Difference between revisions of "Book - An Atlas of Topographical Anatomy 10"

From Embryology
(Created page with "{{Braune 1877 header}} {{Braune 1877 footer}} PLATE X THE upper surface of the section is here shown ; it is from the same body as the foregoing, and is about 1*4 inch thick...")
 
Line 1: Line 1:
 +
=X. Transverse section of the same body at the level of the arch of the aorta and fourth dorsal vertebra=
 +
 
{{Braune 1877 header}}
 
{{Braune 1877 header}}
  
{{Braune 1877 footer}}
 
PLATE X
 
  
THE upper surface of the section is here shown ; it is from the same body as the foregoing, and is about 1*4 inch thick, the saw through the inferior surface of the arch of the aorta, about one fifth of an inch below the division of the trachea, dividing the fourth dorsal vertebra just below its middle, and the sternum immediately below its articulation with the first rib, so that on the right side a small portion only of its cartilage is shown. The scapula is divided below its spine, and the humerus below the tuberosities. The section has passed just through the upper edge of the teres major, laying free the course of the posterior circumflex artery and a portion of the circumflex nerve. The nerve and artery pass directly into the deltoid muscle. The section shows clearly that both these structures must pass behind the humerus in order to attain the middle of the deltoid.
+
THE upper surface of the section is here shown ; it is from the same body as the foregoing, and is about 1/4 inch thick, the saw through the inferior surface of the arch of the aorta, about one fifth of an inch below the division of the trachea, dividing the fourth dorsal vertebra just below its middle, and the sternum immediately below its articulation with the first rib, so that on the right side a small portion only of its cartilage is shown. The scapula is divided below its spine, and the humerus below the tuberosities. The section has passed just through the upper edge of the teres major, laying free the course of the posterior circumflex artery and a portion of the circumflex nerve. The nerve and artery pass directly into the deltoid muscle. The section shows clearly that both these structures must pass behind the humerus in order to attain the middle of the deltoid.
  
 
The axillary vessels and nerves lie on the subscapularis and under the coraco-brachialis. Their position with regard to each other is altered from the preceding section, the artery lying more between the nerve and vein, but so enclosed in the heads of the median nerve that it appears pushed from the vein by the great nervous mass.
 
The axillary vessels and nerves lie on the subscapularis and under the coraco-brachialis. Their position with regard to each other is altered from the preceding section, the artery lying more between the nerve and vein, but so enclosed in the heads of the median nerve that it appears pushed from the vein by the great nervous mass.
Line 56: Line 56:
  
 
The left lung was adherent to the wall of the chest, and in consequence of the pressure from the pleuritic effusion the pericardium had become irregular in shape. The left side of the heart was much hypertrophied, and the mitral valve was covered with vegetations. The section which was made at the same level as mine, namely, through the middle of the first intercostal space, passed through the second, third and fourth ribs and divided the fourth dorsal vertebra in its lower half ; great deviation of the mediastinum is shown. On account of the collection of fluid in the left pleural cavity the trachea is pushed over towards the right side, and the oesophagus lies the breadth of half a vertebra from its usual position towards the right side, so that deglutition must have been considerably interfered with. The plate also shows a dislocation of the superior vena cava almost to the middle of the right half of the thorax. In consequence of the previous inflammation in the mediastinum a considerable amount of adhesion of the structures contained in it has been produced, whilst the arch of the aorta has been so dislocated, and its lumen so altered, that it appears as a narrow cleft. Such changes must have exerted their influence upon the heart ; unfortunately they are not explained in Pirogoff's text. The change in position of the right lung was probably brought about by the organisation of the pleuritic effusion, especially noticeable in the sinking-in of the left half of the thorax, as seen at about the section of the second rib.
 
The left lung was adherent to the wall of the chest, and in consequence of the pressure from the pleuritic effusion the pericardium had become irregular in shape. The left side of the heart was much hypertrophied, and the mitral valve was covered with vegetations. The section which was made at the same level as mine, namely, through the middle of the first intercostal space, passed through the second, third and fourth ribs and divided the fourth dorsal vertebra in its lower half ; great deviation of the mediastinum is shown. On account of the collection of fluid in the left pleural cavity the trachea is pushed over towards the right side, and the oesophagus lies the breadth of half a vertebra from its usual position towards the right side, so that deglutition must have been considerably interfered with. The plate also shows a dislocation of the superior vena cava almost to the middle of the right half of the thorax. In consequence of the previous inflammation in the mediastinum a considerable amount of adhesion of the structures contained in it has been produced, whilst the arch of the aorta has been so dislocated, and its lumen so altered, that it appears as a narrow cleft. Such changes must have exerted their influence upon the heart ; unfortunately they are not explained in Pirogoff's text. The change in position of the right lung was probably brought about by the organisation of the pleuritic effusion, especially noticeable in the sinking-in of the left half of the thorax, as seen at about the section of the second rib.
 +
 +
 +
{{Braune 1877 footer}}

