By Karuna K. Chatterji
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Extra info for A Handbook of Operative Surgery and Surgical Anatomy. With Chapters on Instruments
17. INCISIONS F O R LIGATINO R I G H T RADIAL AND ULNAR A R T E R I E S , AND S U P E R F I C I A L AND D E E P PALMAR ARCHES :—A. Ligation of radial in upper third of forearm ; B, of radial in middle third ; C, of radial in lower thiril ; D, of deep palmar arch ; E, Ligation of ulnar in middle third of forearm ; F, of ulnar in lower third ; G, of superficial palmar a r c h : H, Center of bend of elbow; I, Antoro-internal aspect of styloid process of radius ; J, Radial side of pisiform bone ; K, Anterior aspect of inner condyle of humérus ; L, Point on inner aspect of forearm a t junction of upper and middle thirds.
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 . If the carotid sheath and its contents are gently retracted outwards (laterally) t h e inferior thyreoid is found lying behind. Pass the aneurysm needle from without in, taking great care to avoid the recurrent laryngeal nerve which lies posteriorly and crosses the vessel. LIGATION OF THE LINGUAL ARTERY INDICATIONS (1) Preliminary to excision of the tongue.
Comment :—While using the trephine avoid injuring the dura, brain or the artery by manipulating this instrument and the elevator cautiously. LIGATION OF THE COMMON CAROTID ARTERY INDICATIONS The common carotid is ligatured : (1) in cases of aneurysm of the innominate, the internal carotid and the cerebral arteries ; (2) to control haemorrhage from the face and neck : (3) for pulsat- 28 ing and the so-called idiopathic exophthalmos ; (4) as a preliminary measure to removal of tumours ; (5) for elephantiasis of the face ; (6) for epilepsy.
A Handbook of Operative Surgery and Surgical Anatomy. With Chapters on Instruments by Karuna K. Chatterji