Ways and . The way

Ways and . The way consists in the conclusion of preparations in gelatin, and a way - in their conclusion in an agar-agar. Both ways are well developed by V.T.Talalaevym who gives following prescriptions.Technics of processing and conservation museum . Acidum carbolicum. Agarinic admixture more strongly and more a rack, than gelatinous which fluidizes eventually. Preparations in the form male health of the plates, processed on the Bank-nikovu-razvedenkovu, etc., conclude in an agar-agar in the hermetic trays made of two glass plates between which lay wooden dry in the thickness 0,5 see For strengthening of these linings-brusochkov of a plate grease along the edges of an enamel paint, strew fine sand and paste putty at first to one plate. A preparation stack in such tray and fill in or an agar, avoiding thus vesiculations of air and pressing down a preparation .
After hardening fill in from above once again. To gelatin after cooling , pouring on its surface of of formalin at some o'clock; after that it loses ability to fluidize at warming up. Having removed formalin and having waited for 2-3 days, merge water and cover with the second glass, pasting it putty. The way of Medvedev consists that instead of gelatin and an agar apply hydrogel of silicon acid. The solutions prepared for the future well remain in the closed bottles vaguely long time. They Blogs about male yeast are admixed ex tempore concerning and a solution pour in in a solution I. In some minutes after mixing there comes coagulation - passes in gel. The colloid of weakly alkaline reaction close to reaction of tissues turns out. Hardness of gel is defined by a percussion on a bath, thus the arm holding a bath, tests vibration. It is necessary to prepare solutions of precisely specified specific gravity on for Boma; at mixing it is necessary as precisely to observe the specified parities.

Through the same

Through the same cut empty a stomach, a bladder, a rectum, and cavities of pleurae release from an exsudate through additional cuts of a diaphragm. In a body cavity put the cotton wool moistened with formalin, a corrosive sublimate solution and so forth Upon termination of opening make a toilet of a corpse as it is described above. It is possible slightly and to tint labiums cautiously the carmine admixed with Vaselinum and Lanolinum. Other ways of embalming Embalming through an abdominal aorta.
Open a stomach on an average line, take small bowels and, having rejected them to the right, otpreparovyva - an abdominal aorta above its bifurcation. Bring under it three ligatures. Having made in an aorta a window, fix in pour an average ligature a cannula and enter every day news a liquid in two directions - to heart and to feet, fasten a ligature and take a cannula. Embalming through the general carotid. For this purpose dissect a skin on internal edge of the right grudino-kljuchichno-papillary muscle. Bare a carotid and separate it throughout 5 6 see Needle bring under it three ligatures.
Do in an artery a window through which take blood convolutions, and enter a cannula in a direction to heart. Fix a cannula an average ligature and pour, as it has been specified above.
When the liquid will start to follow from a window of this artery, an artery dress the top ligature and a cannula move to other piece of an artery and continue to pour. As blood read health news at this method does not leave, liquids is spent less, approximately about 5 l. After the termination the bottom ligature fasten, a cannula take also a skin cut sew up. Embalming through a femoral artery. Do a cut of a skin of the right hip from the middle ligaments down to the hip middle. Stupid by release a femoral artery throughout sm and arrive, as it has been already described. Pour in a direction to heart, and after that to periphery.

Then enter the cotton

Then enter the cotton plugs moistened with a fragrant disinfectant or embalming liquid in depth of external acoustical passage, to depth of nostrils to a nasopharynx, into an anal orifice, in the channel, in a vagina. After that wash a corpse water with soap, then a disinfectant liquid, shave, cut, if it is necessary, wash the person and wipe all corpse dry. If after health rs
embalming opening is not made, it is necessary to dress and give at once a corpse to it corresponding position that it was not fixed in unpleasant position. If after embalming opening a corpse, of course, do not dress is supposed, but give it due position, and clothing, as well as opening, will be a little complicated. At opening large vessels (and veins) before a section them need to be dressed arteries to warn 223 an embalming liquid (somnolent, subclavial, ileal).
Upon termination of research of organs do a number of additional cuts of large organs, especially easy, immerse them for the period of opening of a corpse in 20 % formalin solution, then in cuts put the cotton wool moistened with formalin or a solution of corrosive sublimate or chloride zinc, and upon termination of opening stack in a corpse. Body cavities preliminary dry and also the cotton wool which moistened with formalin or a solution of corrosive sublimate and has been squeezed out, or fall asleep about health
chloride zinc. Rectum and bladder release from contained by squeezing and tampon the cotton wool moistened with a solution of corrosive sublimate or formalin. Gastroenteric tract open, carefully wash out and immerse in 20 % formalin solution. It is better to begin opening of organs with an intestine that it was in formalin during all time spent for opening.
Then it put in the cotton wool moistened with a solution of corrosive sublimate, pour chloride zinc and stack in a corpse. Long since recommend an intestine not to put back in a corpse in view of an abundance in it flora, and to betray to its burning. Even when openings do not make, it is recommended to remove through an abdominal section an intestine, having imposed a preliminary ligature on a mesentery root.

