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).