Surgery.

Date:
[1913]
Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

    334/412 page 302
    Mention the Distinguishing Features of these Tumours. (a) Sebaceous Adenomata. — Frequently multiple ; purple appearance and covered with glistening skin. They often fungate. They should be excised. (b) Wens;—Usually multiple ; are fixed to the skin in the centre, but move freely over the deeper structures. The cyst should be completely removed. (c) Dermoid Cysts differ from wens in that they are beneath the occipito-frontalis, and are fixed to the deeper structures (pericranium). There is usually a depression in the bone around the base, and the skin is freely movable over it. The walls are thin ; the contents are hair, epithelial debris, and pultaceous material. (d) A Lipoma lies in the subcutaneous tissue ; is freely movable over the deeper structures ; is not fixed to the skin except by fragile tags of fibrous tissue ; is lobulated, and the manner in which the rounded edge slips from under the finger should be sufficient to distinguish it. (e) A Subcutaneous Njevus is reducible on pressure, without causing any cerebral symptoms, and the bone is felt entire below. Be very careful in cases where a nsevus is placed over a fontanelle or situated at the root of the nose. A nsevus increases in size and tension when the child cries or strains. THE CRANIUM. Distinguish between Concussion, Cerebral Contusion, Irritation and Compression. Concussion is the term given to a condition of unknown pathology which results in immediate unconsciousness following an injury to the brain. Should death occur there may be no feature other than multiple petechial haemorr- hages. The unconsciousness may be momentary but if it is severe or prolonged a more serious brain injury is probable. Cerebral Contusion is the term applied when the injury has resulted in structural damage to the brain. Such a trauma may occur at the site of the blow or at a point diametrically opposite to it (contre coup).
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