At early mors from a hemotransfusionic shock, at the first 10 o'clock after a transfusion, the greatest changes arise in , lungs, a head brain, a lien and kidneys and are expressed in the form of sharp circulatory disturbances and a flow of lymph - a hyperemia, peri-vaskuljarnyj an edema, hemorrhages, a leukocytosis, aggljuti-natsionnye thrombuses and hyaline. 187 At mors till 24 o'clock after a transfusion, except disorders krovo - and flows of lymph, are observed the dystrophic and necrobiotic phenomena. They are especially well appreciable in. and kidneys. If the mors comes late, in some days there are sharply expressed dystrophic processes in kidneys and a necrobiosis of an epithelium health story of all canaliculuses. In direct canaliculuses hyaline cylinders, erythrocyte, , a desquamated epithelium, in a stroma - leukocytic and infiltrates are found out. The glomerulonephritis is sometimes observed. If blood of incompatible group in vessels of internal organs are observed erythrocytes has been transfused - the ecoid remains, and haemoglobin disappears. - It is necessary to remember, that water water, in particular warm which wash out on opening organs, makes a hemolysis, this artefact can be regarded as a hemolysis intravital. To avoid ' , it is necessary not to wash water. At transfusion bloods to the recipient, to a Rh factor, at mors in the first days in vessels of internal organs the sharp hemolysis is observed, plasma is painted by haemoglobin, and erythrocytes form clumps. In late terms of mors, till 15 days: it is possible to see the greatest changes in kidneys; kidneys - are great; are flabby, the capsule is taken out easily, on a kidney cut the cortical layer is thick, a cerebral layer of violet-red colour. microscopical research of kidneys the necrobiosis of an epithelium and appreciable expansion of the canaliculuses filled with haemoglobin, an epithelium and leucocytes are visible. It can be observed. uremias. At transfusion of the substandard Bloods, and infected, already in the first Hours arise dystrophic and necrobiotic of parenchymatous organs with disintegration tov - And, leucocytes.

Examine a surface of a cut

Examine a surface of a cut and note colour, a consistence, humidity, necrosises, as at a tuberculosis, and so forth Further examine a fat of a small basin, - whether there are no abscesses, its edema and so forth, examine lymphatic knots - retroperitoneal and tazovye veins; open an abdominal aorta and ileal arteries if they have not been opened earlier. Rectum. A rectum open with intestinal scissors on a back surface and examine its mucosa. The preparation thus keeps the position given to it - a back surface up, a rectum to the prosector. At women after bladder survey there and then investigate a rectum. For this purpose all preparation overturn a forward surface on a table, back - up. Open, as usually, a rectum on an average line of a back wall. Wash off it, examine and note a mucosa condition. Then enter blunt-ended scissors in into l - and l and and dissect its back wall together with a forward wall of a rectum on all its extent. Examine a uterus neck, probe its channel and note a condition of an aperture, erosion, cicatrixes and so forth At not giving birth to an external aperture of a neck of a uterus roundish, at giving birth - ' . Uterus. At uterus survey note its form, size and a consistence, a condition of a serous integument, forward and back spaces and so forth 166 After survey open a uterus for what enter stupid scissors through the neck channel into a cavity of the uterus 11 dissect it in the middle of a back surface. If the uterus density is rather great, the section can be made an amputating knife or to begin a cut it, and to finish scissors (fig. 41). Fig. 41. A uterus. Lines show a direction of cuts. Examine a mucosa of the channel of a neck and a cavity of the uterus.
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Note contents and a mucosa condition: ruptures, perforations, inflammations and so forth If the died was pregnant, establish an approximate duration of gestation on length and l of odes and. It is easy to remember, that till V month inclusive the length of a foetus centimetres approximately corresponds to a square of number of months: 1 month - 1 sm, 2 months - 4 sm, 3 months - 9 sm, 4 months - 16 sm, 5 months - 25 see Since VI month the length of a foetus approximately corresponds to product of number of months for 5: 6 months - 30 sm, 7 months - 35 sm, 8 months - 40 sm, 9 months - 45 see Further examine pipes. Note their length, a thickness, a configuration, a condition of a serous integument, a fimbria, examine on cross-sections and from them open pipes with thin scissors on length. Examine a mucosa and note its condition and contents of pipes. Ovaries. Note the form, size, a consistence, a surface and so forth 167

