Then a plate with taken out

Then a plate with taken out apertures to impose on graph paper and on it to count up the area. There was still an opinion - to photograph an aperture (one to one), but it is even more difficult, demands change of a method of opening of heart and a lot of time. All ultram last three ways buy order ultram could be suitable, if valval apertures of heart with firmness gaped, as, for example, a trachea, bronchuses, but they do not gape, and open and closed under the pressure of blood. At a stopping. hearts and circulations of movement of valves stop, and if thus there is considerably any aperture it mismatches the valid disclosing of valves at heart activity. At strong stenoses of an aperture can gape, but also in these cases ultram at warm reductions and pressure of blood , and so, and the area can change. Summing up , it is necessary to recognise, that degree of possible disclosing of valval apertures of heart, their passableness and aperture perimetre at defects of valves can be defined most authentically only a palpation, touch in advance measured fingers ultram of the researcher. For this purpose we develop a method and the formula allowing approximately to calculate the area of valval apertures of heart in square centimetres is deduced. To measure a circle of the fingers it is necessary a soft wire, not rendering on ultram pressure fingers.
Then a wire to develop and measure by its millimetric ruler. It is necessary to measure fingers in three places: 1) on border of a distal and average third ultram of fingernail, 2) on border of an average and proximal third of fingernail and 3) at level of the nail platen. Measurement needs to be repeated some times and to take an average arithmetic. Result of measurement of the fingers: 1) index, 2) an average, 3) the index 146 And an average together, 4) index, average both anonymous together and 5) a little finger to write down and remember. At research by fingers it is necessary to concentrate to touch all attention with the big thoughtfulness and care. If aperture perimetre to accept for a circle order etodolac it is easy to ultram calculate the circle area, instead of the true area of an aperture. Circles possess extreme properties: 1) from all possible closed curves having the given length, a circle of this length limits the greatest area (maximum), and 2) at the set area from all closed curves limiting this area, the circle has the least length (minimum). From ultram this follows, that the circle area always more than the true area of valval apertures and can have only rough value. As valval apertures have no circle form, and are more similar to wrong polygons on perimetre to define their area it is impossible. If them ultram to assimilate to the correct entered polygon the area of the last ultram and will be closest to the true area of the given valval aperture of heart. But also correct polygons as has shown Gauss, it is possible to construct by means of compasses and a ruler only under certain conditions - when the number of the, Where - any whole rational indicator, and pi 2... - various simple ultram numbers of a kind, where 5 - whole rational . Under theory Galois of other correct polygons, except specified Gauss to construct by means of compasses and a ruler it is impossible. So, it is possible to construct the correct entered polygons only at number of their parties 17... Also it is impossible at number of their parties ... From told leaves, that one of six p-squares can be a required polygon: squares disappear. To take polygons with the big number of the parties it is not meaningful, as their perimetre will come nearer more and more to a circleIt is necessary to choose the closest from these six polygons on the area to the given ultram valval aperture of the heart, one perimetre with it. Only then it will be possible on perimetre of the given valval aperture of heart with enough approached accuracy to calculate its area. Abundantly clear, that the area of any correct entered polygon cannot be more areas of the described circle of radius of the same polygon. It cannot be and less areas of the entered circle of the radius peer to an apothem of this polygon. It means, that the perimetre of a required polygon is between two circles limiting the area of a ring. In it all perimetres of all accepted polygons, including ultram required, the closest on the area to the given aperture of heart ultram also are concluded. To approach to the decision of the question, what correct polygon is closest on the area to the given valval aperture, we have made calculations of parametres of all six correct polygons on their perimetre peer to perimetre of a normal mitral orifice, accepted for, under parity formulas in correct polygons (B.N.Delon, L.S.Hrenov, etc.). Results of these calculations are presented to tab. 1. Within this ring also there is the required n-square closest to the area of a mitral orifice of heart. The criterion as for the task in view decision, should be selected an agent average size from the areas of rings of all polygons, and a variation measure - an average square-law deviation () as more exact. The averag ultram e calculated under the formula: Calculation of an average square-law deviation () is made under the formula applied at small number of variants: 1 Length of perimetre of normal valval apertures of heart is taken from A.I.Abrikosova. 148 Table 1 The calculated parametres for a heart mitral ultram orifice at its perimetre of 100 mm under parity formulas in correct polygons It is peer. It allows the area of a 5-square with perimetre 100 mm to consider approximately the equivalent area of a normal mitral orifice. The 5-square area calculated under the formula resulted in tab. 1 where To - length of the party of a 5-square millimetres - there is a size the variable depending on length of perimetre of the given valval aperture of heart, and numerical expression 1,72 there is a constant for a 5-square and number abstract (dimensionless), i.e. Factor.

Considering biological features

Considering biological features of a valval aperture of heart, colchicine extreme properties of circles to which d-squares come nearer at augmentation of number of their parties, errors at the calculations, depending on imperfection calculation systems, it is admissible factor 1,72 to approximate to 1,50. However if the length of perimetre of an aperture is expressed by number, not multiple cheap colchicine five division, squaring and multiplication colchicine to fractional number 1,50 to make in mind inconveniently, the paper and a pencil, the assistant and time is required. Therefore colchicine it is necessary to simplify calculations. Let's notice, that with augmentation of number of the parties of a polygon, i.e. Reduction of their length, the factor increases (tab. 1) see, and the area comes nearer to the circle area. If number of the parties of the accepted n-square to enlarge twice, having transformed it in a 2n-square, i.e. In a 10-square to divide perimetre not on 5, and on 10, that is easier and easier, the factor needs to be quadrupled it: colchicine Then to multiply it is necessary on six whole, instead of on fractional number. It will be easier and closer to the valid area of a valval aperture that will be compounded with results of the same method of variation statistics, but with the areas not than rings, and polygons where the colchicine, and/n=yo0,43.
Then the area of a normal mitral orifice is defined in colchicine So, on its perimetre it is necessary for definition of the area of the given valval aperture of heart: 1) in advance measured own fingers, touch to define length of perimetre of an aperture colchicine the received length of perimetre (to part on 10, I.e. To define length of the party of a 10-square 3) received private from division a square And 4) the received size to increase by factor colchicine. Using this formula, it is possible without special work and even in mind with enough approached accuracy to calculate the area of any valval aperture of heart on its perimetre. The areas of all normal valval apertures of heart calculated thus on the offered formula are presented to tab. 2. Correctness of parities of the calculated areas can be checked up a proportion, having based on judgements a principle of a continuity of a circulation: the area of the right atrioventricular ultracet aperture should so to concern the area of an aperture of a pulmonary artery as the area left atrioventricular concerns the aperture area : this Proportions product to product of averages, so, the proportion is correct. Here it is found out, that in norm the area of each atrioventricular aperture in 2 times is more than area of an aperture of a corresponding vessel, . the mitral orifice area in 2 times is more than area aortal, and the area an aperture in 2 times is more than area of an aperture of a pulmonary artery. From this follows, as power of a right ventricle in norm 51 1 Where: With - perimetres of apertures; To - length of the parties of ten-squares; R - radius described yokes - radius entered circles; Z - width of rings in millimetres. In 2 times there is more than power of the right auricle, and colchicine power of a left ventricle in 2 times is more than power of the left auricle. Applying the offered formula, the pathologist on opening, and the surgeon during operation komissuroto-mii can easily calculate the area of any valval aperture of heart. As it is made by a finger any additional manipulations it is not required. Method of separate weighing of heart After opening and research of heart it separate from large vessels and weigh. This weighing is not exact enough for definition of its hypertrophy, in particular at an idiopathic hypertensia. Therefore the method of separate weighing of heart by which the absolute and relative colchicine weight of muscles of a left ventricle is rather precisely defined is recommended. 152 This method has been offered by V.Muller in 1883 and G.I.Ilinym in 1956 is in detail enough described and specified Heart release from Adeps, own vessels, valves and part on four parts: both auricles with their septum separate on atrial-zheludochko-howl to a sulcus, separate walls of ventricles from their septum. Receive 4 parts: 1) both auricles together with their septum, 2) a left ventricle, 3) a right ventricle and 4) an interventricular septum. If heart has been opened how it is described on p. 132-140, that is it is necessary to separate only heart colchicine from an aorta and a pulmonary artery and on a lredserdno-ventricular sulcus to separate auricles with their septum. If heart has been opened by other method it is necessary to cut off ventricles parts, that will complicate all operation, and without that labour-consuming enough a little, moreover colchicine will frame danger to mix separate pieces of ventricles. When separation of heart into four parts is finished, weigh each part separately and there and then the assistant writes down weight of each part. The interventricular septum contains muscles both right, and left colchicine ventricles. It is necessary to part proportionally therefore septum weight between ventricles. For this purpose the number of grammes of weight of a septum needs to be parted on number colchicine of grammes of weight of both ventricles together. By it it will be defined, what part of grammes of a septum is necessary on one gramme of the general muscular mass of both ventricles. Further received private from division multiply by number of grammes of each ventricle separately. The received products also are expression of proportional separation of weight of a septum between ventricles, they need to be added accordingly to weight of each ventricle. Weight of a part of the interventricular septum belonging to a right ventricle, it is possible to receive also, having subtracted the weight received for a left ventricle from gross weight of all septum.

