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The neck, Thoracic Inlet and Outlet, the Axilla and Chest Wall, the Ribs, Sternum and Clavicles.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
The manubrium usually has a slightly curved shape, with the clavicles articulating with its upper part on both sides, via the sterno-clavicular joints. These have a fibro-cartilaginous disc in their centres and are normally about 2 to 4 mm wide.
Minimally Invasive Aortic Valve Replacement
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
CT TAP is an important and mandatory assessment tool for operative planning and evaluation of the patient. The location of the ascending aorta and its relationship with the manubrium play an important role. The groin vessels and condition of the thoracic aorta also need to be evaluated before a surgical decision can be made (Figure 7.2.19).
Esophageal replacement with colon
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Naziha Khen-Dunlop, Carmen Capito, Christophe Chardot, Yann Révillon
Once the colon graft is mobilized, the distal esophageal stump is resected, if possible at the stomach with a linear stapling device to avoid reflux in the stump. In some cases, a normal gastroesophageal junction may be preserved, anastomosing the distal esophagus to the colon. Normally, the graft is pulled through the chest, into the posterior mediastinum (Figure 10.2a). Scarring in the native esophageal bed may preclude this and a substernal route may be used (Figure 10.2b). If this is chosen, removal of the sternoclavicular joint or a part of the manubrium may be necessary to enlarge the space and avoid a kink at the thoracic inlet. Numerous devices have been used, from plastic laparoscopy camera cable covering to a large Penrose drain, to help facilitate the passage of the graft.
Assessment of middle ear structure and function with optical coherence tomography
Published in Acta Oto-Laryngologica, 2023
Sebastiaan W. F. Meenderink, Michael Warn, Laura M. Anchondo, Yuan Liu, Timothy T. K. Jung, Wei Dong
To demonstrate the 3D OCT visualization, the volume scan in Figure 1(A) shows the posterosuperior aspect of the TM, as well as the incus and the LPI that connects to the head of the stapes. Reorienting the OCT beam would show different aspects of the TM (e.g., the manubrium and umbo) and the ossicular chain (e.g., the malleus). We re-emphasize that the ME ossicles were visualized without the need for myringotomy, and the OCT light beam was capable of penetrating the TM. A more quantitative analysis of the middle ear volume scan is illustrated in Figure 1(B), where the thickness of the reconstructed TM was calculated. In this thickness reconstruction, the manubrium and the ‘spoon-shaped’ umbo at its distal end are readily identified. We found that TM thickness was on average 160 μm (S.D. 34 μm, using a refractive index of n = 1) but showed systematic variation: it was thicker near the edges and in the area surrounding the manubrium. The current TM detection algorithm was unable to separate the manubrium from the TM.
Salmonella aortitis successfully treated with antibiotics without surgery
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Gabriel Melki, Mina Fransawy Alkomos, FNU Komal, Vinod Kumar, Sushant Nanavati, Sugabramya Kuru, Linda Laham, Yasmeen Sultana, Shaker Barham, Walid Baddoura
We suspected sternal osteomyelitis as an explanation for the patient’s chest pain. A subsequent bone scan was ordered and revealed increased uptake in the region of the manubrium and upper body of the sternum. (Appendix A) This was suspected to be secondary to chronic inflammatory changes associated with his prior sternotomy. CT angiogram showed peri aortitis with a small air bubble/locule of gas suggesting that this may be infectious etiology, thus confirming the diagnosis of aortitis [Appendix B]. The sternal biopsy was positive for osteomyelitis and blood cultures grew Salmonella Enteritidis. Antibiotics were switched to IV Ceftriaxone, and the patient was treated for six weeks inpatient. The patient responded positively to treatment with no further complications and remained asymptomatic and inflammatory markers normalized at 2 weeks follow up (ESR, CRP, and WBCs).
Sternal Route More Effective than Tibial Route for Intraosseous Amiodarone Administration in a Swine Model of Ventricular Fibrillation
Published in Prehospital Emergency Care, 2018
James M. Burgert, Andre Martinez, Mara O'Sullivan, Dawn Blouin, Audrey Long, Arthur D. Johnson
Intuitively, the SIO route may be an advantageous infusion site for the administration of resuscitative drugs during cardiac arrest in civilian populations. The SIO infusion site is rapidly and easily located as the sternal notch is readily palpable and there is usually little subcutaneous tissue overlying the manubrium. There are IO devices specifically designed to safely access the sternal manubrium, the FAST- 1 and the more recent FAST Responder (Pyng Medical, Vancouver, BC, Canada).47,48 The venous drainage of the manubrium leads directly to the central circulation, and the effect site of many resuscitative drugs, via the right and left internal thoracic veins, to the brachiocephalic veins, and then to the superior vena cava. The hydraulic action of chest compressions could accelerate the movement of SIO administered drugs into the circulation compared to the TIO, HIO, and IV routes that do not benefit from pumping action. The combination of proximity to the heart and rapid hydraulic movement of drugs during CPR make the SIO an appealing choice for the administration of resuscitative drugs during cardiac arrest when IV access cannot be rapidly obtained.