A Handbook of Operative Surgery and Surgical Anatomy: With by Karuna K. Chatterji

By Karuna K. Chatterji

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COURSE AND D I S T R I B U T I O N OF T H E INTERCOSTAL REPRODUCED FROM DAVIS' APPLIED ANATOMY liy the Courtesy of THE J. B. LIPPISCOTT CO. To face paye 3

BLOOD SUPPLY OF T H E FAUCIAL TONSIL. REPRODl CED FROM DAVIS' APPLIED By the Courtesy of THE J. />*. LIPPINCOTT To face paye HH. ANATOMY CO. 33 gland laterally to the medial border of the sterno-cleido-mastoid muscle. Divide t h e skin, platysma and deep fascia, retract t h e sterno-cleido-mastoid outwards (laterally) and the sterno-thyreoid inwards (medially). The carotid sheath is now exposed on t h e outer (lateral) p a r t of the wound and t h e thyreoid gland in, t h e inner (medial) p a r t .

The circular piece of bone is raised by an elevator and removed. The artery is seen lying on the dura mater with its vein. I t is separated from the dura, and the aneurysm needle passed so as to include the two veins with the artery. I n some cases it will be found necessary to pass a fully curved threaded needle through the dura mater under the artery. The split fibres of the temporal muscle are allowed to come together and close the trephine hole and the scalp flap allowed to return. Comment :—While using the trephine avoid injuring the dura, brain or the artery by manipulating this instrument and the elevator cautiously.

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