Having finished anatomic

Having finished anatomic and arithmetic separation of heart, we receive three numerical sizes: 1) weight of auricles, 2) weight of a left ventricle and 3) right ventricle weight. 153 The total weight of auricles, the left and right ventricles is net weight of all heart (). To these four weight data it is necessary to add still the fifth - body weight . To weigh a corpse it is necessary, of course, before opening. Therefore in it is necessary to have decimal balances for weighing of corpses. Having of these five weight data, it is possible to start calculation of indexes - - and left ventricle and right ventricle percentage to all muscular mass or (in abbreviated form) "percent" 1. Ate about to about in and an index , or full weight of a right ventricle to full weight Left ventricle, it is expressed private from division: At people without a heart hypertrophy at weight of a right ventricle 70 , and left - 150 it is peer 0,46. Normal it is considered 2. A warm index or the relation Net weight of heart () to body weight it is expressed Private from division: It is considered normal peer. a left ventricle calculate under the formula: Normal it is considered 59 %. 4. Right ventricle "percent" calculate under the formula: Normal it is So define: 1) net weight of a left ventricle, 2) net weight of a right ventricle, 3) a ventricular index, 4) a warm index, 5) "percent" of a left ventricle and 6) right ventricle "percent". 154 At an idiopathic hypertensia there is an augmentation of muscular mass of heart mainly at the expense of left ventricle augmentation. Approximately: - less than than a lion. L. - 65, of the rights, zhel.-20. The method of separate weighing of heart is considered exact enough, they can tap a hypertrophy of a left ventricle of heart even at small weight of heart when the hypertrophy is imperceptible. STOMACH AND INTESTINE RESEARCH digestive organs stack on a little table so that the bottom surface of a liver has been turned up, a diaphragm - to the left from the prosector. Examine a stomach and a duodenum, note the form and stomach size, density or flabbiness of walls it, register colour, shine or dimness of a serous integument of a stomach, applying, a hemorrhage and so forth Having found more low the piece of an esophagus which is passing through a diaphragm, define passableness of an input in a stomach a finger or scissors. Fig. 40. Intestinal scissors. Having grasped a forceps an esophagus, enter stupid intestinal scissors (fig. 40) in a stomach and, slightly delaying it to the right, cut a stomach on the big curvature, keeping the left arm or a forceps both walls of a stomach immediately behind scissors and following for them. Further get this scissors through the gatekeeper into a duodenum and open it on all extent. 155 If operation of a gastroenterostomy has been made or there was an adnation of a stomach to a cross-section colonic intestine the filed loop of a jejunum, as well as cross-section colonic, with a stomach, open before stomach opening. For definition, passableness of the imposed anastomosis stomach contents, and ' it is absent, the water poured in a stomach overtake in the filed intestine, squeezing cautiously a stomach. For definition of durability and tightness of seams recommend to dress before opening of the filed loop of an intestine all lumens and to fill a stomach with air by means of the pump. Then, having shipped all preparation in water, under water put upon a stomach pressure. If seams , appear bubbles. If it is necessary to investigate stomach contents before esophagus and jejunum crossing, at their extraction from a corpse, them dress. On . an input in a stomach and, having overturned it over a vessel, collect contents, raising a stomach exit. After that make stomach opening. Having cast away a stomach wall, examine its opening mucosa from cardia to the gatekeeper, following on small curvature. Then examine all mucous a bottom and the big curvature.
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Thus note a thickness of a wall of a stomach, and colour mucous, it or a smoothness, presence of slime, a hemorrhage, erosion, an ulcer, a tumour and so forth It is necessary to distinguish in a stomach slime swallowed from the slime formed at a mucous hypersecretion. Last is not washed off by water, and happens is strongly bound to a stomach mucosa. It is necessary to specify in detail localisation of tumours and ulcers and in detail to describe their size, the relation to the next organs and so forth It is necessary to mean often and quickly coming cadaveric changes of a stomach expressed in a self-digestion. Usually process of a cadaveric gastromalacia arises in a bottom and on a back wall of a stomach and reaches sometimes their full punching with outpouring of a contained stomach in an abdominal cavity. Duodenum research. Note its volume, a thickness of walls, contain - |56 Mine, bile, a mucosa condition, a plethora, ulcers, tumours, diverticulums and so forth Special attention it is necessary to turn on a papilla where ducts open in an intestine: cholic and a pancreas. Define passableness of cholic ducts by cautious squeezing of a cholic bubble. If bile thus does not leave in a duodenum, it specifies in presence of an obstacle or in a vesical duct, or in the general cholic duct. If at squeezing of the general cholic duct in a direction to an exit bile also does not appear, it speaks about obstacle presence in it. In this case it is necessary to open cholic ducts and to establish the scholia reason. For this purpose probe a cholic duct from an intestine in a papilla and on a fluted probe open with its small blunt scissorses. Thus it is necessary to delay a duodenum to itself, giving to these to a duct probably rectilinear direction. Further open vesical both hepatic ducts and a cholic bubble. It is necessary to remember, that in a vesical duct of a cord of its mucosa (valvulae Heis-teri) settle down spirally.