If in pleural cavities there

If in pleural cavities there are solderings or cavities extraction of ganglions of a boundary sympathetic trunk becomes rather inconvenient. In this case they need buy ultram online to be taken together with a pleura and after bracing otprepa-rovat. GANGLIONS NERVOUS THE PLEXUS OF INTERNAL ORGANS It is necessary to search in places of their greatest clump. The warm plexus - plexus cardiacus - is formed by branches of wandering and sympathetic nerves. In it distinguish two plexuses: superficial and deep. Superficial to an aortic arch and to a place of division of a pulmonary artery also it is stretched in a left-hand side. Deep - behind an aortic arch, at a trachea bifurcation. Branches of both plexuses go down on heart and form: 1) plexus coronarius cordis anterior dextri. It lays at a root of an aorta and reaches to a. coron. cordis dextri. Supplies the right auricle and a right ventricle; 2.) plexus coronarius cordis posterior goes to a. coron. cordis sin. Also supplies the left auricle and a left ventricle. Plexuses are accompanied by a considerable quantity of ganglions (nodal fields ). V.P.Vorobev has allocated six plexuses in heart. The first and second forward plexuses - left and right - lie down from both parties of an atrioventricular cone. The third and fourth back plexuses - right and left - settle down more difficult: the third plexus lies down on the top border between auricles and passes to a back wall of a right ventricle; the fourth plexus spirally bends around external the left auricle, crosses a coronal sine of heart and passes to a back surface of a left ventricle. The fifth plexus lays on a forward - wall of both auricles. 120
The sixth plexus - in the top department of a back wall left predserdija. - In a trachea the greatest clumps of ganglions are found out in a back wall. In an esophagus - in a forward wall. In lungs, to th forward surface of the right and left branch of a pulmonary artery. In a stomach wall - in the field of the gatekeeper. In intestine walls - . a bubble - from a place of a confluence of ureters, in its bottom and in a triangle. In a vagina - in its parts and to a fat; in a depth of a neck of a uterus. In the item and from l about and to iron - in its departments and in to a fat. PARAGANGLIONS (CHROMAFFIN BODIES) Settle down near to sympathetic ganglions and their trunks, whence there health blog was also their name: "paraganglions". At processing by solutions of salts of chrome they get light yellow or dark brown colouring, that for the first time it was revealed Russian anatomist V.A.Betsem in 1864 also has formed the basis for their name: hro-maffinnye bodies. They are well expressed at children. At adult people they disappear. Following formations concern paraganglions or chromaffin bodies. Paraganglion abdominate. At their newborns two, they lay on each side aortas, above a place of its division. Right more left - length to 10 mm and more. At adult people they disappear. Glomus caroticum no to the form and size it is peer to rice grain, its length to 5 mm. It lays in an angle, about ' division of the general carotid, a little . To take it it is necessary together with an artery. Glomus cardiacum lays on a trunk of the left coronal artery of heart, in that its place where it passes under the left ear. Its length about 15 mm, in width about 3 mm. Glomus coccygeum - the roundish form, about 2,5 mm in diameter. Lays on an internal surface of coccyx, at final bifurcations a. sacralis media. 121 Last two glomes, according to some authors, do not possess chromaffin properties. the paraganglion - paraganglion supracardiale - is between a pulmonary artery And an aorta.-. l and in and 12 OPENING AND RESEARCH OF THE TAKEN INTERNAL ORGANS At research of organs of a mouth, a neck, a breast, a stomach and a basin it is necessary to adhere to a certain order not to forget and to miss something. The order can be any, it is important, that it has been strictly sustained, that opening was regular. Most easier to use for research by that plan on which extraction of organs is made also. Its disadvantage is that natural systems of an organism appear separated and it is necessary the prosector all changes on systems of an organism in the end of opening. If the opening report, is written under dictation during opening, that especially it is recommended, and in the report of system of an organism will be separated. However at the sustained plan the description of separate organs-will always on a certain place that will facilitate the subsequent studying of reports of openings so this disadvantage of great value has no. At research it is necessary to avoid excessive , not to cause shifts and movings of alien bodies, thrombuses and so forth So, we begin research with organs of a mouth and consistently we finish organs of a small basin. All complex of organs of a neck and breast stack on a little table a forward surface from top to bottom, back - up, and tongue to itself. 122 Tongue. Examine a surface, note a mucosa condition. For this purpose, keeping a preparation the left arm for a larynx, an edge of slantwise put knife take out from tongue a liquid covering it. Note the form of tongue, applying, cicatrixes, ulcers, a condition jazych - ache a tonsil which are settling down at a root of tongue and so forth On cross-section parallel cuts investigate its muscles. Cuts should be deep, but cut off pieces does not follow. So, the opened tongue can be combined again, it will not lose the form and will be suitable for a museum and for the subsequent demonstrations. Fauces. Would examine the top surface soft not and.

After that it dissect scissors

After that it dissect scissors to the right of a uvula, and from the prosector at the left and movement of scissors to the right turn on a uvula with a soft palate part. Now examine the bottom surface and handles of a soft palate: note size of tonsils, degree of their protrusion and fauces, their mucosa, cryptas, slightly squeeze them and examine allocated stoppers, cut them healt news and note colour of a tissue, a consistence, ab-stsessy, wounds, cicatrixes and so forth Pharynx and an esophagus. All remains in the same position. Intestinal scissors dissect on a back surface and in the middle a back wall of a pharynx and an esophagus on all € an extent. Turn on in the parties of edge of a cut of a pharynx and an esophagus and examine their mucosa, bulb-shaped sine and a pharyngeal tonsil if the pharynx is separated highly enough together with fornix pharyngis.
Further note esophagus contents, measure its length and width in the top, average and bottom third. Pay attention to ulcers, cicatrixes, diverticulums, aortic aneurysm perforation in an esophagus and so forth if they are. Esophagus diverticulums settle down on Back and on to its wall. If it is necessary with at l with and about m and diverticulums, pour to a wall, an esophagus cut back It is necessary to conduct not in the middle, and to reject aside, that Not to spoil news health diverticulums. Traction , settling down on a forward wall, from - also establish their connection with subjects Organs. 123 At an esophageal stenosis before it to cut, investigate degree of passableness a probe, a catheter or a finger. It is necessary to mean and cadaveric changes of an esophagus which maceration and digestion can be two sorts. At a posthumous maceration the mucosa of cords becomes and can even disappear, baring . At posthumous digestion by a gastric juice that is observed in the bottom part of an esophagus, the wall gets is dirty-brown colour, is blasted and even is punched in a pleural cavity or in a mediastinum. For survey of the lymph nodes located at a bifurcation of a trachea, a knife the bottom part of an esophagus, holding its forceps, also note size of knots, colour, a cut surface and so forth Larynx, trachea and bronchuses. Them open with pugovochny scissors also on a back surface, dissecting thus and a forward wall of an esophagus if last does not represent interest as a preparation.
If the esophagus needs to be kept, opening of a larynx and a trachea make on a forward wall. For this purpose cut tongue on an average line and further open a larynx and a trachea on a forward wall. Even before larynx opening examine an input in it, the epiglottis, arytenoid cartilages, examine about, larynx-light from above, and find out a condition goloso-howl clefts. Leaving all preparation in former position, with tongue to itself and a back surface up, open, as it has been told, a larynx and a trachea in the middle and further the right bronchus, and then and left, not damaging thus an aorta bent through the left bronchus. Having put the big fingers of both arms on outstanding plates of a thyroid cartilage and having brought under a larynx other fingers, move apart plates in the parties and examine opened lumen of a larynx. If there was an ossification of cartilages as it, is observed in advanced age at delution in the parties of plates of a thyroid cartilage the big resistance is tested; it is necessary to apply effort to its overcoming, and the thyroid cartilage with a crunch is fractured. 124 If resistance is great and to break the be health stiffened cartilages it is not possible, them dissect osteal scissors. Now examine and note contents of a larynx, a trachea and bronchuses, applyings on their mucosa, its condition and so forth If there is a suspicion on an aspiration of a contained stomach make definition of reaction by a litmus paper. Note deformations of a larynx, narrowing or expansion, cicatrixes, ulcers, , tumours and so forth Pay attention to colour of a mucosa, of vessels - a plethora or an anaemia, humidity or dryness, its tumescence and so forth At it is necessary to cut a mucosa and to define, than this tumescence - an edema, blood, pus and so forth is caused At an input in a larynx the mucosa sometimes happens rugosity. It depends on the strong edema which has decreased after mors. If there is a suspicion on alien bodies it is better to make opening on a place, before extraction of organs. For this purpose knife a forward wall of a trachea in the middle and further continue a cut upwards and downwards scissors. Having moved apart cut edges, it is possible to examine trachea and larynx contents. RESEARCH OF LUNGS All , not raising it over a little table, turn tongue from itself, phrenic surfaces of lungs to itself. Examine lungs and note their form, size, attacks or protrusions, colour, measure length, width and a thickness of each lung. Examine a pleura at first right, and then the left lung, note its colour, a thickness, a transparency, thickenings, cicatrixes, wounds, hemorrhages and so forth For definition of shine or dimness of a pleura it is necessary to spend cautiously on a lung surface the dry knife put slantwise; not to scrape, but only to remove a liquid, its covering and to look sideways on from - 125 Light. Very gentle fresh applyings are thus well visible, being moistened, they shine and can be quite often seen. Having convinced of that applyings are available, it is necessary them slightly a knife and to define, how they are taken out: easily or hardly. Fresh applyings are taken out easily, old - hardly or are not taken out at all. Now, having put a knife aside, it is cautious each lung both arms, at all not kneading

