larynx is removed from the chimney arches, so that the skeleton is not affected.

In such a rank, a man's cranial bones behind their development can be divided into 3 groups.

1. Drawers to fit a brain capsule:

a) the land, which is developed on the basis of the resulting fabric - the crypts of the crypt: dark
ni, lobova, upper part of the luska of the tilting brush, luska and drum
a part of the curtain list;

b) the edge, which develops on the basis of cartilage - the cysts of the present: wedge-like (for
a vignette of the medial plate of the cryopodic outgrowth), the lower part
luschi, basilar and lateral parts of the tilting, kamyanist chastin
precocious brush.

2. Kissts, which unfold into a connection with a nasal capsule:

a) on the basis of a good fabric - slizna, nasov, lemish;

b) on the basis of cartilage - lattice and lower nasal concha.

3. Drawers, which can be developed from the chimney arches:

a) non-rukhomі - upper slit, pіdnebіnna bristle, willow bistka;


Small. 26. Scheme of interchangeable old chimney arches. Cartilage and cyst elements, which are found in humans from the chimney arches: the lower slit, the laryngeal apparatus, the cartilages of the larynx and trachea.

Zyabrovi arcs: 1 - persha; 2 - third; 3 - fourth; 4 - p'yata; 5 - friend.

b) crumbled - the lower slit, pid'yazikova brush and rumors of the brush.

The cups, which have grown out of the cerebral capsule, fold the cerebral skull, and the cups of the other two, for the sake of gratitude, make the extracts of the individual.

At the junction with a strong development of the brain, the stars of the skull, which pop over the sieve, in people, there are even more opuces and rounding. I get to know the human skull quickly to see from the skulls of not only the lower survivors, but also people-like maws, as an example of what can serve as a place of cranial waste. Obsya її in humans is close to 1500 cm 3, in people-like maws, the reach is less than 400 - 500 cm 3. In the vicopian monkey-man (Pithecanthropus), the space of the skull is close to 900 cm 3.

Table 1

Changing wintry arches and common nerves(Braus)


Visceral (wide sense) arches


Visceral arches of the people


cranial nerves

Persha branchial arch Druga branchial arch

Third branchial arch Fourth branchial arch P'ata branchial arch


Hammer, kovadlo, ventral cartilage of the lower slit

Stirrup, awl-like outgrowth of early cyst, small horns and part of the tila pid'yazikova cyst, ligamentum sty-lohyoideum

Great Horns and Part of the Tila Pid'yazikovy Kistka

Thyroid and іnshі cartilage of the larynx


Third head of the tricyclic nerve (V)

Facial nerve (VII)

Iaziopharyngeal nerve (IX)

Upper larynx throat of the blusky nerve (X)

Lower larynx throat of the blukus nerve (X)



SKULL BRUSHES

Potilichna kistka

Potilichna kistka, os occipitdle, fixing the back and bottom of the cranial box, beruchs the fate of one hour both in the raised skull, and in the first place. As far as it goes (being a small brush) there is a bone and a crooked brush on the ground with a full fabric ( top viddil lusca), as well as on the ground of cartilage (іnshі parts of the cyst). The people won є the result of the evil of decilkokh kistok, which are independent of the little creatures. That won’t be stored in an okremo, 4 parts are mortgaged; Tsі parts, priіntsevі great potilichny opening, foramen magnum(Mісce transition of the spinal cord to the back of the spinal canal from the spinal canal to the empty space of the skull), step: in front - the basilar part, pars basilaris, on the sides - lateral parts, partes laterales,і behind - potilichna luska, squama occipitalis. The upper part of the luska, wedged in between the small knots, the bone around and often overwhelmed all life with a transverse seam, but also in the imaginations of the self-conscious people, the interdimensional osteoarthritis

Potilichna luska, squama occipitalis, like a curved brush of a plate, a lumpy call and a curved middle. The name of the reference to the attachments of the links and the links. So, in the center of the outward surface is the outward, protuberantia occipitalis externa(Misce show ossification points). Viewed laterally on the skin side along the curved line - the upper line, linea nuchae superior. Trochi vishche to see the mensh pomitna - Npea nhchae supr "ema(Naivisha). Going down to the rear edge of the great doorway along the middle line, crista occipitalis externa. From the middle of the ridge to the side, go to the bottom of the line, lineae nuchae inferibres. Relief of the inner surface of the shape of the brain and attachment of its shells, as well as the surface of the surface to be distributed behind the aid of two perekhresnyh pid with a straight cut of combs on the chotiri of the fossa; offending against the comb at once make a cross-like appearance, eminentia cruci-fbrmis, and on the cross-baptism there is an internal power line, protuberantia occipitalis int "erna. The lower half of the later ridge is larger than Gostr and I will name it crista occipitalis int "erna, the upper and the offense of the half (part of the law) of the transverse disease with good curving bears: sagittal, and crosswise, sulcus sinus transversi(Follow the adherence of the same venous sinuses).

Skin from lateral parts, partes laterales, take the fate in the bottom of the skull with the ridge stop, to that on its lower surface it carries a midwife, condylus occipitalis - mіsce zelenuvannya z Atlantі.

Approximately here, in the middle of the condylus occipitalis, the canalis hypoglossalis canal passes through the cyst.

On the upper surface of the pars lateralis there is sulcus sinus sigmoidei (a trace of the same venous sinus).

Basilar part, pars basilaris, up to 18 rocky grows with a wedge-like cyst, fitting one cyst in the center of the base of the skull os basilare.


On the upper surface of the chain of retouching, an angry stingray, clivus, is angry from two parts, on which there is a small brain and a small brain. On the lower surface there is a pharyngeal hump, tub "erculum pharyngeum, until the fibrous membrane of the pharynx is attached.

wedge-shaped brush

Wedge-shaped brush, os sphenoiddle, unpaired, nagadu to fly a coma, but to zoom in, I will name її parts (krill, krylopodіbnі adrots).

Wedge-shaped brush є a product of evil decoh kistok, which is self-sufficient in creatures, that is how it develops as a wedge of deciduous guys and unpaired ossification points, which will last until the end of the day At nіy razrіznyayut offensive parts: 1) tіlo, corpus(In twarin - unpaired basisphenoid and presphenoid); 2) great krila, alae majores(Twarins have alisphenoid boys); 3) small krill, alae minores(Twarin has a guy orbitosphenoid); 4) crylo-like outgrowths, processus pterygoidei(Yogo media plate is a great guy pterygoid, it develops on the basis of full fabric, at that time all parts of the cyst appear on the ground of cartilage).

tilo, corpus, on its upper surface, along the middle line of perishing - Turkish sidlo, sella tur "cica, at the bottom of which there is a hole for the hypophysis, fossa hypophysidlis. In front of her there is an uzvishya, tuberculum sellae, cross the yak sulcus chiasmatis for crossing (chiasma) healthy nerves; on the edges of sulcus chiasmatis, you can see the zorovi canals, candles optici, Zorovi nerves pass through the empty spaces and into the empty skulls. The back of the Turkish seat is surrounded by a cyst plate, the back of the seat, d "orsum sellae. On the bichn_surface of the dust, pass the vignuta sleepy borozy, sulcus caroticus, slid of internal sleepy artery.

