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Pre-staircase space. Topography of the pre-staircase space. Venous angle of Pirogov. Vessels of the prestage space. Nerves of the prestalis space.
Between the deep (posterior) surface of the lower half of the sternocleidomastoid muscle with its fascial sheath and the anterior scalene muscle, covered by the 5th fascia, is formed pre-staircase space, spatium antescalenum.
Its anterior wall also includes the pretracheal plate of the neck fascia (3rd fascia). Thus, pre-staircase space bounded in front by the 2nd and 3rd fascia, and behind by the 5th fascia of the neck.
The carotid neurovascular bundle is located medially. The internal jugular vein lies in the preallocular space not only lateral to the common carotid artery, but also somewhat anteriorly (superficial).
In the pre-lagoon space its bulb (lower extension), bulbus venae jugularis inferior, connects to the subclavian vein that is suitable from the outside. The vein is separated from the subclavian artery by the anterior scalene muscle.
Venous angle of Pirogov
Immediately outward from the confluence of these veins, called Pirogov venous angle, the external jugular vein flows into the subclavian vein. On the left, the thoracic (lymphatic) duct flows into the venous angle. Connected v. jugularis interna and v. subclavia give rise to the brachiocephalic vein. The suprascapular artery, a suprascapularis, also goes through the pre-scapular gap in the transverse direction.
Thus, in the pre-stairway the carotid neurovascular bundle, subclavian vein, thoracic duct (left), external jugular vein and suprascapular artery are located. Here, on the front surface of the anterior scalene muscle, item phrenicus is visible, but it lies already under the 5th fascia.
PIROGOV VENOUS ANGLE
(n. and. pies) see Venous angle.
Medical terms. 2012
See also the interpretation, synonyms, meanings of the word and what is PIROGOV'S VENOUS ANGLE in Russian in dictionaries, encyclopedias and reference books:
- INJECTION in the Essential Guide to Weapons:
RISE - the angle between the direction of the flight axis of the projectile and the lift of the barrel. Varies from 0 to 90 e ... - INJECTION in the Dictionary of Russian Railway Slang:
car traffic transferred from one system grade. station to another by means of transfers (from 1-2 to 8-10 per ... - INJECTION in the Thieves Jargon Dictionary:
- … - INJECTION in the Dictionary of Economic Terms:
(slang.) - monopoly behavior of the company, consisting in controlling the volume of the aggregate supply of goods; in this case, the price can rise until the appearance of ... - INJECTION in the Biblical Encyclopedia of Nicephorus:
The aforementioned word is often found in the Holy. Scripture in its ordinary sense (2 Chronicles 28:24); but it is often used allegorically as well. So … - INJECTION in the Big Encyclopedic Dictionary:
(flat) geometric figure formed by two rays (sides of an angle) emanating from one point (apex of an angle). Every corner with a vertex in the center ... - INJECTION in the Great Soviet Encyclopedia, TSB:
flat, geometric figure formed by two rays (sides Y.), emerging from one point (top Y.). Any U. with a vertex in the center ... - INJECTION in the Encyclopedic Dictionary of Brockhaus and Euphron:
(mat.). - If we draw straight lines OA and 0B from point O on this plane, then we get the angle AOB (Fig. 1). ... - VENOUS
related to a vein or located in a vein (for example, venous ... - VENOUS in the Encyclopedic Dictionary:
oh, oh Related to veins, veins. Venous ... - INJECTION in the Encyclopedic Dictionary:
, corner, about the corner, on (in) the corner, m 1. (in the corner.). In geometry: a flat figure formed by two rays (in 3 ... - VENOUS in the Encyclopedic Dictionary:
cm. … - INJECTION
́ ANGLE OF DIELECTRIC LOSSES, the angle on which the electric vector. induction in the medium lags behind the voltage vector of the alternating electric. fields. Characterizes the dielectric. ... - INJECTION in the Big Russian Encyclopedic Dictionary:
́ ANGLE OF ATTACK, the angle between the direction of the speed of the translational movement of the body and c.-l. a characteristic direction chosen on the body, for example. at the wing - ... - INJECTION in the Big Russian Encyclopedic Dictionary:
́ ANGLE (flat), geom. a figure formed by two rays (sides Y.) emanating from one point (top Y., Fig. a). Every U. ... - INJECTION* in the Brockhaus and Efron Encyclopedia:
(mat.). ? If we draw straight lines OA and 0 B from point O on this plane, then we get the angle AOB ... - INJECTION