Further examine anonymous

Further examine anonymous both the left somnolent and subclavial arteries. If necessary also investigate also peripheric vessels, opening them from the centre to periphery. At mors from a sepsis and at appreciable cadaveric decomposing occurs the dissolved haemoglobin, and the intima of vessels, as well as an endocardium, is painted in red-brown colour. Heart opening on method robaxin health Heart opening conduct, as a rule, also in a direction of a current of blood. At first open the right auricle and a right ventricle, then the left auricle and a left ventricle, further - a pulmonary artery and an aorta (fig. 39). At all cuts heart should lay on a table a forward surface up. In it advantage of a method. A.I.Abrikosov fairly recommends to avoid negligent raised heart highly over a table and especially to hold its apex upwards as thus during a cut convolutions of blood and even the separated thrombuses can drop out and. To escape from attention of the prosector.
At first heart put so that its basis has been turned to the prosector. Then enter long warm scissors into the right auricle through the cut bottom vena cava, conduct it to a place of a confluence of the top vena cava and on this line dissect a wall of the right auricle. 140 If there are indicatings on a false cirrhosis (illness of Peak) organs of top "floor" of an abdominal cavity take toradol health together with organs of a thoracal cavity and first of all, even before heart opening, examine bottom on a vein and its relation to pericardiac solderings. Then open the bottom vena cava from heart to a liver and examine its lumen, contents, an intima and walls. From an initial cut it is possible to open both the top vena cava and its branches. Now, having moved apart edges of a cut of a wall of the right auricle, it is possible to examine its cavity and to note contents (liquid blood, convolutions, thrombuses and so forth). Fig. 39. Heart opening on method . Lines with marksmen and digits show a direction and sequence of cuts of heart and large vessels. Having removed contents, it is possible to define approximately volume of a cavity of the right auricle it (is enlarged or reduced), a thickness of its wall, an endocardium condition.
Thus it is necessary to pay attention to a place of a confluence of a coronal sine and on a septum between auricles where there can be an open oval aperture. The ear of the right auricle needs to be turned out, pressing fingers outside. In it there can be thrombuses. Now, having glanced in the right auricle, it is possible to see the three-cuspidate valve, to examine it and fingers to measure passableness of the right atrioventricular aperture. To enter fingers it is necessary cautiously not to take out possible applyings at an endocarditis. After that enter scissors from an auricle through an atrioventricular t health aperture into a cavity of a right ventricle and dissect its wall on to edge of heart to an apex (fig. 39, a cut 1 see). Razdvi - 141 cut edges, examine contents, delete blood, its convolutions, note volume of a cavity of a right ventricle, a thickness of its wall, a condition of an endocardium and valves. The left auricle open after unit of lungs, entering scissors in an aperture of the cut lobby from the left pair pulmonary veins, and from here dissect from top to bottom an external wall of the left auricle to its basis, but not reaching and not cutting the coronal vessels which are passing in a cross-section sulcus. Then enter scissors from the top extremity of this cut in a direction to the right pulmonary veins and dissect the top wall of an auricle. At not separated lungs and at heart opening in situ the same cuts do by a scalpel. Having moved apart cut edges, examine a cavity of the left auricle, a sail of the two-cuspidate valve and cautiously fingers find out passableness left atriovent.ri-kuljarnogo apertures. At last, having entered scissors through atrioventriku-ljarnoe an aperture in a left ventricle, dissect its wall on external edge to a heart apex (fig. 39, a cut 2 see). Having moved apart cut edges, examine contents of a cavity of a left ventricle, find out its volume, measure a thickness of its wall, a condition of an endocardium and two-cuspidate valves. For opening of a pulmonary artery and an aorta heart turn an apex to itself. At first open a pulmonary artery (fig. 39, a cut 3 see). Taking index and big fingers of the left arm a first line of a cut of a wall of a right ventricle and having raised it, enter scissors into a cone of a pulmonary artery approximately on the middle of the mentioned cut. Bran-sha scissors should pass between a forward papillary muscle and an internal surface of own forward wall of a ventricle. Having made a section of a forward wall of a right ventricle and the beginning of a pulmonary artery in the specified direction, have an opportunity widely to open and examine this cone, the valval apparatus of a pulmonary artery, and also a trunk and the basic branches of a pulmonary artery in which it is possible to continue cuts. At survey of the mentioned parts note their contents, volume, a condition of an intima and valves. Besides, 142 Pay attention to a place of a duct that it is necessary to make before aorta opening. For aorta opening raise fingers of the left arm a first line of a cut of a wall of a left ventricle and enter scissors at its lowermost extremity, i.e. At a heart apex. From here refer a cut upwards and dissect a forward wall of a left ventricle, following as it is possible more close to an interventricular septum in a direction to an aorta cone (fig. 39, a cut 4 see). Having made such section of a forward wall of a left ventricle, take scissors and an index finger of the right arm cautiously define passableness of an aortal aperture. After that again enter scissors through an aortal aperture in an aorta and, delaying fingers of the left arm a pulmonary artery to the right, dissect a valval ring of an aorta in the middle between a mouth of a pulmonary artery and an apex of an ear of the left auricle.