On the front surface of the bed, before entering the warehouse of the rear wall of the nose light, you can see the crest, crista sphenoidalis, at the bottom, enter between the opener krills. Crista sphenoidalis sit in front of a perpendicular plate with a gratuitous brush. On the sides of the comb you can see the wrong form open, aperturae sinus sphenoidalis, lead to the airway / sinus, sinus sphenoidalis, how to sit in the wedge-shaped brush and be separated by a partition, septum sinuum sphenoiddlium, in two halves. For help, the chick opening the sinus will come from the nasal emptying.

In the newly formed sinus, it is even of an insignificant size and only close to the 7th fate of life, a quick growth.

Little krila, alae minores, are two flat tricut forms of the plate, as two edges go forward and lateral from the anterior-upper edge body of wedge-like brush; mіzh countries malikh krill are known zorovі channels, candles optici. Mіzh malimi and the great krill are the upper orbital fissure, fissura orbitdlis superior, is provided from the empty skull to the empty ochnitsa.

Great krila, alae majores, go out from the surface of the family laterally and up the hill. Close to tila, to the back of fissura orbitalis superior є round holes, foramen rotundum, lead in advance in the cryopodial-infantile fossa, surrounded by the passage of the other head of the tricyclic nerve, item trigemini. Behind, the great crunch at the gaze of the gosting kut protrudes through the lone and pan of the skinny brush. Close it to the back of the mouth. foramen spinosum, pass through the yake a. meningea media.


A much larger oval opening can be seen in front of it, foramen ovale, through the yake pass the third head of the item trigemini.

Great krila may cause chotiri surfaces: mozkov, fades cerebrd-lis, glo z n i h n y y, fades orbitalis, skronevu, fades temporalis,і maxillary, fades maxilldris. Name the surface vkazuyut areas of the skull, kudi the stink of the beast. The skirted surface is split into skrone and crone-like parts behind an additional edge-to-edge comb, crista infriitemporalis.

Krilopodіbnі growths, processus pterygoidei go as far as the day of the great krill through the wedge-like brush vertically downward. Pidstava їkh is permeated sagittally by a channel, canalis pterygoideus, - mice passage of the same nerve and sudin. With the front opening, the canal opens into a cryopodial-infantile fossa.

The skin is stored in two plates - lamina medialisі lamina lateralis, there is a hole in the back, fossa ptery-goidea.

The media plate at the bottom bends with a hitch, hamulus pterygoideus, through which tendon to be thrown to repair on the ts_y plate m. tensor veli palatini (one of the soft drinks).

Skroneva kistka

Skroneva kistka, os temporale, a pair of kisstka, I can fold Budova, so as a vison of all 3 functions of the skeleton and not only a part of the basic wall and the base of the skull, but to take advantage of the body's hearing and gravity. Won є a product of zlittya decilkokh kistok (zmishana kistok), which are self-contained among the little creatures, and that is stored in three parts: 1) luskata chastin, pars squamosa; 2) drum part, pars tympanicaі 3) kam'yanist chastin, pars petrosa.

By stretching out the first fate of life, the stinks get angry into one basket, the ringing rumors pass through, meatus acusticus externus, such a rank, when the luskata part lies over it, the rocky part is to the middle to the bottom, and the drum is to the back from the bottom. Follow the evil around the outer parts of the rim of the brush to be saved for all life by the eyes of the industrial seamstresses and schilins, and by itself: on the cordon pars squamosa and pars petrosa, on the antero-upper surface of the rest - fissura petrosquambsa; in the glybin, the lower slit fossa - fissura tympanosquambsa, how to grow into an adolescent rocky part on fissura petrosquamosaі fissura petrotympanica(The chorda tympani nerve goes through it).

Luskata chastina, pars squamosa, take care of the fate in the approved biches of the skull. You should be able to stand up to the curved bins, that is, Kostenin on the ground with good fabrics and it’s easy to just stand upright at the viewer with rounded edges, put on the top edge of the thighs, squiggles, name.

On the brain surface fades cerebrdlis, wake up to the brain, fingers, impressibnes digitatae,і from the bottom of the house, the furrow from a. meningea media. The name of the surface of the luska is smooth, take care of the fate in the established early fossa and to be called fades temporalis. From her come to the wilderness, processus zygomdticus, as you go forward to the day with the Vilichnaya kistkoy. Its ear of willow has two roots: front and back, where there is a hole for joining from the lower slot, fossa mandibularis. On the lower surface


the front root is placed on a dark hump, tuberculum articuldre, scho pereshkojaє vivih of the head of the lower slit forward with a significant opening of the company.

Drum chastina, pars tympanica, the limb of the cyst is installed in the anterior, lower and part of the posterior edge of the ear canal, bone endesmally, as all the curved cysts, but the view of the plate, only slightly curved.

The famous rumors of the passage, medtus acusticus externus, It is a short channel, which is straight in the middle and trocha forward and leading into the empty drum. The upper edge of the last opening, poms acusticus externus,і a part of the rear edge is made up of a flat front brush, and on the sieve - a drum part.

In a newly born callous rumor, it has not yet been formed, so the drum part is not just a ring (annulus tympanicus), tighten it with a drum ring. As a result of such a close rozstashuvannya drum rewind is called among the new women and children of the early age, most often are encouraged to get rid of drum emptying.

Kam'yanista chastin, pars petrosa, It is named so for the miraculousness of its cyst speech, informed by him, that a part of the cyst takes care of the part of the skull, and the cyst in the style of the organs of hearing and gravitational, when I may still want to think that I will need It grows out on the basis of cartilage. Another name of the tsієї part - pіramіda, It is given according to the її form of the trigonal pyramid, the basis of which is called a wedge, and the top - forward and in the middle to the wedge-like chain.

Piramida has three surfaces: front, back and bottom. The anterior surface extends to the bottom of the middle cranial fossa; the posterior surface is turned backwards and medially and fixing a part of the anterior wall of the posterior cranial fossa; the lower surface is turned down and only visible on the outer surface of the skull base. The famous relay of the foldable and of the building of the budovy and the interior for the middle (empty drum) and the internal vuh (cystic labyrinth, which is stored up from the peers and the passage of such nerves). On the front surface of the pyramid, near the top, there is a slight depression, impressio trigemini, from the node of the tricular nerve (item trigemini,). The name of the two thin grooves to pass through, medial - siilcus n. petrbsi majoris, i lateral - siilcus n. petrosi minoris. The stench leads to two identical openings: medial, hiatus candlis n. petrosi majoris,і lateral, hiatus candlis n. petrbsi minoris. Named from these openings, eminentia arcudta, the zavdyaki vipinnya grows burstingly into the labyrinth, the zokrem of the upper semicircular canal. The top of the brush mіzh eminentia arcuata і squama temporalis set the drum empty, tegmen tympani.

Approximately in the middle of the rear surface of the pyramid, there is an internal auditory opening, pbrus acusticus internus, when you have internal rumors, meatus acusticus internus, de pass facial and auditory nerves, as well as artery and veins to the labyrinth.

From the lower surface of the pyramid, brutal to the base of the skull, there is a thin aggravation of the styloid sprout, proces-sus styloideus, a serviceman of a m_scem attachment of the "anatomical bouquet" (mm. styloglossus, stylohyoideus, stylopharyngeus), as well as a ligg. stylohy-oideum i stylomandibulare. The shilopodibnyy sprout is a part of the withers of the finch wandering. At once z lig. stylohyoideum vin є too far from the yazic arc.


