China
Africa
Explore chapters and articles related to this topic
Lymphatic anatomy: lymphatics of the breast and axilla
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
With proper injection techniques and timing, certain anatomic landmarks are helpful for identifying the sentinel node. If one draws a line from the lateral border of the pectoralis major muscle and another at the lateral border for the latissimus dorsi muscle in the axilla, these lines will outline the outer borders of the axillary limits for dissection. A tangential line is drawn at the axillary hairline in a perpendicular, anterior-to-posterior direction. Another line can then be drawn through the axis of the axilla, through the center point of the hairline. The intersecting lines mark the center of a 5-cm circle on the axilla. Ninety-four percent of the SLNs are within this circle. The remaining 6% are in the level II location (Figure 7.3). Once the SLN is identified on the skin, an accurate incision may be made, overlying the area of highest activity with the gamma probe. Internally, the anatomic landmarks are the central axillary vein and the third branch of the intercostal nerve beneath the clavipectoral fascia. The vein may be found easily, and when the nerve crosses over the vein, four quadrants are defined within the circle described earlier. The node is considered an SLN if it is blue or has a blue-stained afferent lymphatic vessel leading to it. In addition, the node is sentinel if it has an in vivo radioactivity (radioactivity in the SLN/neighboring non-SLN) of 3:1 or an ex vivo activity of 10:1.11
Surgery of the Peripheral Nerve
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Ravikiran Shenoy, Gorav Datta, Max Horowitz, Mike Fox
A clavicular osteotomy may be required to facilitate access, especially if there is a vascular injury. In this case a plate should be precontoured and holes predrilled for easy fixation at the end of the procedure, remembering that the bone will be shortened by the thickness of the saw blade. Distally the pectoralis major muscle is detached from the humerus in its upper portion or, if required, its entirety. The muscle is then reflected medially exposing the clavicle, pectoralis minor muscle and clavipectoral fascia (Figure 5.12). The pectoralis minor muscle is divided at its tendon taking care not to damage the musculocutaneous nerve. The subclavius muscle is divided with the suprascapular vessels (once ligated). This exposes the entire plexus and vasculature from the first rib to the axilla.
The arthroscopic Latarjet
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Johannes E. Plath, Laurent Lafosse
The rotator interval is widely opened at the upper border of the subscapularis, which will expose the coracoid process and the conjoined tendon. The clavipectoral fascia is incised lateral to the conjoined tendon paying attention not to violate the tendon attachment.
Contemporary review of management techniques for cephalic arch stenosis in hemodialysis
Published in Renal Failure, 2023
Gift Echefu, Shivangi Shivangi, Ramanath Dukkipati, Jon Schellack, Damodar Kumbala
The Cephalic vein is part of the upper extremity’s superficial venous system. It originates in the anatomical snuffbox from the radial aspect of the superficial venous network of the dorsum of the hand. Coursing along the anterolateral forearm to the elbow, it communicates with the basilic veins via median ante-cubital veins. It then courses along the lateral aspect of the biceps toward the pectoralis major muscle as it enters the deltopectoral groove (a triangular space formed by the adjacent borders of the deltoid and pectoralis major muscles Figure 2). It then passes under the clavicle, turning sharply to pierce the clavipectoral fascia terminating as the axillary vein. The cephalic arch refers to the final arch of the cephalic vein before it drains into the first part of the axillary vein.
Effectiveness of Ultrasound Guided Erector Spinae Plane Block Compared to Ultrasound Guided Modified Pectoral Nerves Block in Modified Radical Mastectomy: A Randomized Single Blinded Study
Published in Egyptian Journal of Anaesthesia, 2022
Mohamed Elsaid Abdel Fattah, Osama Sayed Ibrahim, Nevine Mahmoud Gouda, Mohamed Mohamed Abdel-Hak
The patient was put supine. The first rib was discovered by a high-frequency linear probe put caudal to the lateral third of the clavicle to determine the location of the axillary arteries beneath the pectoralis major and subclavian muscles. After that, the probe was advanced distally towards the axilla until it reaches the third rib. The pectoralis minor is elevated above the serratus anterior in this position, and the clavipectoral fascia continues as Gerdy’s ligament into the axilla. We injected 10 ml of levobupivacaine 0.25% into the interfacial plane between the two pectoralis muscles and 20 ml into the interfacial plane between the pectoralis minor and the serratus anterior muscles using an in-plane medial-to-lateral approach once the structures have been identified with US.
The thoracoacromial axis in salvage head and neck reconstructive surgery, a case series
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Matthew J. Davies, Rhys van der Rijt, Roger Haddad, James Southwell-Keely
The thoracoacromial artery arises from the second part axillary artery and divides into acromial, deltoid, clavicular, and pectoral branches. The pectoral branch, which supplies the pectoralis major muscle, penetrates the clavipectoral fascia 6–10 cm lateral to the sternoclavicular joint. It then runs along the deep surface of the pectoralis major muscle encased in a protective perivascular fatty tissue (Figure 1) [8].