To work as a knife it is necessary

To work as a knife it is necessary cautiously casually not to wound adrenals and other organs. Further, coming nearer to a backbone, from an aorta and the bottom vena cava, leaving them on a backbone and cutting celiac and mesenteric arteries; a pancreas and the bottom horizontal part of a duodenum. Then, having grasped the left arm the bottom part of a mesentery, it is cautious it up. Now all deduce from a corpse, throw on its right party and dissect stretched bonds of an esophagus with an aorta out of a corpse. Taken thus stack on a dissecting table at the left-from a corpse. If died gastrostomy order pyridium online operation during lifetime has been made, the stomach needs to be taken together with an abdominal wall part where the operational aperture is imposed; at a gastroenterostomy a stomach take together with the loop filed to it, a small bowel, and sometimes and with a mesentery part intestines. EXTRACTION OF GENITOURINARY ORGANS With and and l and it is necessary to examine attentively position of all organs laying in a back part of an abdominal cavity, - kidneys and adrenals, to note them 107 Mutual relation to examine ureters, about l u-lunar bonds celiac or with about l This ~ plexuses-plexus coeliacus (solaris), laying on a forward surface aortas at level from it a celiac artery (a. coeliaca). Further at level II or III lumbar vertebra under the right side of an aorta, having raised it, it is necessary to find the tank (cisterna chyli) which proceeds in a thoracal lymphatic duct.
The tank open with small scissors. Also under the right side of an aorta, but a little bit more low, at level of III lumbar vertebra, it is possible to find out paraganglions. At last, examine the retroperitoneal lymph nodes located on a course of an aorta and the bottom vena cava. Now it is possible on a place scissors in with to to dig an abdominal aorta and the bottom vena cava on a forward surface, the general ileal arteries and veins, femoral arteries and veins, not damaging ureters. From an aorta and the bottom vena cava open renal and epinephral arteries and veins. It is especially possible to recommend this method in cases of a clottage of arteries and veins, their wounds, an aneurysm and so forth At last, start extraction of kidneys, adrenals, ureters and organs of m and l about about and and. For this purpose the left arm reject a right kidney to a backbone and its in parallel external edge, on 1-2 sm , spend a cut of a retroperitoneal fat the big amputating knife taken in a fist so that an edge settled down at the big finger. Continuing to reject a right kidney to a backbone, it to the backbone. Having put a right kidney on the place, the left arm grasp a left kidney and, rejecting it to a backbone, an amputating knife it the same as also right, up to a backbone. Having grasped now the left arm both kidneys with adrenals and raising them, definitively separate from a backbone together with an aorta and the bottom vena cava. 108 Further, having grasped an aorta and the bottom vena cava more low Kidneys together with - ureters and a fat in a fist The left arm and buy ultram 50mg delaying them to itself, from Backbone, gradually approaching to a bifurcation Aortas. Not letting out from the left arm, the amputating knife handle take in a fist of the right arm so, that the knife blade settles down at a little finger, and, holding a knife upright an edge from top to bottom, ileal arteries and veins together with a fat. Continuing to delay to itself and to reject all orga-nokompleks in that and in other party, holding it in the left arm as it is told, organs of a small basin from a sacrum and lateral walls of a small basin, holding a knife blade as it is possible more close to bones. Having separated organs of a small basin behind and from sides, all stack in a corpse on the place and further-arrive variously, in zavi-simosti from a floor of a corpse. At men At first take from a scrotum testicles. For this purpose from the interior of the right inguinal channel dissect a peritoneum and a subperitoneal fat, reach a seed funicle and it. Then the left arm bring the right testicle to an external aperture of the inguinal channel and it is strong it there fix. Thus at an internal aperture of the inguinal channel the camber corresponding to a testicle is shown. Knife the tissues covering a testicle and its vulval cover, and fingers of the left arm push out a testicle, take it in the left arm and, delaying, with a part of a vulval cover and a seed funicle. As arrive and with the left testicle. To pull for a seed funicle at testicle extraction does not follow, in particular at thrombuses of veins of a funicle. At wounds of testicles, fistulas and so forth testicles take not through the inguinal channel, and through a lateral scrototomy, and delete both a vulval cover, and a part of a skin round a fistula. Having allocated testicles, take organs of a small basin. For this purpose do a peritoneum cut closely under pubic bones. Then stupid by or a knife from - 109 . and to at m about in about about a bubble and an urethra with a prostate from associates it, rejecting them in that and in other party and that framing access to a knife. Having bypassed, thus, around all organs of a small basin, grasp their left arm and with force pull to. The amputating knife taken in a fist, make a cross-section the channel below a prostate and, at last, cut a rectum. If the rectum has been well separated from a small basin and strongly involved inside, that, cutting it is deep enough, it is possible to take easily and all anus (anus). For extraction of all the channel at men that is especially important at its diseases and wounds, m. arrive the following about-razo, Having rejected a sexual member on a pubis, an acute scalpel Do a cut of its skin lengthways on a seam from a bridle edge It a flesh to a root of a sexual member and more low on a seam (raphe) Scrotums.

Then by means of a scalpel

Then by means of a scalpel All skin from a member, reject it on a pubis and a scalp allocate a member under a pubis outside and from within, and on Volume separate from muscles of a perineum and take together With other organs, preliminary having pushed it under Pubis in a pelvic cavity. _ - Here too it is necessary to work cautiously, to avoid a disfiguration. At cleaning of a corpse a scrotum skin cover seams, and a skin of a member simply stack on a scrotum. If not to look narrowly buy medrol dospak at genitals of a corpse it is possible even not to notice, that they are taken, as their impression is made. At women After organs of a small basin behind and about a boat separate mainly stupid by fingers a neck of a bladder with an urethra and a vagina. Strongly extending all genitals with the left arm and bringing a knife under pubic bones, cut an urethra, a vagina and a rectum. 110 - If, organs have been well separated from a small basin and strongly extended, and the cut is spent deeply enough it is possible to take a vagina together with small labiums, and a rectum together with an anus. Thus, all genitourinary organs appear taken; them also stack on a table, to the left of a corpse. After extraction of all internal organs examine. On a neck examine its deep muscles, places of damages if they were, sympathetic trunks and ganglions (top lay on cross-section processes II and III cervical vertebra, behind internal carotids vagus nerves, and bottom - on heads of I ribs or on cross-section processes of VII cervical vertebra). In a thorax examine. a pleura, ribs, intercostal muscles. In an abdominal cavity - a retroperitoneal fat, muscles of a back wall of a stomach, the big and small basin.
Simultaneously examine a backbone from cervical vertebra to coccyx; turn "attention to its curvature, to bodies of yokes processes of vertebra, on intervertebral cartilages and ligaments. METHOD OF FULL EVISCERATION As a method of full evisceration understand extraction of all organs of a mouth, a neck, a breast, a stomach and a basin together, not separating them from each other, in the form of one orga-nokompleksa. Method this, developed prof. G.V.Shorom (1925) has the big advantage, consisting that each system can be investigated in full integrity. This method is irreplaceable for research of vascular and lymphatic system, and also at the combined wounds, at widespread metastasises of tumours and . Evisceration has also that advantage, that at it all organs till the end of research remain in the natural mutual relation. It gives the chance in lju - . organs p. 168 see. 111 Fight the moment to come back back, again to investigate and show the pictures which have been found out on a vskry-habit spasm. Its disadvantage is bulkiness organokom-pleksa and difficulty of orientation of pupils in changes decadron online of organs. The technics of a method in the beginning of opening differs nothing from technics of the described basic method. Skull and backbone opening, as well as extraction head and a spinal cord, make as. Cuts make the same for extraction of internal organs. At last, and allocation of organs of a mouth, a neck and a breast make as, but these organs do not cut, and after allocation stack on the place. Then cut a diaphragm from costal edges at first on the right, and then at the left. Not reaching a kidney, with that and on the other hand spend a cut peritoneums on a lateral wall of a stomach from a diaphragm to a small basin. From here partly a knife, partly stupid by (it is simple arms) separate from muscles of a back wall of a stomach and a backbone absolutely all organs. At last, allocate organs of a small basin as it is already described, also keeping their interconnection. After that all take and stack on a little table of the big sizes (than it is specified in p. 14) that organs from it did not overhang. G.A.Berlov (1950) suggests to change an extraction order ' with "descending" on "ascending". Motive to it as the author specifies, are difficulties of evisceration at a fusion of pleural cavities and an abdominal cavity, and also inconvenience of extraction of organs of a small basin owing to accumulation in it blood and a hydropic liquid. The author considers more convenient to begin evisceration with organs of a small basin, allocating at first a bladder, then separating organs from lateral and back walls-stomachs, reaching to a diaphragm. Further cut a diaphragm from ribs. Here, between a pleura and a diaphragm, the fat layer is developed considerably, that allows to get stupid by in okolodia - 112 and a fat and to separate a parietal pleura together with lungs from thorax walls. Then cross diaphragm legs at first at the left, and then, rejecting on itself, cross its legs on the right. Now allocate tongue, organs of a neck and take all . At an adnation of organs of a stomach with a forward abdominal wall a sectional cut continue to a pubis and in depth to an external slanting muscle of a stomach. In suprapubic area, having reached a preabdominal and prevesical fat, it is necessary to get into space (cavum s. spatium Retzii). Stupid by a peritoneal bag in the parties from back surfaces of direct muscles and upwards to semicircular lines of Douglas (linea semicirculares Douglasi). Further from within over a pubis cross-section dissect stomach muscles, open a forward wall a moisture direct muscles from both parties. Then, it is strong aside the left direct muscle, make an incision a knife Back wall of its vagina from the semilunar Lines (linea semilunaris Spigeli) and muscular Fascicles of subject muscles, reaching to parietal Splints. The same make and on the right.

Having dressed an intestine in this

Having dressed an intestine in this place two ligatures, a cross-section dissect an intestine between ligatures. Now, strongly having grasped fingers of the left arm the jejunum beginning, separate its knife from bry-zhejki, all time delaying an intestine to itself. To medrol separate an intestine from a mesentery it is necessary long a knife, holding it for the handle, as a bow, its plane perpendicularly to an intestine, Doing thus, as a bow, wide free a knife to the right and to the left to cut all edge, Instead of its part, and not rendering thus any having given .,--. When the jejunum, will be separated on distance of the lifted left arm, it better accurately to put on a neck of a corpse then not to lose its beginning and not to spend time for searches. The left arm grasp a new loop at the mesentery where the cut has stopped, and continue in its same way, separating and an ileal intestine '. Length of a jejunum approximately 2,5 m, and ileal - 3,5. 104 Now separated loops of intestines stack directly on a dissecting table to the right of a corpse, i.e. About itself. For this purpose it is necessary to take place, that the intestine and its contents casually have not polluted a floor and feet of the prosector. Therefore we recommend a corpse to stack not on the table middle, and a little bit further, from ourselves, leaving to the right of a corpse on a table there is more than place, than at the left. Having reached a place of a confluence of an ileal intestine in blind, start unit of colons.
For this purpose, having rejected a caecum to the left, dissect a knife a peritoneum on the right side of its and ascending colonic, and - fields to the right, separate a part a knife, a part stupid by from a back wall of an abdominal cavity. Having reached so to the right flexure of a colon, delay "it in a caudal direction and dissect ligament intestines with a stomach (lig. gastro-colicum) and its mesentery (mesocolon transversum). Continuing to delay the left arm in the same direction the subsequent parts of a colon, approach to its left flexure, a descending colonic intestine and sigmoid. Separate last from its mesentery and reach a rectum. Here, in the heart of a basin, dress an intestine two ligatures and between them dissect it. All intestines lay now on the middle of a table to the right of a corpse, and their beginning - on a neck of a corpse. So usually take an intestine. If there are indicatings on the pathological processes proceeding simultaneously in an intestine and in a mesentery in that case it is better to take an intestine together with a mesentery. For this purpose at first allocate colons, since blind as it is already described, not separating it from the ileal. After otde - a sigmoid intestine from a straight line postpone colons in the right party of a corpse, and small bowels allocate together with a mesentery, having cut off it. places ' attachments to a backbone. If there are fistulous reports, strong solderings or enteroanastomoses they should buy tramadol ultram not be separated, and it is necessary to take separately, preliminary having dressed loops of intestines ligatures. In the same way arrive and at an adnation of intestines with - a liver, a stomach, a cholic bubble, with the loop of a small bowel filed to a stomach at operation of a gastroenterostomy, fecal fistulas etc. . 105 In detection cases about m about and vessels of a mesentery the unit of intestines is better to suspend and take an intestine together with a mesentery and an aorta at a clottage of arteries or together with a portal vein, a liver, a stomach, a duodenum, a pancreas and a lien at a vein thrombosis. LIEN EXTRACTION Lien extraction make usually separately From other organs. For this purpose the right arm reject In the right party of a corpse a greater cul-de-sac, and the left arm for a lien also delay it to itself; thus It is possible to examine hiluses lienis, vessels and its ligaments - lig. gastro-lienale and lig. phreni, ligaments dissect a knife, And the separated lien stack on a table to the left of Corpse., In cases when there are strong adnations of a lien with a stomach or a pancreas, at wounds, a clottage of its vessels or at germination by a tumour, the lien needs to be taken not separately, and together with a stomach, a liver and others 1. LIVER AND STOMACH EXTRACTION WITH THE DUODENUM, PANCREAS AND MESENTERY These organs take all together in the form of one . First of all dissect a diaphragm. For this purpose the left arm reject a liver in a left-hand side of a corpse, paternal right . stretches. Thus it is convenient enough for cutting from ribs usual movement 1 In the press to us the reproach concerning separate extraction of a lien as the integrity of portal system of a circulation is thus broken is made. This reproach quite lawfully can be carried and to an intestine. However hardly probable there is a necessity to take every time all , that considerably complicates opening. If for joint extraction of a liver, a stomach, a duodenum, a pancreas, a mesentery, a lien and an intestine there are indications it us is recommended both in the first, and in the second edition of the book both for a lien, and for an intestine. About it also it is spoken and in introduction (p. 8) and. p. 114 given editions. 106 Amputating knife from left to right. Having reached a right kidney and continuing to reject a liver further, it is cautious the right adrenal from a liver under the control of eyes. - Then cross in a cross-section direction the bottom vena cava, leaving its part which has been-bound to a liver; with a liver separate also a vertical part of a duodenum with a pancreas head. After that a liver return in former position. Now, having grasped the left arm the left part of a diaphragm and delaying it to itself, cut it from ribs. Further, removing the left arm in the right party of a corpse a stomach and having grasped fingers a pancreas tail, from the left adrenal and a back abdominal wall under the control of eyes.