Between the awl-shaped and nipple-like outgrowths there are the sylloid openings, foramen stylomastoideum, through the yake enter the item facialis and enter a small artery. Medially from the styloid appendix, the glide of the jugular fossa is removed, fossa juguldris. In front of the fossa jugulafis, from the Kremlin, we go out with a comb, there is a new opening of the sleepy canal, foramen caroticum externum.

The pyramid has three edges: front, back and top. The short front edge is made up of the gostry kut with a lining. At the end of the codend there is a hole in the target tube channel, canalis musculotubdrius, in the empty drum. The channel with a partition extends into two sections: upper and lower. Upper, smaller, half-channel, semicandlis m. tensoris tympani, vmeschuє in itself a whole muscle, and the lower, larger, semicandlis tubae auditivae, is a cyst part of the auditory tube, which serves to carry out the throat into the drum empty.

Along the upper edge of the pirudin, where the front and rear surfaces are distributed, there is a good groove, sulcus sinus petrosi superi-oris, - slid of a single venous sinus.

The posterior edge of the paramid anteriorly of the fossa jugularis is located at the basilar part of the capillary cyst and at the same time is closed with the cyst sulcus sinus petrosi inferioris - the next of the lower stony venous sinus.

The name of the surface is supposed to serve as a place of attachment of the music, which is the reason for the development of the її zvnіshnіy relєf (wadrostok, virizki, shorstkostі). To the bottom of it, you can find yourself in a nipple-like growth, processus mastoideus. The sternocleidomastoid nipple-like meat should be attached to the new one, as I put my head in the pivot, which is necessary when the body is upright. That nipple-like sprout is seen in chotirinoids and to navigate humanoid maws and develop only in humans in conjunction with their upright walking. On the medial side of the nipple-like protuberance є the side of the nipple-like protuberance, incisura mastoidea,- attachment m. digastricus; even more to the middle - small bearded, sulcus a. occipi-talis,- Slid of the same artery.

On the last surface of the nipple-like outgrowth, there is a smooth tricycle, which is a shortcut for quick access to the middle of the nipple-like outgrowth when the gnomes are stored.

In the middle of the nipple-like sprout and in the middle of the middle cellulae mastoideae, which are like empty beams, which can be seen from the empty drum, from which smell you can see behind the middle antrum mastoideum. On the cerebral surface of the base of the pyramid, there is a gliba boron, sulcus sinus sigmoidei, de lie one venous sinus.

The channels of the early list. Highest channel є canalis caroticus, through which to pass the inner sleep artery. Having felt his own inviting opening on the lower surface of the pyramid, one must go to the fire, then turn into a straight cut and see one's inner opening at the top of the medial canalis medially. Special channel (fig. 27), canalis facialis, to repair in the glibin porus acusticus internus, the canal springs from the front and laterally to the hiatus on the anterior surface of the pyramid; in chicks, having opened the canal, becoming horizontal, turned towards a straight kut laterally and backward, creating a vigin - a ring geniculum canalis facialis, and then down and end for help foramen stylomastoideum, We will re-weld it on the lower surface of the pan-shaped brush. Canalis musculotubarius(div. vische).


Small. 27. Skroneva copy (os temporale), right; vertical saw cut parallel to the axis of the pirandi.

/ - cavUm tympani; 2 - tegmen tympani; 3 - canalis facialis; 4 - canalis caroticus (internal opening); 5 - impressio trigemini; b - semicanalis tubae auditivae; 7 - canalis caroticus (open hole); 8 - fossa jugularis; 9 - canalis facialis et for. stylomastoideum; 10 - cellulae mastoideae.

tim'yana kistka

Tim'yana kistka, os parietale, guy, I'll fix the middle part to the star of the skull. The people have the greatest reach in the context of the creatures, the development in conjunction with the most appropriate development in the new brain. Vaughn is a typical brush, but a vison is important to the function of a visitor. To that, I won’t have a simple Budova at the viglyadi chotiricut plate, the opaque call and the evaned middle. Chotiri edge її to serve for the sake of the sidnіmi cistes, and itself: the front - s forehead, margo frontalis, posterior - from the pillars, margo occipitalis, medial - from the same side of the side, margo sagittalis, and lateral - from the thin flap, margo squamosus. The first three edges are notched, and the rest of the attachments to illuminate the lusky seam. From the chotiroh kutiv of the anterior medial, one must meet the frontal knuckle, angulus frontalis, ne-red-lateral with a wedge-like cyst, angulus sphenoidalis, the posterior medial with the pylical cyst, angulus occipitalis, and the posterolateral one with the nipple-like appendage of the lateral cyst, angulus mastoideus. Relief of the zoning opaque surface of the lumps of attachments to the muses and fascias. Near the center of the city, tuber parietale(Misce a cob of ossification). Lower yogo go boggle skronevі lines - lineae temporales(Superior et inferior) - for early fascia and muscle. Close the medial edge to see the openings, foramen parietale(For art and veni). Relief of the inner surface, fades int "erna, fumigation of adhesion to the brain і especially hard shell; the mission of attaching the rest to the brush may look through the medial edge of the furrow of the sagittal sinus, sulcus sinus sagittalis superibris(Slid of the venous sinus, sinus sagittalis superior), as well as in the area of ​​the angulus mastoideus of the transverse furrow,


sulcus sinus sigmoidei(Slide of a single venous sinus). The judges of the yak bi shell were carbouled at the eyes of the furrowed heads on the entire inner surface of the furrows. On the sides of the sulcus sinus sagittalis superioris, one can see the so-called granulation of the pavutin shell, foveolae granulares.

Forehead

Lobova kistka, osfrontdle, unpaired, take care of the fate in the established crypt of the skull and be carried up to the curved cysts of yogo, growing on the ground with the full fabric. In addition, it is tied with the organs of senses (scent and zoru). According to the basic sub-function of the won, it can be stored from two types: vertical - lusks, squama frontal is,і horizontal. The remainder of the report to the body and scent is distributed to the guy's eyebrow, pars orbitalis, i unpaired nose, pars nasalis. V The bag in the front of the handset has 4 parts:

1. Lobova luska, squama frontalis, as if the brush was crooked, the plate might look like a lumpy call and bend from the middle. There are two points of ossification, which can be found near the grown-up on the last surface, fades externa, the viglyad has two frontal humps, tubera frontdlia. The hump turns only at the people in the connection with the brain. The stench from the daytime is not only in people-like maws, but to be found in the wimer-like forms of people. The lower edge of the luska is called the supraorbital, mdrgo supraorbi-talis. Approximately at the cordon between the inner and middle third edge of the nadochnyamkova virizka incisura supraorbitdlis(Transformed into a foramen supraorbitale), a place where one arteries and a nerve pass. Inaccurately, the eye of the supraorbital rim is heavily varied for the size and stretching of the period - overbriving du-gi, arcus superciliares, as medially, along the middle line, go into the big-mensh, glabella(Glabelli). Vona є a strong point in the production of skulls of modern people with vicissitudes. The famous edge of the supraorbital edge grows into the willowy growth, processus zygomdticus, z'єnuatsya zі vilichnogo kistkoyu. From the end of the sprout, wherever you burn, the edge of the line is clearly visible, linea temporalis, I will round off the yaka with the skrone surface of the luska fades temporalis. On the inner surface, fades interna, along the middle line, from the rear edge of the furrow, sulcus sinus sagittalis superioris, yak at the bottom to go into the frontal ridge crista frontalis. Tsi affirmation - attachment of the dura mater. I will close the middle line of the paputinous fossa of the granulation of the pavutinous membrane (virost of the pavutinous membrane to the brain).