y "goal, angles", angle ", angle" in, angle ", angle" m, y "goal, angles", angle "m, angle" mi, angle ", angle" x, ... - VENOUS in the Complete Accentuated Paradigm by Zaliznyak:
veno "knowing, veno" knowing, veno "zealous, veno" zealous, veno "zealous, veno" hot, veno "zealous, veno" zealous, veno "zealous, veno" hot, veno "zealous, veno" zealous, veno " knowing, vein "I know, vein" hot, vein "zealous, vein" zealous, vein "I know, vein" hot, vein "zealous, ... - INJECTION in the Popular Explanatory and Encyclopedic Dictionary of the Russian Language:
angle "a, z" a angle, n "a angle, about angle" e, into angle "y and into angle" e, into angle "y, m. 1) (into angle" e) In mathematics: ... - INJECTION
Sometimes it's stupid, but if it's straight, then ... - INJECTION in the Dictionary for solving and compiling scanwords:
Two lines ... - INJECTION in the Thesaurus of Russian Business Vocabulary:
- VENOUS in the New Dictionary of Foreign Words:
(Latin venosus) adj. from sl. vein; related to the vein or located in it, for example, in the th ... - VENOUS in the Dictionary of Foreign Expressions:
[lat. venosus] adj. from sl. vein; related to the vein or located in it, for example, in the th ... - INJECTION in the Thesaurus of the Russian language:
‘Geometric figure’ Syn: vertex, angular ... - INJECTION in Abramov's Dictionary of Synonyms:
|| head of the corner, around the corner, bearish corner, endless corner, all over ... - INJECTION
geometric figure Syn: vertex, angular ... - VENOUS in the dictionary of Synonyms of the Russian language:
military, ... - INJECTION
1. m. 1) a) A geometric figure formed by two straight lines emanating from one point (in mathematics). b) The part of the plane enclosed between ... - VENOUS in the New Explanatory Dictionary of the Russian Language by Efremova:
adj. 1) Corresponding by value. with noun: Vienna, associated with it. 2) Peculiar to the vein, characteristic of ... - VENOUS in the Dictionary of the Russian language Lopatin.
- INJECTION in the Complete Spelling Dictionary of the Russian Language:
angle, angle, offer at (at) the corner and (mat.) at ... - VENOUS in the Complete Spelling Dictionary of the Russian Language.
- INJECTION in the Spelling Dictionary:
`angle, angle`a, sentence in (on) angle and (mat.) in ... - VENOUS in the Spelling Dictionary.
- INJECTION
locality (usually remote) In a remote corner. Bearish y. (backwater). angle In geometry: a flat figure formed by two rays N3 emanating from ... - VENOUS in the Ozhegov Russian Language Dictionary:
<= … - ANGLE in Dahl's Dictionary:
husband. fracture, fracture, knee, elbow, protrusion or hall (depression) about one face. The angle is linear, all sorts of two opposite lines and a gap ... - INJECTION in the Modern Explanatory Dictionary, TSB:
(flat), a geometric figure formed by two rays (sides of an angle) emanating from one point (apex of the angle). Every corner with apex at ... - INJECTION
angle, about the angle, on (in) the corner and (mat.) in the angle, m. 1. Part of the plane between two straight lines emanating from ... - VENOUS in the Explanatory Dictionary of the Russian Language by Ushakov:
venous, venous (anat.). Adj. to Vienna. Venous ... - INJECTION
angle 1. m. 1) a) Geometric figure formed by two straight lines emanating from one point (in mathematics). b) The part of the plane enclosed by ... - VENOUS in the Explanatory Dictionary of Efremova:
venous adj. 1) Corresponding by value. with noun: Vienna, associated with it. 2) Peculiar to the vein, characteristic of ... - INJECTION
I m. 1. Geometric figure formed by two straight lines emanating from one point (in mathematics). Ott. The part of the plane, enclosed between two ... - VENOUS in the New Dictionary of the Russian Language by Efremova:
adj. 1.rel. with noun vein associated with it 2. Peculiar to the vein, characteristic of ... - INJECTION
I m. 1. Geometric figure formed by two straight lines emanating from one point (in mathematics). 2. Part of the plane, ... - VENOUS in the Big Modern Explanatory Dictionary of the Russian Language:
adj. 1.rel. with noun veins associated with it; coronary II 1 .. 2. Characteristic of veins, characteristic of ... - PIROGOV'S BANDAGE in Medical terms:
see Pirogov bandage ... - PIROGOV'S VEST BANDAGE in Medical terms:
see Pirogov bandage ... - PIROGOV SPACE in Medical terms:
(n. and. pies) see Parony - Pirogov ... - STEAM-PIROGOV SPACE in Medical terms:
(f. parona, italian surgeon of the 19th century; n. and. pirogov, 1810-1881, edematous surgeon; syn. pirogov space) cellular space in the lower third ... - LYMPHATIC NODE OF PIROGOV in Medical terms:
Rosenmüller - see Pirogov - Rosenmüller lymphatic ...