Kerner have developed a method

Kerner have developed a method of opening of all organs on a place, in a corpse, without their extraction. At last, Letul has offered, and G.V.Shor has developed a method of extraction of all organs of a neck, a breast and a stomach together - a method of full evisceration. In the present management two methods will be stated: 1) the modern method developed by a number order decadron now of researchers, being typical and characteristic in the symmetry and clearness, that is why and named the basic, or classical, a method; 2) a method of full and incomplete evisceration. Owning these two methods, the prosector can feel in the relation of technics of opening quite assured of all cases. . the method is the most widespread And standard. It consists in extraction of the internal . in the form of complexes. Extraction order the following. At first take organs of a neck and a thoracal cavity - all together. Then take separately an intestine and a lien which can be taken in common with the following - to a liver, a stomach, etc. 101 Further - a liver and a stomach with a duodenum, a pancreas and a mesentery all together. At last, take kidneys with adrenals, the ureters, all organs of a small basin, with an abdominal aorta and the bottom vena cava. Thus, it turns out three complexes of organs and two organs separately - an intestine and a lien. EXTRACTION OF ORGANS OF THE NECK AND BREAST
Taking the right arm a small post-mortem knife as a writing feather, and the left arm fixing and rejecting a head, pierce a knife blade a mouth diaphragm in a mental part on the right and short sawing movements, keeping closely to an internal surface of a horizontal part of a mandible, cut a diaphragm of a mouth with right, and then and on the left side. Then cross the remained muscular ponticulus at a chin - a podborodochno-pod-lingual muscle and a tongue bridle. Through the formed aperture in a bottom of a mouth extend an end of tongue and, having grasped its fingers of the left arm, delay to itself. Now it is possible to see a soft palate and its handles. Having entered a knife blade in a mouth over tongue through the formed aperture, a cross-section separate a soft palate from firm with one and on the other hand. Continuing these cuts aside to mandible angles (angulus mandibulae), them bridge to the cuts spent for renunciation of muscles from a horizontal-'noj of a part of a jaw. All these cuts, thus, cover outside both tonsils, and handles of a soft palate, and a uvula. Then as it is possible above, approximately at atlas level, do a pyridium online cross-section of a back wall of a pharynx. To cut it is necessary to a backbone. -Continuing to delay tongue, a knife separate a back wall of a pharynx from bodies of cervical vertebra. At the basis of a skull dissect internal and external carotids, bulbar veins and vagus nerves. Continuing to delay tongue to itself, all organs of a neck from a backbone. Having reached a thorax, grasp now all organs of a neck in the left arm and, rejecting them at first in the left 102 The party , cut with a knife under the right clavicle The right subclavial artery, vein and nerves; then Neck organs reject in the right party of a corpse and , - the left neurovascular fascicle under left . Now all keeps communication with a corpse only by means of the quaggy fat of a postmediastinum going down to hiatus oesophagus diaphragms and informed sometimes through a cleft with a fat, being between omentulum leaves. Last circumstance should be meant at transition of a purulent inflammation from a postmediastinum in an abdominal cavity. Taking neck organs in the right arm and having pulled in a direction to feet of a corpse, it is possible to break off a postmediastinum fat and by that to allocate all organs from a thoracic cavity without the big effort. If thus the arm tests appreciable resistance to make the big effort not, follows, as it is possible to break off organs. In particular it is dangerous at wounds, ulcerations And esophagus and trachea tumours, and also at () aneurysmal aortectasias And so forth; preparations will be spoilt, research will be Incomplete, and not skilled prosector of an artefact, is made by it , can accept for the pathological phenomena. In these Cases it is necessary not to break off a fat of a mediastinum, And to dissect its knife, taking organs the left arm in that Direction. - At strong adnations it is better to arrive as follows. The right lung needs to be deduced from a pleural cavity on a left-hand side of a thorax and a knife to make a discission of the pleura and intercostal vessels along a backbone, between it and an unpaired vein v. azygos). Now the right lung needs to be laid on a place, to deduce the left lung on the right half of thorax and to make a discission of the pleura and vessels between a backbone and a semiunpaired vein v. hemiazygos). After that organs already easily separate. Having separated organs of a breast from a postmediastinum, them deduce from a corpse and throw through a thorax right edge. The aorta, the bottom vena cava and an esophagus which is passing through a diaphragm become thus visible. All They are dissected by a cross-section out of a corpse, at the edge of ribs. If lungs strongly with a diaphragm she should be taken together with lungs. For this purpose before cutting off of an esophagus, an aorta and so forth it is necessary to cut a diaphragm from ribs, and on the right still and the ligament supporting a liver. Taken stack on a little table. Now start extraction of organs of a stomach, and begin with an intestine. INTESTINE EXTRACTION Having rejected the big epiploon with Intestine and its mesentery on a thorax, remove All loops of small bowels to itself, i.e. In the right half Corpse. At the left at level of II lumbar vertebra find the beginning of a jejunum and, having delayed its left arm to itself, cut a knife a window in the beginning of a mesentery about the intestine.

Examine a mesentery of a cross-section

Examine a mesentery of a cross-section colonic intestine and feel through its root a pancreas. Examine intestines, not tampering with them, and note position, an inflation or fall of their departments. Then, having removed loops of small bowels from a blind corpse in a left-hand side, examine a caecum and its process. Then examine all colon to a straight line. After that, buy ultram tramadol cautiously moving apart loops of intestines, note their interposition, further choose intestines from an abdominal cavity to itself, in the right party of a corpse, examine a mesentery notice its thickness that depends on larger or smaller quantity of Adeps, lymph nodes, a condition of vascular and lactiferous vessels. If the last are dilated and look like narrow strias, it is necessary to investigate the lactiferous tank (cister-na chyli) and a thoracal duct. Further examine organs of a small basin, them Position, bladder size, and at women - on a uterus and its appendages and their relation to the neighbour It to organs and to a peritoneum. ' Then feel kidneys and find out their position and degree of mobility and, at last, as far as possible, examine a back wall of an abdominal cavity. If there are operational cuts or stomach wounds, carefully examine the channel, not concerning it, and then cautiously separate the organs, all time under the strict control of eyes, Only now it is possible to make the necessary cuts.
Having entered a finger in an epiploon pocket (bursa omentalis) che-rez foramen epipiocum Winslowi, it is possible to open a portal vein a hepatic artery and the general cholic duct, not damaging ; open an epiploon pocket, cut mesentery lymph nodes, part adnations, mesentery vessels, open them and investigate on presence of thrombuses and so forth At a strong gastrectasia A.I.Abrikosov recommends to look, whether the duodenum to a backbone by the tense mesentery of small bowels and the top mesenteric artery, , is pressed. Whether is not present arterio-mezenterialnogo duodenum closing. Having finished survey and research of an abdominal cavity, note a condition of a visceral peritoneum at which on a research course all time it is necessary to look narrowly (colour, vessels, a hemorrhage, dimness or a transparency, humidity or dryness, a roughness from applyings of fibrin, pus and so forth). At last, note quantity and character of a liquid in brjush - Ache cavities, its colour, a transparency or , a consistence, a smell, an impurity of a feces, nutrition, gas and so forth If in an abdominal cavity the feces, nutrition, ascarides and so forth it is necessary to find a place of a perforation of the stomach or intestines before extraction of organs, carefully looking through a stomach, an intestine, an appendix are found out. Can meet and exsudates; in these cases for soldering research it is necessary to dissect. THORAX OPENING After survey of a cavity of a stomach start thorax opening. However before to open a thorax, it once again examine, already bared, and note the form, size, symmetry and asymmetry; then note the breast bone form (for example, a "chicken" breast and so forth) and its relation to ribs, junctions of ribs with cartilages, places of operations and so forth For pulmonary collapse prevention it is necessary to dress a trachea before thorax opening to have possibility to judge a lung expansion buy pyridium online and atelectases. The last can arise and be lethal after a narcosis and after operations on heart and on lungs. Now, taking in a fist a costochondral knife (fig. 32) and holding it it is horizontal, put its cutting edge on a cartilage of II rib. An eye plan a line of its movement which should pass on cartilages of all ribs from II to X, for 0,5 sm from a junction of cartilages with ribs. For development of larger force by a palm of the left arm press a knife to a cartilage of II rib. Now one movement of arms to the right dissect all costal cartilages on the planned line. This operation make at first on the right, and then and at the left. To work it is necessary resolutely and confidently, but it is cautious not to damage organs. It is easier for observing, giving to a knife blade the position parallel to a surface of a thorax, cutting all cutting party and doing fast movement. Last circumstance provides fast hit of a knife on the following costal cartilage and prevents it in depth. 90 If there is no costochondral knife this operation can be made and a small post-mortem knife, observing the same conditions. Together with crossing of cartilages dissect intercostal muscles and a pleura. Having grasped a breast bone fingers of the left arm at a xiphoid process, it raise also a post-mortem knife cut from it a diaphragm and mediastinal th fat a little, holding a knife all time as is possible more close to costal cartilages and a breast bone not to wound organs and not to open a warm shirt. Fig. 32 Costochondral knife. Now, taking a post-mortem knife in a fist for the handle and holding it upright an edge upwards and an edge from itself forward and having raised the left arm a breast bone, simultaneously take away it in a left-hand side of a corpse, enter a fist into the Thoracal cavity under a breast bone so that the knife blade came out through the right cut of cartilages. Having referred an edge obliquely outside, to the left from itself, dissect a cartilage of I rib on the right and further, without efforts turning an edge inside, to the right from itself, to a median line, then forward, to a head, easily make a section of grudino-kljuchich th joint with right, and then and on the left side. At correct movements it is possible easily and vessels thus will not be wounded.