2 і 3. To the part of the site, partes orbitales, Imagine two horizontally displaced plates, like their lower, curved surface of the furrow into the vivid fossa, the upper one - into the empty skull, and the posterior edge is closed with a wedge-like cyst. On the upper cerebral surface є next to the brain - impressiones digitatae. Lower surface, fades orbitalis, I set the upper wall of my eyes and carry them on my side in order to adhere to the ancillary eyes; at the zygomatic appendix-fossa laznoy zalozi, fossa gldndulae lacrimalis, close incisura supraorbitalis - fovea trochledrisі a small thorn, spina trochledris, de attach cartilage block (trochlea) for the tendon of one of the oysters. Offended in-person parts of the video are one from the same virizkoy, incisura ethmoidalis, zapovnyutsya on the whole skull with a gratuitous brush.

4. Nosov part, pars nasalis, borrowing the front part of the gratuitous virizka along the middle line; here is a little comb, which will end up with an adolescent - spina nasalis, how to take part in the approved noso


Vitta partitions. On the sides of the comb, there are pits, which serve as the upper wall for the middle of a thick brush; before going through them є openings, going into the frontal sinus, sinus fronta-lis,- empty, yak roztashovu in comrade kistki behind the overhead arches and the value of which is very variable. Lobova's bosom, how to take revenge on the wickedness, is shattered by a partition septum sinuum frontalium. In some cases, there are additional foreheads of the sinuses behind, or even with the main ones. Lobova cistka for her shape is the most characteristic of the cranial cranks for people. In the found hominidivs (like people like mavs), she was sharply nailed back, making abductions, "tikak back" forehead. For the ophthalmic ringing, the won razko razlilas on the lusk and ochnoyamkovy part. Along the edge of one zygomatic ridge to the last one, a suction ridge is laid. At a bitter people, the roller has changed sharply, so only the arcs have lost their heads. As a result of the development of the brain, the lus became protruding and took up a vertical position, the foreheads of the humps immediately moved apart, as a result of which the forehead from the abducted became swollen, pushing the skull characteristic of the vig-eyed.


Small. 28. Gratchasta kistka (os ethmoidale); rear view.

/, 2 - crista galli; 3 - lam. cribrosa; 4 - lam. orbitalis;

5 - concha nasalis superior;

6 - lam. perpendicularis; 7 -
labyrinthus ethmoidalis.

gratchasta kistka

Gratchasta kistka, os ethmoidale, unpaired, zazvychay describe the middle of the cysts of the cerebral cranium, wanting to take care of the fate of the established individual with a greater part of it. Roztashovuyuchis centrally between the bristles of the individual, come across more of them, take a part in the established emptying of the nose and ochnitsa, and on the whole skull is closed by them. Vona grows into a ligament with a nasal capsule, on the ground of cartilage, prompted by thin cystic plates, so that you can feel rewind emptying (Fig. 28). Kistkovі plates of a grated brush, roztasovany at the top of the letter "T", at the vertical line to become perpendicular to the plate, lamina perpendicularis, and horizontally - the grid part of the plate, lamina cribrosa. From the rest on the sides of the lamina perpendicularis, there are gratuitous labyrinths, labyrinthi ethmoidales. You can see 4 parts in a small bag in a small bag:

1. Lamina cribrosa- rectangular plate, yaka visonuє incisura
ethmoidalis frontal cyst. Vona is pierced, like a sieve, with other openings
(Name), through which the scent
nerve (close to 30). For the middle line of the temporal Greco
Ben, crista galli(Mice attachment of the dura mater to the brain).

2. Lamina perpendicularisє part of the nasal septum.

3 and 4. Labyrinthi ethmoidales represent a young complex of cyst-based turnarounds, cellulae ethmoidales, close the call of the thin, full-bodied platyvkoy, lamina orbitalis, Confirming a medical wall ochnitsa (Fig. 29). The upper edge of the orbital plate is closed from the intra-hollow part of the frontal cyst, in front - from the lacrimal brush, to the back - from the wedge-like and the orbital otrostrum of the patient, below - from the upper slit; all the cysts are attached to the edges of the cellulae ethmoidales. On the medial side of the labyrinths


4 Human Anatomy


Small. 29. Gratchasta kistka (os ethmoi-dale); kind of evil.

1 - crista galli; 2 - lam., orbifalis; 3 - cellulae eth-moidales posteriores; 4 - concha nasalis media; 5-lam. perpendicularis; 6 - cellulae ethmoidales anterio-res.


two nasal shells can be retouched - cbnchae nasales superior et media,іnodі buvaє і third - concha nasalis supre "ma.

The shells represent curved cyst plates, the surface of the mucous membrane of the nose, which is curved, grows.

KISTKI OSOBI

Individuals, ossa faciei, They create a set of structures for organs of senses (zoru, scent), as well as for cob species of grass (empty company) and dysfunctional (empty nose) systems, which are responsible for the beginning of the day. At the same time, those changes in the soft parts of the head appeared on them, which were reinforced by the process of youthfulness, i.e. znryad - organs of the senses, nareshty, living in pieces is getting ready for the piece, which will lie down to the robot of the chewing apparatus.

Upper slot

Upper slot, maxilla, a pair of folds with a collapsible budget, we will amalgamate with various functions: participation in the establishment of emptying for the organs of the eyes - eye and nose, in the eyes of the septum between the empty of the nose and mouth, as well as participation in the robot life.

Transferred by the people to the connection of the labor force of the hapal function from the slit (like the creatures) to the hands called for a change in the size of the upper slit; At the same time, when the people were singing, the cracks of Budova were shattering more thin. All the reasons are the beginning of the Bud's upper slit, which can develop on the ground with a good fabric.

The upper slot is stored from the floor and from the number of sprouts.

A. Tilo, corpus maxillae, take revenge on the great airway, sinus maxillaris(Maxillary or maxillary sinusitis is called sinusitis), yak with a wide opening, hiatus maxillaris, come up in the nasal empty space. On the other hand, there are choices of surfaces.


Front surface, fades anterior, In the case of the bitter people, in connection with the weakened functions of the zhuvannya, the zoomed out piece-made preparations, it was knocked in, and in the Neanderthals, the boola was flat. At the bottom of the von, go into the alveolar outgrowth, juga alveoldria, how to adjust the position of dental roots. Pidnesennya, vіdpovіdne іklu, rotated more importantly. Yogo and laterally located the Clique fossa, fossa canina. In the mountains, the anterior surface of the upper slit is seen to be adjacent to the orbital bottom edge, margo infraorbitalis. Significantly lower and smitten infra-ocular opening, foramen infraorbitdle, one nerve and artery go through the yake from the ochnytsi. Medial cordon of the front surface to serve as a nasal viral, incisura nasalis.

Pidskroneva surface, fades infratempordlis, from the anterior surface behind the zygomatic protuberance and carry the upper crevice on its own, tuber maxillae,і sulcus palatinus major.

Nosova surface, fades nasalis, at the bottom, go to the upper surface of the dehydrated outgrowth. On a new comb for the lower nasal concha (Crista conchdlis). Behind the frontal outgrowth, there is a tearful beard, sulcus lacrimalis, both from the lacrimal cyst and the lower concha into the nasolacrimal canal - canalis nasolacrimalis; More posteriorly - the great opening, leading to the sinus maxillaris.