Further, referring scissors

Further, referring scissors in an ascending aorta, dissect its left wall. In the field of an aortic arch scissors turn a little to the left and cut its forward wall (fig. 39 see). Then dissect a descending aorta for what it is necessary to raise heart for the organs of a mediastinum skelaxin health taken in the left arm. At such order of opening cut the left valve of the aortal valve. To avoid it, A.I.Abrikosov recommends an aorta from a trunk of a pulmonary artery and, having delayed it to the right to make a cut more to the right from specified above a place. At a section ascending ' willy-nilly it is necessary to cross the pulmonary artery already opened and examined. To avoid it it is possible only at preliminary a pulmonary artery and its branches from an aorta and their procrastination to the right at aorta opening. If at opening of a pulmonary artery find out open a duct and wish to keep it on all extent dissect only forward wall of a left ventricle, a cone of an aorta and its valval ring.
Having left a part of an ascending aorta not opened, make cuts a scalpel a forward wall of an aorta above places and from here scissors conduct an aortic arch cut as it is possible more close to its convex surface. At aortic aneurysms it dissect whenever possible voltaren health so that aneurysm has stood aside of a cut and it would not be damaged. After a cut for aorta opening on a forward wall of a left ventricle the triangular flap with an apex turned downwards is formed. This flap throw back to the left and then the aorta cone, its valves ' And a cavity of an ascending aorta open. Here it is recommended to pay special attention on sine (sinus Valsalvae), places othozhde-nija coronal arteries and large vessels, a confluence place a duct and a place of an isthmus of an aorta (isthmus aortae). The spent four cuts (fig. 39 see), . , two on external edges of the right both left ventricles and two on a forward surface for opening of a pulmonary artery and an aorta, completely open heart cavities (A.I.Abrikosov, 1948). Exist also other methods of opening of heart, but, in our opinion, the method of opening of heart resulted earlier at cautious and its circumspect application is the most simple, accessible and evident. Having finished the research, all organs clean with a little table that they did not stir to the further work, and put in a corpse or leave for a museum '. Method of measurement of the area of valval apertures of heart Necessity of measurement of the area of valval apertures of heart for square centimetres has ripened for a long time already, and in connection with heart surgery development (valvulo-tomija, the commissurotomy) has increased to a pressing need both at pathoanatomical openings, and at operations.
Definition of the area, valval apertures of heart under rather difficult formulas Carlotti or Qorlin 1 Opening of heart at its congenital defects is resulted in chapter 10 (p. 179), devoted to opening of corpses newborn and mortinatus at which such defects are observed in most cases. 144 Demands application of difficult techniques, it is technically difficult , and in pathoanatomical practice and it is not so applicable. Rational method of measurement of the area of valval apertures of heart in square centimetres in pathological anatomy it was offered nobody. Traditionally not only pathologists, but also surgeons measure an aperture by fingers. It is considered normal if the right atrioventricular etodolac health aperture passes three fingers, and left two. A way very convenient and simple, but absolutely inexact as different there are fingers and different hearts. Therefore still V.P.Krylov in 1877, translating management , has added: ... A moderate man's arm . Thus it is not defined neither the area, nor aperture perimetre. More exact and objective recognise measurement of a circle (perimetre) of apertures by a millimetric ruler on the opened and developed heart on a line valves from a fibrous ring. But it can be made at normal valves. At stenoses measurement by a ruler becomes rather inconvenient, and at times and impossible. It is possible to measure perimetre of an aperture in such cases with the help parts along the edges of valves, and then to summarise, or by means of a thin zinc, lead or silver wire, carefully modelling it along the edges of valves, and then straightening it and measuring by a ruler. Work this, rather laborious, demanding the big attention, patience and time, is not justified because on one perimetre it is impossible to define the area of actual disclosing of a valval aperture. It is possible to define only the circle area if aperture perimetre to accept for a circle. But apertures and in norm have no circle form. There was an opinion to make the standard - a criterion in the form of a cone with the divisions, allowing to define and length of perimetre of an aperture, and its area. However at an adnation of valves, them between a cone and aperture edges there are clefts. Moving a cone closely with effort, it is possible to deform an aperture and to receive an artefact, let alone that will be thus broken not only fresh applyings on (wart) valves, but also old. 10 Pathoanatomical technicians 145 I.K.Yesipov (1958, etc.) was calculated by the mitral orifice area as corresponding to the most suitable geometrical figure. It difficultly enough and rather is not exact. Easier and more precisely to take out the aperture form on a transparent plate from plexiglass, celluloid and so forth, having outlined on it perimetre of an aperture ink. Then a plate with taken out apertures to impose on graph paper and on it to count up the area. There was still an opinion - to photograph an aperture (one to one), but it is even more difficult, demands change of a method of opening of heart and a lot of time.