Then cut soft parts from the breast bone handle

Then cut soft parts from the breast bone handle, take out a breast bone, examine its internal surface and put aside, on a dissecting table. At survey of a breast bone pay attention to a fat of its back surface, on a periosteum. For elasticity definition incurvate a breast bone, for density definition stick in it a knife, for survey and research of an osteal brain saw it and squeeze edge to squeeze buy decadron now out an osteal brain, do a breast bone on which the osteal brain is widely bared. 91 Examine costal cartilages and note obyzvest-vlenie, ossification (advanced age), a thickening (rachitic "beads"), unit of cartilages from ribs, hemorrhages (a scorbutus, illness ). It is useful happens to make longitudinal ribs for survey of an osteal brain. This operation - thorax opening - is easy on children's corpses and corpses of young subjects; at elderly and old men there is an ossification of costal cartilages, since I rib. Therefore at corpses Fig. 33. Costal scissors. Such subjects to cut a cartilage of I rib it is not possible, and it is necessary to have a bite it costal scissors (fig. 33). At ossification of all costal cartilages and an ankylosis to a breast bone-clavicular of a joint the section should be made costal scissors or a saw. For wider opening of a thoracal cavity dissect ribs scissors on an axillary line. So recommend to arrive at opening of corpses of newborns and children of early age. Water assay At suspicion on a pheumothorax before thorax opening it is necessary to separate dermo-myshech th flap from a breast in the form of a pocket, to pour in it waters and to cut an intercostal space under water, of course, not a lung.
Occurrence of bubbles will specify in positive water assay on a pheumothorax. At suspicion on an air embolism of heart opening begin not with a skull, and from brjushch th and thoracal cavity. To work it is necessary extremely cautiously not to wound vessels. 92 The breast bone handle is better to begin the basic cut not on a neck, and on the basis. Cartilages of the first ribs and grudino-kljuchichnye are better be not to tampering with a joint. Having separated a breast bone, it raise and or fix or a cord for a head of a corpse if the assistant, saw at level of the second intercostal spaces. A warm shirt open with a linear cut scissors. Strongly having grasped forcepses of edge of a cut of a shirt, plant them and, having transferred to hold to the assistant, pour in a warm shirt water. Now a peaked scalpel under water cut a wall of a right ventricle of heart. If in it there is air it will leave through water blisters. It also is water assay on an air embolism of heart. It is necessary to mean, that at late opening cadaveric gases can be formed. buy medrol That a breast bone to keep on a place and that it did not sink down under a skin mending of a corpse, it is possible to apply the following reception. Dissect costal cartilages I switch off a clavicle only with the parties of a corpse. The assistant standing to the left of a corpse, delays a breast bone on itself as a cover, for the cut cock, having wrapped it , not to wound an arm, framing access for extraction of organs of a neck and a breast. Conservation of costal cartilages at the left prevents breast bones after mending of a corpse and the deformation of a breast bound to it. N.F.Melnikov-Razvedenkov (1922) for detailed survey of lungs before their extraction has suggested to cut through all intercostal spaces and to exsect some ribs. Through the formed apertures (window) it is possible well and to examine and feel in details lungs, to investigate wounds, and so forth This way it is possible to recommend their topography, character of adnations for research of wounds of lungs, survey of reactive changes around the channel, exsudates and so forth In case of wound of a breast bone or tumours of a mediastinum the breast bone should not be separated: she needs to be taken together with organs and then already to arrive depending on necessity. 93 G.A.Berlov (1953) has offered updating of a way Melnikova-Razvedenkova for research of lungs at a fusion of pleural cavities and for orientation of pathological processes in relation to ribs. Dermal flap of a torso to back under-kryltsovoj lines. A lung dissect through intercostal spaces up to a spine column. Planting the extremities of ribs on 15-35 sm, it is possible to investigate in detail a lung on cuts and to focus pathological changes in relation to ribs. The author recommends to do these horizontal sections in the taken lungs on a little table, combining them with usual face-to-face or instead of face-to-face cuts. SURVEY AND NECK RESEARCH The general review of a neck make immediately at external survey of a corpse and at its skins. Now it is possible to examine all its organs in details. Most conveniently and more full it is possible at cuts on Medvedev's method (Opening of the person see). Examine muscles, channels, their direction, inflammatory reactions, exsudates and so forth Cut from a clavicle the bottom extremities of grudino-klju-chichno-mamillar muscles, cross lopatochno-djazych th muscles (m. omohyoideus) also delete them. Examine opened supraclavicular hollows and neurovascular fascicles from both parties. Here sometimes there are traumatic aneurysms of vessels. Investigate lymph nodes; find out mutual relations and a condition of the general carotids, bulbar veins and vagus nerves from both parties on all their accessible extent. In a place of a bifurcation of the general carotids where they are parted on internal and external, examine carotid glomes. Having cut a carotid wall in the bottom part, open with its scissors in a longitudinal direction and note a condition of an intima, a lumen, a thickness of walls, contents (liquid blood, convolutions, thrombuses and so forth).

To manipulate more freely, it i

To manipulate more freely, it is possible to remove two-three top cervical vertebra. This way can use and not opening a skull, When skull opening for some reason or other to make it is impossible, and a nasal cavity and nasopharynxes to examine it is necessary, it is possible to use also way on which exarticulate a mandible, take away it on the person and, by means of a decadron online gouge having blasted the firm sky, get into a nasal cavity and nasopharynxes. This way with full excision of a mandible is more convenient a wasp-shchestvrt at neck cuts on a method of Medvedev, It is possible to open adnexal cavities of yokes separately. Sinuses to open the basic with a wide gouge, making two-sections. The first section do ahead of visual apertures, putting a gouge in a face-to-face direction and strong blow of a hammer driving in a gouge on 1 the Second section see do by horizontally put gouge on the right sideways from a Turkish saddle which entirely chop off from right to left (see fig. 23). Frontal sinuses quite often happen are opened already at skulls. If it has not occurred, them open with a gouge. Cells of a trellised bone * (os ethmoidale) open, deleting a bone gouge between it lamina cribrosa and internal walls of orbits (fig. 23 see, and). If thus still to separate the top part of a trellised bone (lamina eribrosa and crista galei) and a forward part of a body of the basic bone the top department of a nasal cavity will open. 77 Antrums of Highmore open after opening of orbits and extraction of eyes. Having released the bottom walls of orbits from soft tissues and having delayed them upwards and to front a hook (which give to hold to the assistant), hollow out at the bottom of orbits an aperture through which antrums of Highmore examine. Thus they open extremely insufficiently and in detail them to examine it is impossible. More well antrums of Highmore open at opening of the person on
Medvedev's method. After face skin putting off the top jaw that gives the chance to investigate easily and in detail antrums of Highmore and a teeth which usually do not investigate though it can have essential value is completely bared. the cavity widely opens a gouge of its forward wall. Possibility of full and clear representation about its form, size, a condition of its walls, apertures (hiatus maxillaris), opening in an average nasal course is thus framed. Teeth becomes quite accessible to research, can be taken, and lunulas are easily opened with a gouge. In the opened sinuses examine mucosas, their condition contained, an exsudate and so forth write down. sialadens with their ducts are convenient for investigating, applying a method of opening of the person on a method Vitushinsky or Medvedev. Chapter 8 OPENING OF THE NECK, BREAST AND STOMACH For opening of a neck, a breast and a stomach a corpse stack on a back a head to light; under a neck and shoulders of a corpse podkla-dyvajut so that the head overhung a little and completely the neck opened. 78 The prosector becomes to the right of a corpse and keeps a position during all time of opening. It is more convenient to lefthander to stand to the left of a corpse (fig. 26). TEHKA CUTS By small post-mortem knife do the basic cut (fig. 26) from a chin to help avandamet a pubis on a median line, bypassing a belly-button on the left side of a corpse not to damage round ligament of a liver. The post-mortem knife thus needs to be held horizontally, having grasped its handle in a palm and to cut not the extremity, and an edge paunch (2 fig. see p. 23). On a neck cut only a skin not to damage subject organs. Rice 26 Basic cut of a wall of a trunk. On all extent of a breast bone to a xiphoid process the cut should get to a bone. On a stomach, as well as on a neck, cut only a skin and a hypodermic fat. If on a way of this basic cut wounds, fistulas, operational wounds are located, they need to be bypassed, instead of to cut. After the basic cut of a skin of a stomach do a cut of all depth of an abdominal wall. For this purpose at a cut right edge under a xiphoid process grasp a skin fingers or a gear forceps, delay up and to itself and a knife paunch cautiously rasse - ' cabins an abdominal wall throughout 3-4 see Through the formed aperture air enters into a cavity of a stomach with some hum, the abdominal wall finishes, and the impression of an inspiration (the corpse has sighed) is made. It is a sign of that the prosector has got into a stomach cavity. Now enter index and average fingers of the left arm turned by a palm up, through a cut in brjush - 79 a cavity and, fingers, raise an abdominal wall, and a post-mortem knife between fingers cut it to a direction of already made basic cut of a skin, advancing fingers of the left arm to a pubis. At this way of a cut stomach organs are damaged. If at a strong inflation of an intestine there is a danger to damage organs the cut should be spent warm or bellied scissors If there is a suspicion on presence of gases at a stomach cavity, preliminary a skin in the form of a pocket in which pour water. An abdominal section do cautiously under water. If in a stomach cavity there is a gas it will leave through water blisters. If there are adnations of abdominal interiors with Peritoneum of a forward wall and fingers of the left arm or a knife them will come across, them it is cautious and without efforts part. When adnations are very strong, time them does not follow, and it is necessary in their place Skin and muscles, and a peritoneum to leave in connection with organs and This place to bypass a knife.