Smooth, flat orbital surface, fades orbitalis, maє trikutnu form. On the medial edge, behind the frontal appendage, there is a tear, incisura lacrimalis, where to enter sl_zna brush. Near the posterior edge of the orbital surface, repair the infraorbital furrow, sulcus infraorbitalis, yaka beforehand will be transformed into canalis infraorbitalis, see the foramen infraorbitale on the front surface of the upper slit. From the infraorbital canal to enter the alveolar canal, candles alveoldres, for nerves and nerves, go to the front teeth.

B. Adults. 1. Lobovy sprout, processus frontalis, go to the fire and go to the pars nasalis of the frontal brush. On the medial surface є ridge, crista ethmoiddlis - slid attached to the middle nasal concha.

2. Alveolar outgrowth, processus alveolaris, to your bottom
krai, drcus alveolaris, ma zubnі komіrki, alveoli dentdles, eight top
their teeth; midsections are subdivided by partitions, septa interalveolaria.

3. Childish growth, processus palatinus I will make a big part
hard palate, palatum osseum, together with a young adult prototype
on the side with the middle seam. Bridle of the middle seam on the upper,
beaten into the empty nose of the sides of the sprout and the nasal ridge,
crista nasalis, close the bottom edge of the opener. Close to the front end
crista nasalis on the upper surface there are a few holes,
channel, canalis incisivus. The upper surface is smooth, the lower surface is brushed
in the empty company, shorstka (vidbitki zalozov mucous membrane) and not
late furrows, sulci palatini, for nerves and sudins. At the front view
often worn cut suture, sutura incisiva. Vіn vіdokremlyuє was angry
from the upper slit of the riztsev kistka, os incisivum, yak at the bagatokh tvarin
buvaє at the viglyadi okremoyi kistka (os intermaxillare), and at the people the yak
ridkisny option.

4. Willow's growth, processus zygomaticus, go down the cheekbone
Vittya kistkoyu and I approve tovstu pidporu, through yaku transferred to
zygomatic bone a vice with zhuvanny.



Small. 30. Піднебінна Кістка (os palatinum), rights; kind of call (A)і from the middle (b).

1 - processus sphenoidalis; 2 - incisura sphenopalatina; 3 - processus orbitalis; 4 - lam. perpendicularis; 5 - sul. palatinus major; 6 - processus pyramidalis; 7 - lam. horizontalis.

піднебінна Кістка

Піднебінна Кістка, os palatinum, parna; Take care of your part in the set of empty skulls - emptying of the nose, mouth, internal pits, and cryopodial-small-pitched fossa. This is the fate and the beginning of a kind Budov at the viglyad of a thin brush, which can be stacked in two plates, one by one with a straight cut and add the upper slot (Fig. 30).

1. Horizontal plate, lamina horizontalis, add
posteriorly processus palatinus maxillae, palatum osseum.
On the lower surface of the horizontal plate of the double brush є
great open-air opening, foramen palatinum majus, through koto
swarms of canalis palatinus major (div. lower)
nerves.

2. Perpendicular to the plate, lamina perpendicularis, adjoining
Gaeta to fades nasalis maxillae. On the lateral surface її pass boron,
sulcus palatinus major, at the same time from the same furrow upper slit
canalis palatinus major. On the medial surface there are two
comb for two turbinates: middle (crista ethmoidalis) and lower
(Crista conchalis). Піднебінна містка has three growths: one, processus
pyramidalis, go out from the center horizontally and perpendicular
new plates backwards і laterally і on the whole skull
a crylo-like outgrowth of a wedge-like cyst. Kryz nyogo vertically through the ka
naltsi, canales minbres, pass the nerves and judgment. Two of them are playing
on the upper edge of the perpendicular plate,
incisura sphenopalatina, yak when closed with a wedge-like brush
zamikak otvir, foramen sphenopalatinum (for current vessels and
nerves). The front from the cich of the growths to the additional bottom is from the very
the back codend її and that is called processus orbitalis, and the back rest
to the lower surface of the wedge-like brush and be called processus
sphenoidalis.



Small. 31. Slіzna kіstka (os lacrimale), lіva; kind of call. 1 - sul. lacrimalis; 2 - crista lacrimalis posterior.


Small. 32. Lemish (vomer).

/ - lam. perpendicularis gravelly cysts; 2 - margo superior coulter; 3 - margo posterior coulter.


Lower nasal concha

Lower nasal concha, concha nasalis inferior, parna; The won is a self-contained basket on the view of the upper and middle shells, which are storage parts of a gratuitous basket. Attach its upper edge to the side of the nasal emptying and the middle nasal run to the lower one. The lower edge is vilny, and the upper edge is located behind the crista conchalis of the upper slit and the small brush.

nasal box

Nosova kistka, os nasdle, lie down to your steam, fixing the back of the nose at the root. Among the people, in the context of the creatures, the won is under-acclaimed.

sl_zna kistka

Слізна кістка, os lacrimale(Fig. 31), pair; the won is a thin plate, which can enter to the storehouse of the medial wall ochnitsa neatly behind the processus frontalis of the upper slit. On the lateral її surface є slavish ridge crista lacrimalis posterior. In front of the comb, pass a slovenly boron, sulcus lacrimalis, at once from the furrow on the frontal ridge of the upper slit, I fix the pit of the lacrimal mouse, fossa sacci lacrimalis. Likewise, the people of Volodya are similar to such people-like mapps, but one of the proofs of a close dispute with homosexuals.

Lemish, vomer(Fig. 32), unpaired hand; win is a wrong payment, which is not likely to happen to the hliborobs, and to enter before the warehouse of the cystic septum of the nose.


The posterior edge of the cystic septum is the posterior edge of the cystic septum of the nose;

Vilichna kistka

Vilichna kistka, os zygomdticum, a pair, hiring from face kistok; won є an important architectural part of the individual, flattening the willow outgrowths of the frontal, early and upper slit cysts and spilling cysts of the cysts when they were worn up to the skull. Vaughn is also a great surface for a cob of chewing meat. As a result, the brush has been expanded into three surfaces and two sprouts. Bichna surface, fades lateralis, M viglyad chotirikіntseviy zirki і slightly protruded at the viglyadі hillock. The posterior, smooth, turned towards the cranial fossa and called the fades temporalis; third to the surface, orbital, fades orbitalis, Take care of the fate in the approved glasses. The upper outgrowth of the wedge, processus frontalis, is located behind the wedge-shaped frontal and great krill of the wedge-like wedge. Lateral outgrowth, processus temporalis, z'yudnyuchis with the wedges of the sprout of the rim brush, fixing the zygomatic arch - a little cob of zhuvalny meat.

