Pathological technique : a practical manual for workers in pathological histology and bacteriology including directions for the performance of autopsies and for clinical diagnosis by laboratory methods / by Frank Burr Mallory and James Homer Wright.

  • Mallory, Frank Burr, 1862-1941.
Date:
1915
Catalogue details

Licence: Public Domain Mark

Credit: Pathological technique : a practical manual for workers in pathological histology and bacteriology including directions for the performance of autopsies and for clinical diagnosis by laboratory methods / by Frank Burr Mallory and James Homer Wright. Source: Wellcome Collection.

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    % the first rib, and following the irregular line of the joint around the end of the clavicle, while at the same time draw¬ ing the sternum over to the right side of the body. The right sterno-clavicular articulation is to be opened by con¬ tinuing the incision of the scalpel over the upper end of the sternum and into the second joint. The advantage of this method is that there is much less danger of wounding the large vessels at the base of the neck, and thus of mingling blood with any exudation which may happen to be present in the pleural cavities. If preferred, however, the articulations can be opened and the cartilages of the first ribs cut from above before freeing the sternum from the diaphragm. In this case enter a short, sharp, narrow-bladed scalpel held vertically, but loosely, into the left joint on its upper side, starting the incision just outside of the attachment of the sternal end of the sterno-mastoid muscle, and cut around the end of the clavicle by a series of short up-and-down strokes, allowing the blade to follow the irregular line of the joint. After cut¬ ting through the joint continue the incision outward and cut through the cartilage of the first rib. If the cartilages are calcified, use the costotome and cut through the ribs, as more room can be gained in this way, and they are more easily cut than calcified cartilages. When for any reason it is not permitted to open the thorax, the organs within it can be obtained through the opening into the abdominal cavity by freeing the diaphragm from the ribs, and removing first the heart and then the lungs. The sternum should be inspected at the time of its removal. It is perhaps best to examine next, especially in children, the epiphyses of the ribs at the costochondral line for any evi¬ dence of thickening. Inspection of the Pleural Cavities.—In the pleural cavities, as in the peritoneal cavity, the character and amount of any abnormal contents must be determined. If, from the clinical history or from any other reason, the presence of air in a pleural cavity is suspected, a pouch should be formed over the ribs by aid of the skin-flap and filled with water. The pleural cavity is then to be pierced with a scalpel