Revision as of 13:26, 31 October 2012

X. Transverse section of the same body at the level of the arch of the aorta and fourth dorsal vertebra

Embryology - 15 Nov 2019    Facebook link Pinterest link Twitter link  Expand to Translate  
Google Translate - select your language from the list shown below (this will open a new external page)

العربية | català | 中文 | 中國傳統的 | français | Deutsche | עִברִית | हिंदी | bahasa Indonesia | italiano | 日本語 | 한국어 | မြန်မာ | Pilipino | Polskie | português | ਪੰਜਾਬੀ ਦੇ | Română | русский | Español | Swahili | Svensk | ไทย | Türkçe | اردو | ייִדיש | Tiếng Việt    These external translations are automated and may not be accurate. (More? About Translations)

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.

Plates: 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term
Historic Disclaimer - information about historic embryology pages 
Mark Hill.jpg
Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)


THE upper surface of the section is here shown ; it is from the same body as the foregoing, and is about 1/4 inch thick, the saw through the inferior surface of the arch of the aorta, about one fifth of an inch below the division of the trachea, dividing the fourth dorsal vertebra just below its middle, and the sternum immediately below its articulation with the first rib, so that on the right side a small portion only of its cartilage is shown. The scapula is divided below its spine, and the humerus below the tuberosities. The section has passed just through the upper edge of the teres major, laying free the course of the posterior circumflex artery and a portion of the circumflex nerve. The nerve and artery pass directly into the deltoid muscle. The section shows clearly that both these structures must pass behind the humerus in order to attain the middle of the deltoid.

The axillary vessels and nerves lie on the subscapularis and under the coraco-brachialis. Their position with regard to each other is altered from the preceding section, the artery lying more between the nerve and vein, but so enclosed in the heads of the median nerve that it appears pushed from the vein by the great nervous mass.

The thorax is divided close to the lower border of the first rib, and on the right side of the sternum is a small portion of a costal cartilage, whose position corresponds with a broader section of the manubrium sterni than the preceding. Behind the sternum are the origins of the sterno.-hyoid and sterno- thyroid ; laterally are the intercostal muscles, which are attached to the second, third, and fourth ribs, and which help to close in the chest wall. The section of the fourth dorsal vertebra is seen at the back of the cavity, and is divided so close to its lower surface that the articular processes of the fifth dorsal vertebra come into the section ; on the right side a small portion of the fifth rib is seen, and on the left side the boundary is formed by the intra-thoracic fascia.

The form of the section of the thorax is that of a heart as seen on a playing card, and is produced by the projection of the body of the vertebra and the recession of the hinder end of the ribs. It has been remarked by Hyrtl (' Topog. Anat.,' 1860, i, 492) that this form is associated with the upright position of man, since by this formation the centre of gravity of the thoracic viscera is advanced nearer to the support of the trunk. This advantage is not possessed by other animals, and one cannot maintain that this form is only a consequence of this upright condition, since, in the newly born infant, the curvature of the spine amounts almost to nothing (Pirogoff, a a 0, fasc. i A, tab. xvi, fig. 3). But this heart-shaped form of the section of the thorax exists in new-born children, as I can state from my own observations. Pirogoff's transverse sections also show it (fasc. ii, tab. xx). I find, however, that the relation of the breadth to the depth in children is considerably more variable than is that of the adult at a corresponding level. In the newly born child the antero-posterior diameter is to the transverse diameter nearly in the proportion of 1 to 2, whereas in the present plate of an adult it is as 1 to 3 ; in the old man, on the other hand, the proportion is more like the child's, viz. 1 to 2*5. The lungs are in the condition of expiration, and that to such an extent that during life the respiration pause was never reached. As the contraction of the lungs after death is dependent on their elasticity, the size which they gradually assume must be so much the smaller the younger, sounder, and more elastic the said lungs are. And as the contraction of the lungs depends proportionately on the position of the diaphragm, with the heart, liver, and spleen, there is naturally in young powerful individuals a higher position of the diaphragm and of its neighbouring organs after death than in the aged or diseased. If the section of the old man be compared with the present plate, it will be seen that it is deeper by a vertebra (the sixth in the old man). Consequently, in the definition of the position of the arch of the aorta, division of the bronchi, &c., the age of the individual must be always taken into consideration, and no fixed level of a vertebra for the individual thoracic viscera can be given. The lungs themselves are divided through the lower portion of their upper lobes, so that on the left side a small portion of the under lobe falls into the section, which, as the plate shows, quickly increases in size downwards. Between the lungs, in front, is the thymus gland, which is sometimes found as late as the twentieth year, and consequently renders a mesial section possible on the young person, without opening the pleural cavity. In older subjects, after the atrophy of the thymus gland, both lungs lie so close to each other that in such a section it is impossible to avoid opening the pleural cavity.