Bottom slot

Lower slit, mandibula,є ruchomy cyst of the skull. Vona has a form similar to that, I will be equipped with a function (nayvazhivіsha part of the zhuvalny apparatus), and by the development of the first zyabrovy (mandibular) arc, the shape of what was before the singing world zberigak. In the bagatokh ssavts, including the lower primates, the lower slit is a paired cyst. As a matter of fact, people start to lay down two embryos, step by step, grow angry at the 2nd time when people are sent to an unpaired bunch, they are saved, however, in the middle of the mental physis of both sides. Apparently the buzzing appliance with a passive viddil, i.e. corpus mandibulae, Carry on their teeth, and two heads vertically at the viewer, rami mandibulae, services for the coverage of the skrone-lower slit slope and attachment of the jaw muscles. The offense of the part - horizontal and vertical - converge along the edge, angulus mandibulae, until a zhuvalnaya muff is attached to the last surface, when a wicker will appear with the same tuberosity, tubero-sitasmasseterica. On the inner surface of the kut there is a crustal tuberosity, tuberositaspterygoidea, the place of attachment of the zhuvalny mu'yaziv, m. pterygoideus medialis. That is why the zhuvalniy apparatus is infused into the size of the kuta. In new-born women, the wine is close to 150 °, in older adults, it decreases to 130-110 °, and in the elder, with the second teeth and weakened act of juvenile life, it’s getting better again. In the same way, in the case of adult maws with different species of homosexuals, it is more likely that there is a weakening of the function of the reduction of angulus mandibulae from 90 ° in people like maws up to 95 ° in the Heidelbertsian non-educated people, 130 ° 1 .

1 Short anthropological views of the guides of the handlers M. A. Gremyatsky and V. V. Ginzburg.


Small. 33. Bottom slot.

/ -Newborn; 2 - people of 30 years; 3 - people 80 years old; 4 - the slit of the bitter people (the red outline), was added to the slit of the Heidelberzkiy people. It can be seen that there is a change from the statements of the childbearing and vintsevoy sprout.

Budova and the relief of the lower slit of the understanding of the teeth and participation in the company’s education.

So, the upper part of the tila, pars alveoldris, Carry on your teeth, because of someone in the country, arms alveolaris, there are teeth of the alveoli, alveoli dentales, with partitions, septa interalveolaria, as a result of the alveolar temporalis, jiiga alveoldria. The curvature of the bottom edge of the frame is massive, basis mandibulae. In the elder, if the teeth vypadayut, pars alveolaris atrophy and everything becomes thin and low. According to the middle line of the song, the symphony goes to pidborddya pidnesennya tricot form, protuberantia mentalis, the manifestation of what characterizes the present person. With the success of the winners, the bends only among the people, that is the bitchy. In people-like maws, pytecanthropus and Heidelbertsky people, the edge can be bent backwards. In the Neanderthal, the view is also visible, the ale visible edge of the lower slit can be seen as a straight cut. Only the happy people show their help. On the sides of the mid-day there are humps, tubercula mentd-On, one on the skin side. On the lateral surface of the floor, on the edge of the middle between the 1st and 2nd small root teeth, there are foramen mentdle, presenting a view to the channel of the lower slit, canalis mandibulae, services for the passage of nerves and nerves. Back and go to the area of ​​tuberculum mentale, the spit of line stretches, linea obliqua. On the inner surface in the area of ​​the symphony, there are two sides, spinae mentdles, - muscle tendon attachment mm. genioglossi. In people like mavp tsei m'yaz


Attach not to the tendons, but to the meaty part, in which case a fossa is replaced. In a row of copalins, a gap є all transitional forms - from the power maws of the fossa, poured into the meaty attachments m. genioglossus and go from the outside of the footboard, until the development of the spine, the accumulation of the tendon attachments to the chin-viscous joint and go through the onboard footboards. In such a rank, the serpent to the method of attaching m. genioglossus, from meaty to tendon, caused the establishment of spina mentalis and, apparently, as a result. I’ll look at the tendon way of attaching the muscular tissues to the mobile device, having taken the development of the deep-rooted one, re-creating the cyst relief of the lower slit in the area of ​​fiddling, so I’m also purely connected with the people’s winter. On the sides of the spina mentalis, closer to the lower edge of the gap, there is a spot of attachment of the digastric ointment, fossae digastricae. Go back and burn right up to the cracks, linea mylohyoidea, - the place of attachment of the same name.

Gilka slit, ramus mandibulae, go from the skin side out of the back part of the body of the lower slit of the burnout. On the inner surface there are openings of the lower slit, foramen mandibulae, canalis mandibulae. The inner edge of the opening is opened at the viglyadi tongue of the lower slit, lingula mandibulae, de attach lig. sphenomandibulare; lingula are stronger in people than in mavp. To the back of the lingula, to repair і straight down і forward slit-pid'yazikova boroznaya, sulcus mylohyoideus(Slіd nerve and blood-bearing vessels). At the top of the lower slit, there are two sprouts: the front of them, vintseviy, proce "ssus coronoideus(After pretending to be injected with the thrust of a strong, frictionless muff), and the rear one, processus condylaris, take care of the part in the lower slit with the lower cuff. Mіzh about the adolescents pretend to be viral incisura mandibulae. Right up to the tip of the bone, it grows on the inner surface of the throat from the surface of the alveoli of the remaining great root teeth of the comb of the cheek meat, crista buccinatoria.

Mi Shchelkov iy edrostok has a head, cdput mandibulae, i shyku, cbllum mandibulae; in front of the shytsi there is a hole, fovea ptery-goidea(Mice attachment m. Pterygoideus lateralis).

I will describe the lower slit, then it means that the shape and the budova characterize the happy lady. Submit to side 87 officials have led to a drop in the strength of the teeth and reduction of the lower slot. The order of the people began to develop articulate mova, tied with a strong and thin robot mova muzzle, so that it was attached to the lower slit. To that, the chin region of the lower slit was tied with cimi m'yazy, strengthened by the function, and stood in front of the other officials in regression, and on them they appeared on the way out and the appearance. The decision of the rest was also extended to the widening of the slit arc, which was tied to the enlarged transverse cranial deformations of the skull before pouring into the growing brain. In such a rank, the form and the lower slit of the people were formed in the flow of development of the pratsi, the articulate movement and the brain, which characterize the people.

pid'yazikova list

The human organism is dusky. For securing the safety of spilling dishes, use special structures. One of such systems is the breast tissue. It is especially encouraged to serve as a shield for the heart-vascular system, organs of the brain, spinal cord and brain.

The peculiarity of the breast cancer є її ruggedness. Through the dizzying ruins, the won was entangled constantly changing the size and collapse, taking over at the end of the power.

Budova breast klitini people

Budova breast cells are simple - you can store them with decal types of bags and soft fabrics. There is a great number of ribs, the sternum and part of the ridge produce a lot of empty chest. For the size of a won on another scratch. This structure is surrounded by participation in the spirit and support of the human body.

Looseness of such a folding system is created by a complex of slopes. All the bridesmaids are one by one for their help. Krim suglobіv, m'yazі fabrics and play will not stop playing a role in safe mobility. A more complex solution will make a viscous hearthist of the heart and mental systems.

Mezhi

A large part of the population does not know the anatomy of people and does not know the cordons of the breast. Those who are not allowed to enter only the area of ​​the breasts, є graciously. It is necessary to report on the information about the cordons.


  1. The very top of the border is roztashovuєtsya on the level of the shoulders. First pair of ribs should be repaired before them;
  2. The lower boundary does not have a clear line. Vona nagaduє p'yatikutnik. From the sides and from the back of the border, pass on the pins across. The front emptying will end along the line edge of the ribs.

sternum

The sternum is shaped for the correct shape of the anterior part of the breast tissue. Before the sternum, there is a large amount of cartilage, which serves as a gasket between the cyst and ribs. The name of the viglyad is like a plate, from afar it is similar to a shield, it is swollen from one side, and a trochus is escaped from the side of the leg. Build up in three parts. Pull the straps tight at once. Rozpodil into three parts will make it possible to finish the rim of the basket loose, as it is necessary through the widening of the emptying when dikhanna.