That a lens not , it is necessary

That a lens not , it is necessary to put an eye a cornea downwards and slightly to press it and to cut from a back surface one movement of the razor to itself. The lens thus lays on an iris of the eye and nestles on a cornea. Plaintive glands settle down in on an angle of buy ultram online an orbit and everyone is parted by the fascial leaf going from m. levator palpebralae superioris, on two unequal parts. The most part lays over a fascia is top, or orbital, plaintive gland - gl. lacrimalis superior s. orbitalis, and smaller bottom - gl. lacrimalis inferior s. palpebralis. Top (orbital), the size to 25X14 the mm, lays in a frontal bone fossa - fossa gl. lacrimalis also cannot be palpated. Bottom () consists only of 15-20 lobes, to a conjunctiva of the top crest and can be examined at live and at a corpse if to delay an upper eyelid up and . It looks like a yellowish, hilly body. Ducts of plaintive glands open in thirds of top crest in number of 12-15. Through them tear arrives in a conjunctival bag, washing off an eyeball, and flows down to a medial angle of a palpebral fissure. Here it arrives in the plaintive ways beginning two points - puncta lacrimalia. They are on back ribs of eyelids and are an input in plaintive canaliculuses which go perpendicularly to edge of eyelids. Soon they turn under a right angle and 74 Are referred to a nose, running in a dacryocyst - saccus lacrimalis. Canaliculuses are surrounded by elastic fibers and (any) muscles departing from m. orbicularis oculi. At blinking tear arrives from a conjunctival bag in a dacryocyst and forces the way in the nasolacrimal channel. Narrowing of the nasolacrimal channel involves a dacryagogue, and stagnation of tear in a dacryocyst happens quite often the reason of its inflammation. The dacryocyst is the top blind extremity of the nasolacrimal channel - ductus naso-larcimalis. It lays in the osteal excavation formed by a plaintive ossicle and a frontal process of the top jaw - fossa sacci lacrimalis.
From top to bottom the dacryocyst is narrowed and passes in the nasolacrimal channel laying in the osteal channel, going from top to bottom, and a little . The channel direction varies depending on width of a ridge of the nose and width aperturae piriformis, that it is necessary to consider at its sounding. Lumen of the nasolacrimal channel , very narrow, length 12 mm and more. Its bottom aperture lays in a forward part of the bottom nasal course. In plaintive glands there can be inflammations, tumours, both good-quality, and malignant - adenocarcinomas, sarcoadenomas. In the plaintive channel there can be a narrowing, as congenital, and as a result of an inflammation (mushrooms - streptothrix and ), stones - dacryoliths. In a dacryocyst there can be inflammations - dacryocystites, cysts and tumours: polyps, fibromas, carcinomas, sarcomas. It is possible to open a dacryocyst, dissecting lig.palpeb-ralae mediale and then the nasolacrimal channel to probe which more conveniently from the opened dacryocyst very much a stylet. The Nasolacrimal channel. At opening of the nasolacrimal channel an antrum of Highmore laying from it, do not open. If processus frontalis it is is appreciable developed and covers the nasolacrimal channel, a way to the channel prokla - ~ through an antrum of Highmore on which medial wall it is possible to see a channel diverticulum. 75 OPENING OF THE NASOPHARYNX, NOSE AND ADNEXAL CAVITIES For this purpose it is considered the best a way Khark, giving the chance to examine not only a nose and a nasopharynx, but also the basic bone, frontal sinuses, cells of a trellised bone and antrums of Highmore. order pyridium After brain and pituitary body extraction from a frontal bone to edges of orbits and roots of a nose also reject a forward dermal flap of a head on the person. A back dermal flap from an occipital bone and cervical vertebra. A sheet saw saw on a median line in a direction a frontal bone to a nose root, and to work it is necessary rather cautiously not to damage a forehead skin. Then in the same direction saw an occipital bone to an occipital aperture. Now a saw cloth insert into both made , and saw: a trellised bone, the basic, an average part of an occipital bone and the top cervical vertebra. - For performance of this operation it is better to put a corpse prone. Two previous a frontal and occipital bone keep a saw in the necessary direction. After that, having grasped arms of edge of half of basis of a skull, with force plant them from each other (or by means of a wide gouge). Nasal bones and the top jaw are thus separated. A mucosa of a nose and a nasopharynx dissect a knife or scissors. On one of half of basis of a skull it is well visible One half of nasal cavity. For survey of other it on it is necessary to cut its septum at . If to remove nasal conchas it is possible osmot - a mucosa under them and an aperture of the plaintive The channel under the bottom concha. For survey of an antrum of Highmore dissect a lateral wall of a nasal course. Further examine a nasopharynx parted lengthways, apertures of postnarises, and in top they be apertures of Eustachian tubes and a pharyngeal tonsil. In depth it is possible to examine a soft palate, a fauces, a root of tongue and an input in a larynx. 76 Thus are opened frontal , cells of a trellised bone and a sinus of the basic bone, in the cervical part of a spinal cord is inevitably damaged, therefore, if it is necessary to investigate a spinal cord, it take to Khark. Except described, various ways from which the greatest attention the way deserves a skull on are offered more many. After it? To a way the Back dermal flap of a head from cervical vertebra, exarticulate an occipital bone, cutting solderings with I cervical vertebra, and a spinal cord and a skull to front. Between an occipital bone and an atlas the space in which the back wall of a pharynx is visible, and after its section - postnarises, nasal courses, a fauces, a soft palate, a root of tongue and an input in a larynx is formed.

Thus the drum-type cavity opens

Thus the drum-type cavity opens and becomes accessible to survey, as well as acoustical ossicles - , an anvil and (fig. 23 and 24). Opening of an internal ear, osteal labyrinth with its semicircular channels and a cochlea, together with 9 Internal acoustical passage make too a gouge from a skull cavity, but more slowly, than for middle ear opening. Mastoid opening (its cells) make outside. For this purpose also it is convenient to use Rice 24. A kind of the opened adnexal cavities. Cut on Medvedev's method, baring a mastoid and chopping off from it a gouge a superficial osteal plate. Thus open medrol dospak process cells, investigate their and their contents. For full and for microscopical research a hearing aid allocate all temporal bone. Thus, having spent a cut (Medvedev) and all soft tissues together with an auricle from a temporal bone, do cross-section the skull bases vpere - 70 Di pyramids - from scales of a temporal bone to a Turkish saddle. The second spend behind a mastoid, referring it forward to a clivus of the basic bone (clivus Fig. 25, middle ear Opening on Merkulov's method. Blumenbachii). Then dissect a gouge the basic bone between on a median line and separate the bottom surface of a temporal bone from soft tissues. If necessary to take both hearing aids do not lead up to a median line, and finish at the extremities of pyramids here again dissect a gouge, 71 Keeping the basic bone. If it not to make, o the skull breaks up to two half, and the head will be disfigured. Defects of bones can be closed liver or lien pieces that on a skin they were not found out. The cut part clip in a vice and saw a fret saw in a direction from back Edge of external acoustical passage to a first line of internal acoustical passage - Thus a tympanic membrane remains whole, external acoustical passage, a vestibule, a back wall of a drum-type cavity, a stirrup etc. is bared., the cochlea is cut in the middle, and by mastoid cells - in a forward part. G.A.Merkulov (1951)
recommends some different way of opening of internal departments of the ear, consisting in in one step all forward wall and an osteal plate of a forward surface at level internal acoustical apertures. For this purpose after putting off of a firm cerebral cover, it is added put immediately at the edge of an internal acoustical aperture, at level of its average line and approximately in parallel to a forward surface or a little under an angle to it (fig. 25)> At such position of a gouge an osteal plate of a forward surface chop off almost on all extent one strong blow of a hammer on a gouge.
After putting off of an osteal plate internal acoustical passage and all tympanic membrane are well visible both cavities of an average and internal ear, and a cavity mastoid cells. On fig. 25 gouge position, and at the left the opened middle ear is shown on the right For successful single-step an osteal plate of a forward surface it is necessary to use a wide gouge, not already 1,5 sm, differently an osteal plate will be chopped off not entirely, and partially and operation should be repeated, establishing a gouge on other sites, but all as at level of internal acoustical aperture 1 Opening of a hearing aid has most in detail described In And in the book Technics of opening of some areas of a human body \, 1961 72 ORBIT AND EYE OPENING If the person has not been opened, for extraction of eyeballs an orbit open o the parties of the basis of a skull. After putting off of a firm cerebral cover the top wall of an orbit you-deljaja dissect a gouge in three directions, a plate and a kind of the rectangular triangle which top is necessary on foramen opticum, the medial party goes in a direction, - under an angle 45 ° and facial - in parallel a frontal bone (fig. 23, and, see,). After a section a gouge in the specified directions a plate take out a forceps. Examine buy levitra a fatty tissue of an orbit and delete it together with oculomotor muscles. Now it is possible to take an eye, grasping its forceps for a fatty tissue or for a sclera (not to rumple a nerve) and separating a scalpel from eyelids. After that it is necessary to sew cautiously eyelids ton thread and to fill orbits cotton wool. In order to avoid a disfiguration take roofing felt at a back part of an eye where usually and meet naibo-lee the important pathological processes is more often. For this purpose, fiksi-ruja the eye a forceps for a sclera, sticks in it acute scissors or, having made preliminary a cut a scalpel, cross it on equator an eyeball. Back part of an eye take, and the vitreous follows. Examine an eyeground, a retina, and after putting off by its forceps - and a vascular cover. Instead of a remote back part of an eye vkladyva-jut a lien or liver piece that the pupil was dark. If opening is made on Medvedev's method eyes appear on centuries from which they can be easily separated, the released orbits are examined, and their opening from a skull disappears. That it is better to be guided in in definition of the right and left eye after their extraction, it is necessary before taking eye, to note on a sclera a rod of an argentum nitricum or ink the extremities 73 Eye meridians or on an internal direct muscle to leave ku-sochek threads. If it preliminary is not made, it is necessary to use anatomic features of a back part of an eye - an attachment of tendons of a back bottom slanting muscle in relation to back long to arteries which enter into an eyeball near to an optic nerve and go on a horizontal meridian. The tendon of the bottom slanting muscle is under an external artery. If back long arteries appear through well it is possible to give to an eye its normal position and to define, what is an eye - right or left. Opening of the taken eyes is better for making two horizontal cuts, leaving the most valuable average part whole.