I omitted to speak of the details of the form of the mediastinum ; representations of it are given by Hyrtl, ' Top. Anat.,' i, 547, and by Luschka in Virchow's ' Archiv,' xv, 369.

There is nothing more variable in shape than the mediastinal space, for ib is confined by fixed limits only in front and behind, on both sides the boundaries are moveable.

The alteration in capacity of the lung during breathing must also alter the position of the mediastinum. It further obtains that the contents of this mediastinal space are moveable and changeable. The oesophagus when distended takes up more space than when empty and collapsed. The same remark applies to the great vessels, which alter in size considerably after each contraction of the heart. The mediastinum in the region of the sterno-clavicular articulation, as shown in the plate, passes downwards and inwards, so that the space beneath it is contracted and funnel-shaped. In consequence of the position of the thymus gland it is possible to reach the upper edge of the arch of the aorta with its three branches, and the superior caval and innominate veins, without necessarily opening the pleura, and perforation of that portion of the trachea which lies behind the manubrium sterni may take place from the anterior wall of the chest without the pleura being involved. In order to compare the relations produced by pathological changes at similar levels, I have taken some reduced and reversed figures from Pirogoff, so that they may correspond, as far as the observer is concerned, with my own plates.


FIG. 1. Subject A. Thorax. Male, set. 22. Normal. Plate XI, J. 1. Trachea. 2. (Esophagus. 3. Superior vena cava. 4. Arch of aorta.


Fig. 1 is reduced from Plate XI of this Atlas. Pirogoff's drawing, Fig. 2, which shows a body affected with left pneumothorax, was reversed and reduced so that it might be the more readily compared with mine. The section, according to Pirogoff's description, passed through the second intercostal space, and divided the third, fourth, and fifth ribs to the lower border of the second dorsal vertebra, so that in subject C the sternum must have been placed considerably higher than in my preparation. Whilst the posterior osseous portion shows relations similar to mine, the sections through the sternum differ by a rib and an intercostal space. This elevated position of the sternum can be readily explained from the pneumothorax, and the emphysema existing on the right side.


The left lung lies compressed upon the vertebrae by means of a pseudomembranous cord which is attached to the wall of the chest; the right lung which is immensely distended by secondary emphysema, shows no folds in the pleura, such as are to be seen in my plates. The superior vena cava is compressed.


This thorax has an entirely different shape from fig. 1, being fully distended. On account of the greater pressure in the left half of the thorax, the structures lying in the mediastinum, the trachea, oesophagus, and aorta, are pushed over towards the right side. Pirogoff has figured more sections from each body, so that I was induced especially to indicate the individual subject with capitals, in order that the reader may be able to find the same body on the different sections.


FIG. 2. Subject C. Adult thorax. Left lateral pneumothorax. Pirogoff, ii, b. 2, ^. 1. Trachea. 2. (Esophagus. 3. Superior cava. 4. Aorta. 5. Azygos vein.


Subject A is the powerful man from which nay principal plates are taken. Subjects B, 0, D, &c., are from Pirogoff. Subject 0, according to his statement, is from a man of middle age who died in the hospital and had considerable pleuritic effusion. I have found, moreover, a case of hydropericarditis with insufficiency of the semilunar valves of the aorta.