At once the stench will make you feel the visitor's function. Ale dermal part has its own characteristics and specificity.

  • Lever. Tse part, roztashovana from the top, є nibilsh about'єmnoy. MA the form of an irregular chotirikutnik, the lower is lower than the lower, lower is the upper. Along the edges of the upper pavilion, holes are laid out for attaching the collarbones. At the same time, one of the most important musculoskeletal forms - clavicular-sterno-nipple-like;


  • Tilo is the middle viddil of the sternum, ripple to the handle with a small kutom, which nada the sternum opucleus viginum. The lower part of the shirsha, ale to the point of being closed with the handle of the brush, starts to sound. The price is great for a part of the sternum. Behind the form of nagadu
  • The outgrowth is the lower segment of the sternum. Yogo rozmіr, tovschina and the form of individual for skin people, albeit in a large number of vypadkіv vіn nagadu inverted trikutnik. Nayrukhomisha is a part of the kistka.

ribs

The ribs are bent with themselves in the cyst structures. The posterior edge has a more smooth and rounded surface to be brought up to the ridge. The front edge of the Volodya is hospitable, with a sharp edge, which sits behind the sternum behind the supplementary cartilaginous tissue.

The ribs are of the same Budov, and the only one is of the same size. Falling out of the way, the ribs are divided into:

  • Reference (7 pairs). Before them, ribs are introduced, which are attached behind the help of cartilages to the sternum;


  • Pomilkovі (2-3 bets) - do not attach cartilage to the breastbone;
  • Vilny (11 or 12 pairs of ribs are carried to the vilny). Їхн the encampment zberigayut snuggle m'yazi.

ridge

The ridge is the supporting part of the breast plate. Atypova budova slopes, as they knit the ribs and ridges, allowing their brothers to share in the sore and widened breast emptying when they are dyhanna.

Myak_ fabrics of breast cells

An important role in establishing breast emptying is played not only by cyst structures, but by the most plastic elements. For the correct robotic dichotomous system, the chest area is secured without lymph tissue. The stench also helps the handles in their own functions: curling up and filling the gaps, transforming the breast into a single system.

Falsely from the miscellaneous roztashuvannya, subdivided into:

  • The diaphragm. It is anatomically important and a structure is needed, as the sternum extends from the empty abdomen. The viglyada yak is wide, flat matter, the yak has the shape of a pagorba. Straighten and relax, pour into the grip of the middle of the breast and into the correct robot of the legends;
  • Mіzhrebernі m'yazi - elements, which take a great part in the dichotomous function of organism. The stench is to serve as the backing element of the ribs. It is stored in two balls in a straight line, which sound or expand when dikhanna.

A part of the muscles in the shoulder area is fastened on the ribs and forms behind the ruch. Organism is not a hindrance in everyday life, but only in the period of strong physical or emotional stress for a greater, hardened energy.


What is the norm for breast cancer?

The breast cell is an important part for the organism. This form was shaped by the stretching of all the thousandths of the Evolution, and the most important adjunct for the submission of those who are liable to it. The form is infused with growth, decline, discomfort and the statue of people. Variants of the form of a breast cell without lice. But all the same, there are certain criteria, so that they can be brought up to the norms of any pathology.

Prior to the main types, the following are included:

  • Finite abo normosthenic form. Typical for people of average age. A small gap between the ribs, between the wide and straight shoulders, the front and rear area is wider, lower than the bush;
  • Hypersthenic breast cell nagaduє cylinder. The width from the sides is less widespread than the anterior and posterior part of the chest wall, the shoulders are significantly larger, lower in people with a finite shape. Most often it occurs when growth is lower than the average. The ribs are spread parallel to the shoulders, practically horizontal. The musculature is clearly rosy;


  • Asthenichna - the found version of the norms. Budova thoracic clavicles of asthenic type are seen as malim in diameter: the clitine is narrow, twisted into a tight fit, the clavicle clavicles and ribs are swirled, ribs are not spread horizontally, the gap between them is wide. Kut mіzh shiєyu and stupid shoulder. disgusted myazova system... To be seen in people with high growth.

Breast deformation

Deformation is a change to the physiological plan, as it is infused into the last view of the breast cell. The destruction of the breast tissue is meant to be the destruction of internal organs, and in case of certain types of deformation, it can itself become a threat to life. Winikak through a folding break of ailments, opikiv, injuries, or maybe buti pochatkova, from the people. At the connection with the cym, there are a few types of deformation.

  • Vrodzhena - wrong or not on the side of the development of the ribs, sternum or ridge;
  • Pridbana, otrimana stretching life. Є a lot of sickness, injuries or improper treatment.


Ailments, scho to wick deformation:

  • Rakhit is a child of ailment, if the organism is even more mature, it can lead to destruction of the cyst tissue and change the flow of lively words;
  • Tuberculosis of cystoks is a disease that can be hostile to older adults and children, develop without contact with the nose of ailments;
  • Zahvoryuvannya organ_v dikhannya;
  • Syringomієliya - ailment, tied to the mouths of their spaces in the spinal cord. Zahvoryuvannya be chronic;
  • Scoliosis - loss of the form of the ridge stovp.

Deformation is also affected by severe symptoms and injuries.

Prydbanі zmіni buvayut:

  • Emphysematoznimi - barrel-shaped breast tissue. Pathology develops after the transfer of an important form of ailments of legends. The beginning of the growth of the front area of ​​the chest wall;


  • Paralitic, if the diameter of the breast cell is speeding up. The scapula and the clavicular bone are well-rounded, the great progression between the ribs, when dimmed, the scapula collapses at the vigorous rhythm. Paralitic deformation of the infusion with chronic ailments of the dichal system;
  • Scaphoid. Initiative to develop in people with syringomyelia. At the upper part of the chest wall there is a fossa in the form of turi;
  • Kiev Defeat is characteristic of people from the cysts and the ridge, for example, cyst tuberculosis. The breast cells have an external symmetry, which creates the normal robots of the heart system and legends. Zvoryuvannya shvidko progress and disgustingly follow.

vrodzheni wadi

The most common cause of deformation in children is damage to the robotic gene material. In the genes, there is a lot of confusion, yak zooming in the wrong development to the body. The name is tied to the atypical structure of the ribs, sternum, or in the whole of the body, in the filthy development of the meat fabric.

See breast cells with congenital pathologies:

  • Funnel-like. As a result, the frequency of manifestations of congenital pathologies of the breast cancer occurs. Perevazhaє middle of the population. The sternum and the ribs lie down to them to bend in the middle, to prevent a decrease in the diameter of the breast tissue and the growth of the ridge. Pathology is often transmitted in recessions, which gave rise to respect for genetic illnesses. Infused into the robot legends and heart-vascular system. In case of a serious interruption, ailments of the heart can be lost in the wrong place.

Falling down the steps of folding, you see:

  • First steps. The heart system is not damaged, and all organisms can be shattered on anatomically correct mice, lost in no more than 30 millimeters;
  • Another step, if the replacement of the heart meat is spared up to 30 mm and the depth of the funnel is close to 40 mm;
  • Third step. At 3 steps, the heart is reduced by 30 mm, and the funnel of the head is more than 40 mm.