Since one, and then and from other angle

Since one, and then and from other angle, this flap of a skin separate together with a hypodermic fat to a mandible, all organs of a neck which can be more exhaustively investigated thus are easily and well bared. Fig. 22. Cuts on a method Medvedev for neck opening And persons. For research of jaws and the person separate a skin behind an ear, delay it together with an ear to front and dissect external acoustical passage closely at a bone. Further it is cautious by means of a knife bare voltaren emulgel jelly-z at, a mandible, the top jaw, a malar arch, completely separate mucous labiums from jaws from that and other party and cut a cartilaginous septum of a nose. Separating consistently and a forward flap of a skin of a head, for research of orbits it is necessary to allocate and eyeballs, keeping their communication with centuries and cutting optic nerves for 0,5 sm from eyeballs. The huge flap of a skin of a neck, the person and head keeps communication with at about m only in the field of a nose root. At it in this or that party there are accessible persons all to part, forward department mucous a nose and completely both jaws. Thus easily and quite sialadens, lymph nodes can be more exhaustively investigated, 66 Muscles, bones, vessels and nerves. A teeth easily can be are taken for microscopical research. Antrums of Highmore are opened with a gouge outside or from an orbit and can be completely bared and examined. For research can be any parts of bones of a facial skeleton are taken, and their defects are closed by pieces of the hypodermic fat taken from a stomach, or pieces of muscles, a liver and so forth At last, it is possible to take all facial skeleton of a skull, having replaced with its plaster cast! All places of wounds on a face skin, cicatrixes of the begun to live wounds, entrance and outlet openings of wounds, fistulas and so forth remain completely and can be tracked at skins into place and it after orientation. Thus as the mucosa of labiums, cheeks, a mouth can be more exhaustively examined, koto - usually almost never sees. Further, to organs of a mouth and survey of jaws it is possible to make for wider access in case of need exarticulation of the left joint of a mandible, crossing masseters, actually a masseter (m. masseter), a temporal muscle (. tempo ' ralis) both external and internal pterygoid muscles (mm. pterygoideus externus et internus). Now to turn away a mandible in the right party of a corpse, keeping it in this position by a dorsum of a brush or a forearm of the left arm and freely to operate with both arms.
After the termination of research a mandible establish into place.
To warn its lowering, it is possible to strengthen it , made of, about-drag, exhausting the extremities of brackets between molars, and labiums can be sewed a thin thread from within at the turned on flap. Then all dermal flap stack on a place. The skin, possessing the big elasticity, gets quite normal position. Cuts are sewn up and at position of a corpse in a coffin can be absolutely hidden, even if the neck skin will be not covered by a suit collar. It is necessary to do a plaster mask of the person before opening and soon after mors if in it there is a necessity. 5* 67 This method can be applied with success and for issle-dovanija tumours of organs of a mouth, for example, a cancer and so forth If it is necessary to investigate a neck behind, a back flap of a skin of a head, having turned a corpse prone and not making new additional cuts. Offered way we will much easier and easier execute, than a way on which cross-section continue on a back, and it is perpendicular, to it spend the second cut on an average line of a back to a vertex. Thus a skin from a neck from different directions for what it is necessary to turn a corpse that on one, on other side, kneading thus muscles and polluting a table. Independently V.I.Vitushinsky (1940) also under has developed a method of opening what is etodolac of the person. However it before to do cuts from mastoids in the slanting Direction by the top part of a neck to a median line Bodies where these cuts meet with usual a cut. It less conveniently also spoils a neck skin. Eyes at ' , and a line skins At level of eyes it turns out rough. A skin, being kept On centuries, prevents to approach to area of the nasolacrimal The channel, ' The author eliminates this obstacle a section of an orbital septum. From top to bottom the skin separates only to nose wings, and in the bottom part of the person to mouth angles. OPENING OF CAVITIES OF THE EAR For research of external acoustical passage a skin from a temporal bone forward and downwards, beginning from a cut made for opening of a skull the Dermal flap delay for an ear, and acoustical passage cross closely at a bone. It is considerably facilitated at a cut on Medvedev's method for research of the person. Now it is possible to examine cartilaginous (external) and osteal (internal) departments of external acoustical passage. The external cartilaginous department remains in connection with an auricle. For opened osteal, internal department and tympanic membrane research separate on a slice of bonds - 68 a gouge a forward wall of acoustical passage, rabo-thaw rather cautiously not to damage a tympanic membrane, and deleting a forceps slices of bones. Middle ear opening (that has the greatest value that is why and it is desirable in each case) about - Fig. 23. Opening of a bone of the basis of a skull. About, 6, v-meeto orbit openings; , d-cages of a trellised bone; in, zh-bosoms of the basic bone; and, a k-drum-type cavity of an ear. Exhaust from a skull cavity. For this purpose a gouge chop off a roof of a drum-type cavity (tegmen, tympa-ni) from a forward surface of a pyramid of a temporal bone.

Allocating a spinal cord, its all

Allocating a spinal cord, its all time needs to be held for the firm cover grasped once in the beginning of cervical department, cautiously pulling its buy ultracet online left arm up and to a head, lifting the left arm above. To drop a spinal cord thus, to incurvate it, excessively to pull, concern with its instruments or fingers it is inadmissible, as rasping manipulations conduct to deformations and the mixtures of cerebral substance doing a brain unsuitable for microscopical research. At last, at an input in the channel a cross-section dissect a firm cerebral cover and roots of a horse tail. The taken brain cautiously, not incurvating, stack on the dish covered with the wetted towel, a back surface upwards and a cervical part to itself. Keeping a forceps a firm cover, cut its small bellied scissors on all extent and then two mouse-tooth forceps move apart in the parties, baring a back surface of a brain. Having turned thebaic a brain with a forward surface up, such open a firm cover on a forward surface. Now, fixing a brain for a firm cover, cut its one movement of the acute razor in a cross-section direction on a number of segments. Cuts should be spent in intervals between roots that separate segments remained bound at their help with a firm cover. At wounds of a backbone and introduction in a spinal cord of splinters of bones to open a firm cover follows before spinal cord extraction, on a place. Having taken out a spinal cord, examine the channel, a periosteum of a back surface of bodies of vertebra,
Condition of ligaments and so forth it is possible to open the channel and in front after extraction of all organs of a neck, ' a stomach. For this purpose a post-mortem knife dissect intervertebral cartilages of III lumbar vertebra, and a gouge - its handles. Then osteal forcepses tear off a body of III lumbar vertebra. Cartilages and handles of all other vertebra further cross, going on a direction 63 To a neck and osteal forcepses tear off them, baring, thus, the spinal channel This way is technically more difficult, and at it is more often damaged , but it has that advantage, that well opens intervertebral nerve ganglions which to be there and then issledo-vany, and spinal nerves can be taken together with a spinal cord on an appreciable extent And their communication with boundary sympathetic trunks is examined At last, in case of need it is possible to take all backbone without its opening that does not represent special work (For elimination of deformations of a body wedge instead of a backbone a strong wooden stick.) On the taken backbone it is possible to make opening the channel. For this purpose saw bodies of vertebra in ^ Talcum a direction, back handles-on the one hand Such about-at once open the channel and a spinal cord-sideways and find out a parity between a backbone and a spinal cord For spinal cord bracing in a corpse do a lumbar puncture, let out a spinal liquid And enter 1-0 % formalin solution. I.D.Tsyban (1952), then Ampere-second. (1955) have offered the updatings of opening the channel. The first suggests to Cut from bodies of vertebra a sphenoidal tape, doing longitudinal a backbone, on the right and at the left receding on 1 sm from a median line The second suggests to do face-to-face bodies of vertebra at level of an attachment of heads of ribs at forward cheap colchicine edges of handles of vertebra to VII cervical vertebra. Then * the sawn off part of a backbone from cervical vertebra which remain untouched. In that and in other case the spinal channel opens insufficiently, that is obviously shown on fig. 3 at Ampere-second , It zna-chitelno interferes with spinal cord extraction COMPLEX EXTRACTION HEAD AND THE SPINAL CORD Sometimes happens it is necessary to take head and backs ths a brain, not separating them from each other In this case at first make opening of a skull and start to take a brain. However take it not up to the end, and stop on a cut cerebellar . After that a brain stack on a place, and a corpse cautiously turn prone and open the channel. Spinal cord start to take with a horse tail to cervical department. Having allocated a spinal cord, it stack on a place. Then, having raised a brain, cross remained nerves and firm cerebral about - 64 in the field of an occipital aperture then, taking in a palm a brain, cautiously take out it and through an occipital aperture extend a spinal cord. l and in and 7 OPENING OF THE FACIAL PART OF THE SKULL OPENING OF THE PERSON Here it is necessary to arrive especially cautiously. The pathologist should not suppose any cuts of a face skin not to disfigure it. In view of danger of wound of a face skin at its opening and difficulty of approaches the facial part of a skull is investigated not completely and more often its opening is not made at all, for this reason rather important pathological processes remain not studied. For full research of wounds and illnesses of jaws, an antrum of Highmore, a lead and its vessels, nerves and so forth I offer and develop the simple method accessible in any situation and absolutely not not damaging face skin (Medvedev's method). To begin it is necessary from a cut of a skin of a head for skull opening. Spend him, as always, from a mastoid of one party behind an ear, through a cinciput, to a mastoid behind an ear of other party. Further spend a cross-section immediately from the top process (asgo-mion) the left scapula, through a breast in a cross-section direction, an arch turned by concavity to a neck, at level of the second intercostal spaces, and finish symmetrically on acromion the right scapula, than it and differs from cut (fig. 28 see). Now spend a cut from a mastoid behind an ear (as it is possible ) to 5 Pathoanatomical technicians 65 acromion scapulas from one and other party on neck slopes where this cut meets final points of a cross-section. This cut, so, is continuation a cut made for opening of a skull. Thus, the dermal flap having the trapezoid form (fig. 22) turns out appreciable size.