The section in fig. 3, which likewise is a reverse of a plate in Pirogoff's atlas, shows the same relations of the skeleton as mine. The right lung, which was comparatively but little affected, corresponds almost exactly with mine. The anterior portion of the apex of the lung is slightly drawn over to the left side in consequence of the adhesion of the pleurae to the remains of the thymus gland. The left lung shows important changes, due to infiltration and the formation of cavities. On account of the pleuritic effusion the left side of the thorax does not appear much sunken in. According to Pirogoff (p. 15, fasc. ii), the cellular tissue in the mediastinum was essentially altered by the previous inflammation. It shows strong attachments of the pleura to the surface of the ribs and to the inside of the mediastinal space, as well as adhesions of organs lying near to each other a condition which cannot be intelligibly represented in the plate. The patient was a young man, set. 20, who died in the hospital.



Fia. 3. Subject D. Thorax. Male, set. 20. Tuberculosis. Plem-isy. Pirogoff, ii, 5, i, 1. Tracbea. 2. CEsopbagus. 3. Superior cava. 4. Arcb of aorta.


The woodcut fig. 4 is also from Pirogoff, and was taken from the body of a man who died of " scorbutic pleuritis," with great effusion of blood and pus in the pleural cavities. The anterior surface of the left lung was so adherent to the thickened pleura, that the pleural cavity was divided into two portions, each holding a considerable quantity of blood and pus.


Fig. 4. Subject E. Male thorax. Lateral empyema of left side. Accumulation of serum in right pleural cavity. Pirogoff, ii, 18, 1, .

1. Trachea. 2. (Esophagus. 3. Superior cava. 4. Arch of aorta.

The left lung was adherent to the wall of the chest, and in consequence of the pressure from the pleuritic effusion the pericardium had become irregular in shape. The left side of the heart was much hypertrophied, and the mitral valve was covered with vegetations. The section which was made at the same level as mine, namely, through the middle of the first intercostal space, passed through the second, third and fourth ribs and divided the fourth dorsal vertebra in its lower half ; great deviation of the mediastinum is shown. On account of the collection of fluid in the left pleural cavity the trachea is pushed over towards the right side, and the oesophagus lies the breadth of half a vertebra from its usual position towards the right side, so that deglutition must have been considerably interfered with. The plate also shows a dislocation of the superior vena cava almost to the middle of the right half of the thorax. In consequence of the previous inflammation in the mediastinum a considerable amount of adhesion of the structures contained in it has been produced, whilst the arch of the aorta has been so dislocated, and its lumen so altered, that it appears as a narrow cleft. Such changes must have exerted their influence upon the heart ; unfortunately they are not explained in Pirogoff's text. The change in position of the right lung was probably brought about by the organisation of the pleuritic effusion, especially noticeable in the sinking-in of the left half of the thorax, as seen at about the section of the second rib.


Historic Disclaimer - information about historic embryology pages 
Mark Hill.jpg
Pages where the terms "Historic Textbook" and "Historic Embryology" appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms and interpretations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)
Braune Plates (1877): 1. Male - Sagittal body | 2. Female - Sagittal body | 3. Obliquely transverse head | 4. Transverse internal ear | 5. Transverse head | 6. Transverse neck | 7. Transverse neck and shoulders | 8. Transverse level first dorsal vertebra | 9. Transverse thorax level of third dorsal vertebra | 10. Transverse level aortic arch and fourth dorsal vertebra | 11. Transverse level of the bulbus aortae and sixth dorsal vertebra | 12. Transverse level of mitral valve and eighth dorsal vertebra | 13. Transverse level of heart apex and ninth dorsal vertebra | 14. Transverse liver stomach spleen at level of eleventh dorsal vertebra | 15. Transverse pancreas and kidneys at level of L1 vertebra | 16. Transverse through transverse colon at level of intervertebral space between L3 L4 vertebra | 17. Transverse pelvis at level of head of thigh bone | 18. Transverse male pelvis | 19. knee and right foot | 20. Transverse thigh | 21. Transverse left thigh | 22. Transverse lower left thigh and knee | 23. Transverse upper and middle left leg | 24. Transverse lower left leg | 25. Male - Frontal thorax | 26. Elbow-joint hand and third finger | 27. Transverse left arm | 28. Transverse left fore-arm | 29. Sagittal female pregnancy | 30. Sagittal female pregnancy | 31. Sagittal female at term

Reference

Braune W. An atlas of topographical anatomy after plane sections of frozen bodies. (1877) Trans. by Edward Bellamy. Philadelphia: Lindsay and Blakiston.


Glossary Links

Glossary: A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Numbers | Symbols | Term Link

Cite this page: Hill, M.A. (2019, November 15) Embryology Book - An Atlas of Topographical Anatomy 10. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_An_Atlas_of_Topographical_Anatomy_10

What Links Here?
© Dr Mark Hill 2019, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G