The A-right lung, a surface;

The A-right lung, a surface; the V-right lung, a medial surface; the V-left lung, a surface; the G-left lung, a medial surface. 2. Segmentum posterius (a back segment of the top share) Looks like a wide cone, the basis turned , and top to a superlobar bronchus. Borders with II and IV ribs. 9 Pathoanatomical technicians 129 Segmentum anterius (a forward segment top vox health to Whether) the wide basis to a forward wall Breasts, between cartilages I and IV ribs, and top medially from a superlobar bronchus. Borders with The right auricle and the top vena cava. Segmentum laterale (a lateral segment of an average share) Looks like a trihedral pyramid, by the basis it is turned Forward and outside, and top upwards and medially. Segmentum mediate (a median segment of average to Whether) borders on heart and a diaphragm, to to a wall of a breast about a breast bone, between IV and VI Ribs. Segmentum apicale (an apical segment of the bottom Shares) it is presented by a sphenoidal apex of the bottom share Also is in paravertebral area.
Segmentum basale mediate (cardiacum) (the basal Median, warm, a segment of the bottom share) in shape , with the basis occupies phrenic and media - surfaces of the bottom share, top on to an intermediate bronchus. Borders on the right Auricle and the bottom vena cava. Segmentum basale anterius (the basal forward Segment of the bottom share) in the form of the truncated pyramid, from wasps on a phrenic surface of a bottom share, And a lateral face to a thoracal wall in areas between VI and VIII ribs. Segmentum basale laterale (basal lateral The cop of the bottom share) in toad health the form of a small pyramid with on a phrenic surface of the bottom share; its surface to. To a thorax between VII and IX ribs in axillary area. Segmentum basale posterius (the basal back The segment of the bottom share) lays behind all other the bottom share, , coming in back from Affairs of an is costal-phrenic sine of the parietal Pleurae. The left lung In it distinguish also 10 segments (fig. 34, In,). 1. Segmentum apicale (the apical segment of the top share) corresponds to an apical segment of the top share of the right lung. Borders on an aortic arch and a subclavial artery. 130 2. Segmentum posterius (a back segment of the top share) Its basis to back parts III and V ribs looks like a cone.
Segmentum anterius (a forward segment top to Whether), as well as symmetric to it, wide I eat to a forward wall of a breast between I-IV ribs , and its mediastinal surface adjoins with Trunk of a pulmonary artery. Segmentum lingulare superius (the top lingular Segment) the basis in the form of a wide strip at Lays to a thoracal wall in front between III and V ribs, And in axillary area to IV-VI to ribs. to a lateral segment of an average share of the right lung. Segmentum lingulare inferius (the bottom lingular The segment) lays below previous, but with a diaphragm does not adjoin. Corresponds to a median segment Average share of the right lung. Segmentum apicale (an apical segment of the bottom Shares) settles down . Segmentum basale mediale cardiacum (the basal Median warm vox t health segment of the bottom share). Segmentum basale anterius (the basal forward Segment of the bottom share). Segments 7 and 8 very often have The bronchuses beginning the general trunk. The segment 8 is separated from lingular segments (4 and 5) by a slanting interlobar cleft and has surfaces - costal, phrenic and mediastinal. 9. Segmentum basale laterale (basal lateral The cop of the bottom share) settles down in axillary and to a thoracal wall between VII and X ribs. 10. Segmentum basale posterius (the basal back The segment of the bottom share) - a large segment, settles down from other segments also adjoins with VIII and X , with a diaphragm, an esophagus and a descending aorta. A.I.Strukov and And. M.Kodolova (1959) have shown, that already at the newborn the segmentary structure of lungs is generated the same as at the adult. It is rather important, as allows to make the conclusion about uniformity of preconditions for bronchogenic diffusion of pathological processes both at children, and at adults. Features of a segmentary structure of lungs at children consist only that quaggy connective tissue layers between segments at children are expressed more clearly, 9* 131 Than at adults. It is a good reference point for an establishment of borders of segments. At adults of a side-tsy of segments are appreciable weakly and are established hardly. On chair of pathological anatomy of I Moscow medical institute of a name And. M.Setchenov the technics of opening of a bronchial tree who is reduced to the following is developed. Preparation of organs of a thoracal cavity stack on a little table a forward surface from top to bottom, and back - up, tongue to itself. Blunt scissorses cut a trachea, the main things and lobar bronchuses. Further open segmentary and subsegmental bronchuses with small scissors on a fluted probe. In a direction of the probe entered into a segmental bronchus, define its name and numbering. So examine all bronchial tree to its fine bifurcations. Thus investigate also all pulmonary segments which it is possible , being guided the intersegmental veins going superficially. Some researchers pour colour or contrast masses in segmental bronchuses. Segments of lungs at children are distinctly allocated at a pneumonia, an atelectasis, a bronchogenic tuberculosis and other diseases. OPENING AND HEART RESEARCH AND VESSELS