Chapter 6 OPENING OF THE CHANNEL

Chapter 6 OPENING OF THE CHANNEL AND SPINAL CORD To open the channel it is better after skull opening, but before breast and stomach opening as At the devastated corpse this operation to make more difficultly, and before opening of the person not to crumple its skin. If necessity to open a spinal cord has arisen after opening of the person it is necessary order skelaxin to put the person in order and to sew up all cuts made at its opening as, turning a corpse, it is possible to crumple a facial flap and to disfigure the person For opening the channel behind a corpse put prone and under a thorax under-kladyvajut . 59 Rice 20-rachitome-double saw The prosector becomes to the right of a corpse, , . Takes of a usual position at a dissecting table. By a post-mortem knife does a midsection of an occipital flap of a skin and further spends a cut from an occipital hillock to the middle of a sacrum or to coccyx. This cut goes closely about acanthas from this or that party Fig. 21. -* forcepses From them. Further separates a skin with a hypodermic fat and muscles from acanthas and back handles of vertebra from both parties. After a denudation of their back handles saw a rachitome - double saw (rice 20) or have a bite coronoid rachitome (rice 21). Having established saw cloths on the distance corresponding to distance between internal and by the extremities of articulate processes of thoracal vertebra 1, put a saw on a backbone so that acanthas were between saw cloths Now, holding a rachitome for the handle the right arm, and the left arm pressing it to bones, Movements saw handles of thoracal vertebra After that saw handles of cervical and Lumbar vertebra for what it is necessary a little bit more widely 1 This distance is on the average peer 2 sm cloths according to larger
Width of Handles and the channel in cervical and lumbar departments Application of a double saw not always conveniently, as Its cloths should be established - strictly paral - * It is efficient, that mismatches anatomic relations Handles of vertebra. At pathological curvatures Backbone using it becomes impossible. Therefore it is much more convenient to use a rachitome ^ - coronoid forcepses (rice 21), perekusy - it each handle separately with one and with another The parties At last, it is possible to make and a usual sheet saw or to cross their gouge handles are cut, bitten or split by a gouge acanthas on all extent become mobile of what it is necessary to be convinced In the absence of mobility of the handle or again split , or break their cautious, but resolute blows of a hammer, putting them sideways on acanthas with that and on the other hand Thus in order to avoid occurrence of splashes from hammer blows it is necessary to cover acanthas with the dry towel folded double on length, And to beat a hammer on a towel on each side acanthas on the right and at the left After that a sheet saw saw an occipital bone from both parties, from a median line on 5 see conduct obliquely downwards - so that it has entered into edge of an occipital aperture (foramen occipitale magnum) the Back handle of an atlas should be had a bite osteal scissors or rachitome - coronoid forcepses.
Now it is necessary ligaments between vertebra. For this purpose it is recommended to dissect them between III and IV lumbar vertebra, sticking between them a knife Further, having grasped the handle II and III lumbar vertebra the osteal forcepses tearing and strong movement up and to the left tear methocarbamol robaxin off acanthas together with handles in the form of a tape from lumbar Department to cervical and on border with an atlas cut off a knife As thus to tear it is necessary up and to the left, that it is impossible to recognise convenient, we apply other way, a small post-mortem knife we cross in pove - 61 River direction lig. nuchae and membrana atlanto-occipitalis posterior. The handle of I cervical vertebra is very narrow, and between it and an occipital bone there is a big space, as facilitates operation. It is necessary to mean, that membrana atlanto-occipitalis posterior on an average line with firm cerebral, a spinal cord cover. On all other extent dura mater spinalis unlike a firm cover of a brain leaky to bones. Having parted ligament between an atlas and an occipital bone on this way, we grasp osteal forcepses acanthas of cervical vertebra and it is broken them, making jerk up and to the right, that is much more convenient. Further, cutting a firm cerebral cover at back edge of an occipital aperture, we separate the cut part of an occipital bone then the channel on all extent appears opened. -After that examine an internal surface of the taken out handles, the channel and a spinal cord covered with a firm cerebral cover. Note position and the spinal cord form, colour of a firm cover, its surface, , a strain and so forth If the spinal liquid was not is taken earlier it is possible to take it now, punctures by a syringe needle a firm cover in a lumbar part. EXTRACTION AND SPINAL CORD OPENING Strong forceps cautiously grasp a firm cerebral cover at an occipital aperture, not concerning a brain. Holding a forceps in the left arm, cautiously delay a spinal cord for a cover that in one in other party, with a scalpel separating from a clivus, and cut nervous roots out of a firm cover as it is possible more close to intervertebral foramens. If cervical department of a spinal cord to delay in the parties more strongly it is possible to extend and spinal ganglions - intervertebral nerve ganglions. If they are necessary for investigating on all extent of a backbone a gouge chop off articulate processes of vertebra from both parties and open intervertebral foramens with ganglions laying in them. 62

Through the right hemisphere

Through the right hemisphere one cut is made only; the line with a finger shows a direction of the second cut. The corpus collosum is cut in the field of columns and its right leg and cast away to the left. The worm of a cerebellum is dissect, its hemispheres are cast zanaflex online away in the parties thanks to what IV ventricle is opened. Through the left hemisphere of a cerebellum the first cut is made; black lines show a direction of the same cut of the right hemisphere and additional cuts of the left hemisphere of a cerebellum. Cross-section black lines correspond to places of a section of grey knots "the bases and to a brain part. in connection with visual hillocks by means of habenula (bridles). Write down its colour, size, measuring by a ruler; a kind on a cut; separate and weigh. Normally it of krasnovato-grey colour, is surrounded pia mater, at newborns consists of lobes. In its tissue there are calcareous kernels (cerebral sand), defined by touch. 55 7 Now grasp index and big fingers left the right leg of a crest falling to a back horn of the right lateral ventricle, dissect it from top to down and throw together with a corpus collosum, a crest and a vascular plexus to the left.
Thus completely open: a surface of the big grey knots, III ventricle and a surface . Examine and cautiously feel, finding out a consistence of these formations, and note a condition of III ventricle as it is told about the lateral After that it is possible to make face-to-face cuts the knife moistened with water through grey knots and to them white substance. For this purpose it is necessary to bring the left arm a palm up under the basis of a brain and over it to dissect a brain frontally on slices in the thickness of 0,5 sm, slightly raising a brain the left arm; thus slices easily are parted and become accessible to survey of a surface of cuts Now, having moved the left arm under the part of a brain and under a cerebellum and slightly raising them, a cut is dissected by a worm of a cerebellum but an average line - cerebellum hemispheres thus depart from each other in the parties and "IV ventricle opens. it also describe, as well as previous. It is necessary to do this cut especially cautiously not to cut a bottom of IV ventricle. For opening l - and in and a waterpipe also cautiously do a cut through . Dissect each hemisphere of a cerebellum half-and-half from a surface of a cut of a worm on an average branch arboris vitae. If necessary it is possible to spend the same additional cuts of each of half of cerebellum. At last, open a brain part with face-to-face (cross-section) cuts. For this purpose the left arm from below raise it above that cerebellum hemispheres have dispersed as much as possible in the parties and downwards. Cuts spend a scalpel, holding it as the writing feather, is possible cheap tegretol more abruptly These receptions it is possible to spend accurately cuts with legs of a brain, an oblong brain with 56 Bridges and through an initial part of a spinal cord, izvle-chennogo together with head. doing excessive damages. It is possible to open a part of a brain and from the brain basis. For this purpose result all ' in a starting position, that the way quite supposes. CL Rice 18 Cuts brain parts. /, 2, cut 3-lines, a-b-os a brainstem Having clasped arms both hemispheres of a brain, cautiously overturn its basis up and do face-to-face cuts through brain legs, the bridge and an oblong brain. In all time of opening of a brain carefully examine substance of a brain on cuts and describe a degree of wetness (moderated, strong, puffiness or dryness), (a hyperemia or an anaemia). At stagnation of blood it acts on a surface of a cut in the form of the points which are easily washed off (it they differ from hemorrhages). Further note colour of a cortex, knots and white substance, note a consistence - soft or is more dense. Note a condition of gyruses and sulcuses, a thickness of a cerebral cortex and a cerebellum. There can be protrusions or retractions, 4 hematomas, cysts, 57 Abscesses, tumours, tyromatoses and other changes. "For research brain parts horizontal cut is a little suitable, as at it the part is dissected under an acute angle to its longitudinal axis that breaks a segmentary order. Therefore for conservation of position of kernels and fascicles and the subsequent correct orientation a beam - Fig. 19. The Same, that on fig. 18, but a cut to do brain cuts perpendicularly to a longitudinal axis (fig. 18 and 19) a brainstem (oblong see, average and intermediate). It can be reached, doing three cuts preliminary fixed, but not deformed brain: I - through border the bridge and an oblong brain in a direction to fiss calcarinae; II - in parallel this cut behind corpora mammillaria through brain legs to the top third fiss parietooccipitale; III-also in parallel these cuts ahead and behind forward branches sulcuses through forward parts of visual hillocks The brain can be fixed and before skull opening, filling in it of 10 % formalin solution through carotids. It is possible to recommend this way especially 58 For children's corpses as the brain of children is extremely gentle also unstable easily breaks up. Pituitary body usually investigate separately. Having written down its configuration, the sizes and weight, make its opening that is recommended to do by two parallel cuts in a frontback direction sideways from a funnel. the cut through a funnel spoils an organ that for microscopical research its most valuable average part will be lost. a gland (glandula pinealis s. epiphisis cerebri) lays over lobbies under the platen of a corpus collosum at a back wall of III ventricle and it is bound to visual hillocks a leg or a bridle (habenula). It well opens at a horizontal cut of a brain on . At children it is larger, than at adults, and at women is larger, than at men. Its involution comes already at seven-year age. At its tissue often there are calcareous adjournment.