Most organisms are hungry for inhalation, if the breast tissue is most close to its back part and, apparently, the funnel is also. As a result, the deformation is growing, apparently, and the steps of becoming ill progress. Progresuvati at a fast pace, the ailment started three times. Such children suffer from impaired blood circulation and develop more than their one-line. Oh, the immune system can’t do it again, because it often smells bad. Each year the funnel grows larger, and at the same time it grows and health problems.

  • Keel-shaped - pathology, tied with over-cartilage tissue in the area of ​​ribs and sternum. The breastplate is strongly visible and calls to the nagadu keel. In the wake of the camp, it’s going to waste. Unimportant to the call, the picture is scary, the legends do not shine and work in normal mode. The heart of the trophy changes its shape and it is better to cope with physical options. Possibly bad luck, lack of energy and tachycardia;
  • A flat chest pad is characterized by a smaller volume and does not require treatment. Є a variant of the asthenic type, not pouring into the robot of internal organs;


  • Sternum with a gorge. The gorge lasts for a second and a half. It appears during the period of vaginosti. In addition, a crack in the sternum of growth. Chim more enlightens, tempting legends melt into the heart with snuggled vessels. For lіkuvannya vikorystovutsya surgical entrusted. If the operation is carried out for children until one fate, then it can be done simply by stitching the sternum. At the same time, the cases are dull and easy to adapt. If the child of the senior viku, then the brush is expanded, the rosette is filled with a special implant, and the titanium alloy plate is closed behind the auxiliary plate;
  • Vignut deformity - even more rare and small appearance. At the top of the breast plate, a line is established. Vona є is not a natural problem, і not be addicted to the health of the body;
  • Poland's syndrome is genetically ill, which is transmitted in recessions, and is tied with the sinking of breast cells. The twigs are poured into all parts of the breast tissue: ribs, sternum, ridge, tissue and cartilage. Correct for the help of a surgical engagement and prosthetics.


Fracture of the first legacy

Fracture of the breast tissue is most often caused by a strong blow, or in case of a fall. Diagnose blue breasts and hematomas in the area of ​​pregnancy, as well as badly ill, Nabrekom and mossy deformation of the breast tissue. As soon as only the hands were affected in the result, then with the high ymovіrnіstyu all quickly start. Turbuvatisya varto, when є wait for the hammer or shit the legacy. Fragments of parts, or the gostry edge in a moment of fracture, can be pierced into a legend. I will overwhelm you with accelerated and trivial rehabilitation.

If you are suspected of having a lung ear, it is necessary to turn up to the lykar. The ailing person will probably have a lot of fun in the empty space, so that the process will be taken care of, right up to the rest of the time. Independently fit into the legacy not vyde.

Break down on open and close. In case of an open fracture, the integrity of the skin cover breaks down, the risk of infection is increased. A postcritical fracture is characterized by the appearance of open wounds on the skin, or even internal bleeding.


What do you forget?

Zabiy is a closed type injury. Even if the blow does not become a fracture of the cysts, or if the internal systems of the body are damaged, then the symptoms will be diagnosed.

  • Strong swelling of the fabric through the popping of blood-bearing vessels;
  • Bil, localized in the shock, which is susceptible to strong inhalation;
  • Syncy and hematomy.

Most often it is difficult to get through a strong blow or a lock. Before extended reasons to refer:

  • suitable for road transport, if an injury is created by a kermo, a belt or a pillow is safe;
  • profesіynі zmagannya abo boї;
  • bіyka abo attack;
  • It is also possible to eliminate the slaughter by licking and falling on the subject of an uneven surface, in which case the slaughter will be stronger.

We will raise the legacy of the legions, as a result of which they will be bloody, so that they will be filled up. Symptoms are similar with a sharp blow, or a cough with blood, ill-feeling when trying to remember the position.

Breast cell is nasty spoluki: synchondrosis, synostosis і loamy, strengthened with sounds.

Synchondrosis є: between I ribs and sternum, handle and trough sternum, sword-shaped adroitus and til sternum, grave ribs between themselves from the costal arch, cystic parts of the ribs and costal cartilages. Sword-like outgrowth and rib cartilage slugs do not ossify with the stretching of the living life. Synostosis is indicated between the handle and the size of the sternum in people older than 40-50 years. The costal-ridge slopes are described by the vische. Sternocostal slopes between cartilage II-VII ribs and costal ribs with ribs of the sternum behind the shape of the plane. Elastic costal cartilages, costal-spinal and sternocostal slopes, dichal ligaments of the breast tissue are kindly fitted for dyshally collapses: for an hour you breathe out - you feel like it grows wider to be seen, and to see

The breast plate as a whole is an irregular cone with a truncated top. She has a choice of walls - front, back, two women and two openings - the upper and lower apertures. The anterior wall is fixed by the sternum and costal cartilages, the posterior - by the thoracic ridges and posterior ends of the ribs, and by the ribs. Ribs are divided by intercostal intercostal spaces (intercostal spaces). The upper aperture is surrounded by the I pectoral ridge, the inner edges of the I ribs and the upper edge of the sternum handle. Stravohid, trachea, judgment, nerves pass through her into the chest empty. The lower aperture is surrounded by the XII chest ridge, the lower ribs and the sword-shaped spine of the sternum. Vona is closed with a diaphragm, through the opening of which the aorta, stravohid, judges and nerves descend into the empty hole.

The shape of the breast cell is to be found in statues, viku, stati, profession. In the anatomy, there are two extreme forms - vuzka, dovga, similar to the asthenic type of statue, and wide, short, similar to the hypersthenic type. Most people have an intermediate (normosthenic) form of the breast tissue. In newborns and children of early age, the lower aperture of the breast cancer is widened for the opening of the great liver. The anteroposterior size of the breast tissue in them is larger than the transverse size. In people with sickness, the breast cell becomes more flat and full of muscle tone and the lowering of the anterior ribs. In women, milk is poured onto the relief of the breasts, in the choloviks - the contours of the mucous membranes of the shoulder girdle, breasts, back, cranial press.

Pathological changes in the formation of the breast cancer occur when the ridge is affected (scoliosis, kyphosis), rachitis, diseased organs of the breast emptying (emphysema of legends, heart defects). Spasters congenital deformity, for example, a funnel-shaped breast cell or "breast shevtsya". The keel-shaped ("chicken") form of the breast clytini is a zest for rachitic walking. This deformity is manifested as a result of changes or changes in the anteroposterior size of the breast tissue. The barrel-like form of the breast cell is characteristic of the ailments with emphysemoy of legends.

 

Read:



Yak know the point overretin straight and paraboli

Yak know the point overretin straight and paraboli

The zavdannya z joke points overflowing be-like figures ideologically primitive. Difficult to play in them only through arithmetic, that is itself in ...

CRIMINAL CODE of article 105, part 1

CRIMINAL CODE of article 105, part 1

Driving in is not the illegitimacy of the humiliation of the people and the life of the big dweller. The contradiction of the action of the Pole is in the fact that having inflicted the action without capturing ...

Gra Zalizne Rilo: Svin Boots Zalizny p'yatak gra

Gra Zalizne Rilo: Svin Boots Zalizny p'ятак гра

For a description, instructions and rules, as well as thematic research on similar materials - it is recommended to learn. Chi is easy to see ...

Developing іgri with children for vivchennya alphabet

Developing іgri with children for vivchennya alphabet

Kozhen from batk_v learn to give a maximum of all knowledge to his child. One of the most important moments is the creation of the alphabet. Youth ...
feed-image Rss