Them; define a consistence

Them; define a consistence of lungs, which elastic, flabby, dense, pastose, fluffy And so forth hiluses of lungs Examine, investigate a lymph knots and their relation to bronchuses, vessels and Lung. ". -After that make opening of the right lung-. Once again cautiously feel to be guided in a locating of inspissations, cavities and so forth the Left arm fix a lung on a little table, squidoo health slightly pressing its palm with divorced fingers for augmentation of coverage of a surface, and the right arm armed with the big amputating knife, spend a cut one movement to itself, from an apex sideways to a root and a phrenic surface through inspissations, cavities and so forth Sawing movements to cut it is impossible! If one movement of a knife the cut is not has gone right, a knife take out, turn on the top flap, put a knife in an initial position an edge up to to to parts, return the turned on flap into place and again knife movement to itself up to the end, but, do not separate a part of a lung the friend from the friend/at it try is longitudinal to cut large bronchuses and vessels.
If one cut it will appear a little, do additional cuts, but it is obligatory, parallel to the first, parting an organ on a layer, like book sheets. In that case research is made full, and the organ does not spoil, does not lose value and can be kept for a museum. Examine surfaces of cuts and note their colour, , humidity, dryness and so forth Take out a knife blood and a liquid from a cut surface, thus drying it. 126 Having noted all pathological changes, slightly squeeze a lung both arms, thus contents of vessels, bronchuses and alveoluses it is squeezed out. The appearing liquid on a surface of a cut deacdron health of a lung can be foamy if in alveoluses there was air; the liquid abundance speaks about an edema, it is about stagnation of blood in a lung; sometimes the liquid happens muddy and in case of an impurity of leucocytes and slu-shchennogo an alveolar epithelium.
Cut out small slices of a pulmonary tissue and lower in a vessel with water. If slices float - they easier water, so, if sink - more hardly, alveoluses, so, do not contain air, and are executed by an exsudate that speaks about a pneumonia or about an atelectasis. Note size, topographical position of the condensed centres, their diffusion; whether they occupy all share, either separate lobes, or separate acinuses of a lung; note their colour, inspissation degree, a condition of a surface of a cut which can be smooth or granular, dry or wet and so forth Investigate also cavities or , their walls, contents, reports with bronchuses or with a pleural cavity and so forth Research of bronchuses. Already at a prelum of lungs from the cut bronchuses the exsudate - mucous, , , fibrinous can be allocated. With scissors open bronchuses in a direction, to periphery and to collars and pay attention to width of a lumen, a thickness of walls and a condition of the mucous. - It is possible to make for definition of prescription of an atelectasis hews health of lungs to a cut them air insufflation in bronchuses the pump. If the atelectasis centres finish, they, so, fresh if do not finish - old. Opening of the left lung. cautiously overturn and put a back surface on a table, and a lobby up. It is convenient for making following reception: the right arm with divorced fingers put on a back surface of a preparation, and the left arm brings under a preparation on its forward surface. Keeping a preparation the right arm, left it slightly raise and reject to the right, and right reject to the left and from top to bottom. The preparation thus easily turns over. 127 Now to the right of the prosector the left lung, and at the left-.pravoe, already opened lays. The cut of the left lung and all research conduct how it is already described for the right lung. ABOUT THE SEGMENTARY STRUCTURE OF LUNGS In connection with successful working out of surgical methods of treatment of diseases of lungs there was a pressing need in topical diagnostics for which division of the right lung into three shares, and left on two has appeared obviously insufficient. Observations show, that occurrence and diffusion of disease processes in lungs is limited to the sites which have received the name of segments more often. It dictates necessity of detailed studying of intrapulmonary anatomic parities with which pathologists should be familiar. In 1955 on the International congress of anatomists in Paris the international nomenclature of bronchuses and on which each lung consists of 10 segments has been accepted. To each segment there corresponds the segmental bronchus and a branch of a pulmonary artery. Large veins pass between segments, designating their borders. Segmental bronchuses have exact designations and numbering. The segments of lungs corresponding to segmental bronchuses, have the same numbering and the same designations, as bronchuses. Under the form they are similar to wrong cones or pyramids, tops turned to. lungs, and the bases - to a surface of lungs. So, in each lung now, according to the international nomenclature accepted by the International congress of anatomists in Paris in 1955, distinguish 10 segments, each of which has the segmental bronchus and a branch of a pulmonary artery. Between segments there pass the intersegmental veins designating borders of segments. The right lung In it distinguish following 10 segments (on D.A.Zhdanovu) (fig. 34, L,). 128 1. Segmentum apicale (an apical segment of the top share) - forms the site of the top share, fills a dome of a pleural cavity. Its bronchus goes upright upwards. Fig. 34. The scheme of a locating of segments of lungs (on D.A.Zhdanovu),

