File:The breast- its anomalies, its diseases, and their treatment (1917) (14570264690).jpg

Identifier: breastitsanomali00deav (find matches)
Title: The breast: its anomalies, its diseases, and their treatment
Year: 1917 (1910s)
Authors: Deaver, John B. (John Blair), 1855-1931
Subjects: Breast Breast X-rays Breast Diseases Breast Neoplasms Radiotherapy
Publisher: Philadelphia, P. Blakiston's Son & Co
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.

Text Appearing Before Image:
refore directly continuouswith the pre-vertebral layer of the deep cervical fascia. The practical importance of aknowledge of this relationship will be shown in the description of the axillary lymphnodes. Infra-clavicular Triangles.—The space beneath that portion of the clavicle internalto the anterior edge of the deltoid muscle and under cover of the clavicular head of the 32 THE BREAST pectoralis major muscle is subdivided into two triangles by the costo-coracoid membrane.The anterior of these, the superficial infra-clavicular triangle, not infrequently containsseveral small lymph nodes, which, as Poirier has shown, receive vessels from the uppersegment of the breast. Grossman and Schmidt have demonstrated lymphatic vesselsarising in the deep portion of the breast that reach this group of nodes by piercing thepectoralis major muscle and running upward in the clavi-pectoral fascia. The super-ficial triangle is traversed by the cephalic vein, the acromio-thoracic artery and vein and
Text Appearing After Image:
Fig. 15.—Superficial infra-clavicular triangle. The clavicular portion of the pectoralis major musclehas been reflected. The costo-coracoid membrane is thus exposed together with the vessels and nerveswhich pierce this structure. the external anterior thoracic nerve, all of which pierce its floor—the costo-coracoid mem-brane—to enter the deep infra-clavicular space or triangle. The posterior of these spaces, the deep infra-clavicular triangle, the apex of the axillaor the space of Morenheim, as it is variously called, can be fully exposed by removing thesternal portion of the pectoralis major muscle and the costo-coracoid membrane. Theexposure of this space in the operation for mammary carcinoma is of paramount im-portance because it lodges the subclavian lymph nodes, which are especially liable toescape removal owing to their sheltered position, which communicate with all of the SURGICAL ANATOMY OF THE BREAST 33 other axillary sub-groups of lymph nodes and which may, as Stiles

Note About Images