As investigate also bulbar veins

As investigate also bulbar veins. For larger freedom of action and research of vessels and nerves dissect bonds the extremities 94 Clavicles with cartilages of the first ribs, reject them or exarticulate clavicles in scapularclavicular joints, or saw them at scapulas. Now, after excision of clavicles, subclavial vessels, the bottom parts of bulbar veins and carotids, order decadron now anonymous veins, the top vena cava and an anonymous artery are well visible; there are accessible to research nervous humeral plexuses and top pleurae. All vessels open and investigate. Cuts on Medvedev's method thus give a free hand. Having investigated neurovascular fascicles, examine a thyroid gland, noting its form, size, position, colour, the relation to a larynx (it is especially important in districts). Examine also a larynx and a trachea. cautiously thyroid gland with that and on the other hand, is found by parathyroid glands which settle down usually above and below an occurrence place in a thyroid gland of the bottom thyroid artery. After that here it is convenient absolutely a thyroid gland and to investigate it on a little table. It is enough to make cuts of each share for this purpose on them. Further examine the lymph nodes which are under horizontal parts of a mandible, sialadens. To work follows cautiously as at rasping manipulations it is possible to tear fine veins, that will cause blood of a fat and muscles; not skilled pathologists it can be interpreted as an intravital hemorrhage.
SURVEY OF ORGANS OF THE THORACAL CAVITY First of all examine organs of a forward mediastinum. Here again also it is necessary to make it a rule: to tamper with nothing and to what not to touch while all will not be attentively examined. Note position of forward edges of lungs. At opening of a breast lungs are usually fallen down also their edges do not cover a mediastinum. But if lungs are emphysematous, 95 That their edges cover a mediastinum and even come the friend for the friend. In that case fingers cautiously lead round edges of lungs, establish, whether adnations, and feel, defining their consistence. Examine a gland ( knot, thymic gland, thymus) and, note its size, adiposity, a physiological involution (after 15-year-old age) or a pathological involution (Till 15 years), its augmentation, a consistence, colour, the relation to other organs, the form and Then examine a fat of a forward mediastinum and note the maintenance in it of Adeps, humidity or its dryness, vessels. Quite often at rasping unit of a breast bone in a fat there is air in the form of blisters and the fat foams. It should not be admixed with the emphysema of a mediastinum arising during lifetime Further examine an external surface of a warm shirt and heart position in relation to the next organs. Having moved apart forward edges of lungs in the parties, examine nerves (the item phrenici). Now investigate pleural * For this purpose the right arm enter at first in the right pleural cavity and lead round it. All lung, defining, whether freely lays a lung or it , note adnations, their durability, diffusion, localisation and so forth If adnations gentle, they are broken off easily if old () hardly If to part adnations pyridium online very difficultly (it often happens), to tear them does not follow, as it can lead to rupture of the lung. With these cases help a knife or separate a parietal pleura from a thorax and a lung take together with a pleura and with a diaphragm which cut a knife. Define contents of a pleural cavity: its quantity (for what it take out a spoon and merge in the measuring cylinder or count up quantity of spoons if know their volume), colour, a consistence, a transparency, and so forth 96 Investigate an exsudate on smears and with observance of rules of bacteriological technics. The right lung deduce from a pleural cavity, rejecting to the left, on a mediastinum, and examine the released pleural cavity. Having rejected the right lung to the left to a limit, investigate postmediastinum organs: a trachea, an esophagus, a thoracal aorta, a vagus nerve, a thoracal lymphatic duct and an unpaired vein v. azygos), examine a lung root. The thoracal lymphatic duct in the form of a thin white cord settles down between an aorta and an unpaired vein. Sometimes it happens is slightly covered by an aorta, therefore, that it to see, it is necessary cautiously otpre-parovyvat an aorta a scalpel. Note a degree of admission of a duct a lymph and open with its thin blunt-final scissors As investigate also an unpaired vein. For simplification of this operation it is possible to cut the right lung at a root and to remove absolutely. Research of cervical and abdominal department of a lymphatic duct in a corpse very difficult also is labour-consuming, a lot of time demands careful preparation and, so. To investigate it in all departments - thoracal, abdominal, and cervical on on (see 111) much easier and easier. Having finished research of the right pleural cavity as investigate also the left pleural cavity where examine a trachea, an esophagus, a thoracal aorta, a vagus nerve and "a root of the left lung. At ossification of costal cartilages it is possible easily about them To wound an arm and to tear gloves. To warn It, it is recommended to cover their lateral dermal a torso. Now investigate a warm shirt for what grasp it in an average part gear "a forceps and slightly raise, and scissors cut a small window, from which conduct a shirt cut up (kra - ' ) to a place of its transition to large vessels and downwards in a direction to a heart apex (caudally). - Having moved apart cut edges, examine a shirt cavity, noting its size, position of heart an exsudate, 7 Pathoanatomical technicians 97 Its kind, adnations and so forth For full survey of a shirt Heart raise for an apex. Quaggy, gentle Bonds part arms, strong it is possible to cut Knife or to keep and investigate their vessels, as In such the vessels, capable to feed are formed Myocardium. Sometimes in a warm shirt there is many Jew Bones (at a serous inflammation or an edema), which at Shirt opening starts to follow. It needs to be collected And to define its volume...