G.I. Songolov, O.P. Galeeva, V.P. Shevtsov
State Medical University, Irkutsk
Summary
The material on syntopy of the cervical thoracic lymphatic duct is systematized in relation to its use for detoxification in cholangitis, pancreatitis, peritonitis. Variants of the structure and relationship of the thoracic lymphatic duct with the anatomical structures of the left venous angle of Pirogov, including the lymph nodes and the left stellate node, were revealed. A clear knowledge of the peculiarities of the relationship of these structures will increase the efficiency and reliability of drainage and reduce the risk of intraoperative injury.
In resuscitation practice, drainage of the thoracic lymphatic duct is widely used in order to detoxify the body in various pathological conditions. The study was undertaken with the aim of topographic and anatomical substantiation of effective and safe lymphosorption. In the literature, there are reports of damage to the thoracic lymphatic duct and with a number of other surgical procedures, including anesthetic. The implementation and successful completion of many operations on organs and formations of the neck requires from the surgeon a clear understanding of the topographic features, taking into account the options for the inflow of the thoracic lymphatic duct into the venous system.
Material and methods
The work was performed on 50 fresh corpses of both sexes aged from 21 to 83 years. A universal method of anatomical preparation was used, followed by sketching by the method of glass-printing and making dioptograms. Macro preparations of the venous angle with the arch of the thoracic lymphatic duct and lymph nodes were prepared. We also used stereotopometric and reconstructive methods.
Results and discussion
We see the purpose of the message not in presenting comprehensive information about the thoracic lymphatic duct in the anatomical aspect, but in elucidating those issues that have clinical significance. The venous angle of the neck (Pirogov's angle) is located behind the sternocleidomastoid muscle in the prescalternary cellular space in the vascular sheath formed by the 4th fascia of the neck. Many venous collectors flow into the area of the venous angle and their syntopy is extremely complex, which makes it difficult to identify the elements of this area during operations. So, the thoracic lymphatic duct coming from the left scalene-vertebral triangle, the external jugular vein, penetrating sequentially from the outside of the 2nd and 3rd fascia of the neck, the vertebral vein following from the back to the front through the 5th fascia, and also transverse and suprascapular veins passing from the interstellar space of the lateral triangle of the neck.
The cervical part of the thoracic lymphatic duct above the upper aperture of the chest forms a lymphatic arch, facing upward and extending into the layer of loose paravasal tissue. From the gap between the left common carotid and subclavian arteries, the duct follows laterally into the space between the vertebral artery from behind and the internal jugular vein in front and, having formed an extension - the lymphatic sinus, flows into the left venous angle. We have noted various variants of the structure and confluence of the terminal section of the thoracic lymphatic duct into the venous angle and the veins forming it. The individual anatomical variability of the studied structures was manifested as follows: at the place of confluence, by the number of orifices, by the height of the position of the arch and its sitopia with deep cervical lymph nodes.
- At the place of confluence. The thoracic lymphatic duct flows directly into the venous angle (30 cases), into the subclavian vein (14 cases), and into the internal jugular vein (6 cases).
- By the number of orifices. The thoracic lymphatic duct opens with one trunk (35 cases), two branches (8 cases), three branches (5 cases) and four (2 cases). With the Mongorian confluence, lymph enters both the venous angle itself and the veins that form it. This is of clinical importance, since with this form, the likelihood of damage to the duct is higher and in this case it becomes necessary to bandage all branches to prevent lymphorrhea.
By position height. We distinguish the high position of the thoracic lymphatic duct - 1 cm above the upper contour of the brachiocephalic vein (level V of the cervical vertebra), typical - up to 1 cm (level VI of the cervical vertebra), low - at or below the upper edge of the same vein (level VII of the cervical vertebra ). The low position of the arc of the thoracic lymphatic duct, we refer to the closed variants of its syntopy. It is difficult to find, identify and drain the duct, but at the same time it "conserves" the duct when removing deep cervical lymph nodes in laryngeal cancer. All other options should be considered open source. In these observations, we deduced the following syntopy of the thoracic lymphatic duct and lymph nodes. Most often, from 2 to 4 deep cervical lymph nodes are directly adjacent to the arch, which are connected with it by collectors with a length of 3 to 6 mm and a diameter of up to 1 mm. In the relationship between the lymph nodes and the thoracic lymphatic duct, we distinguish 4 options: 1) the nodes are located just in front of the duct - 11 cases; 2) only behind the duct - 9 cases; 3) only over the arc - 16 cases; 4) mixed - 14 cases. Lymph nodes are concentrated mainly along the descending knee of the thoracic lymphatic duct arch.
The arch of the thoracic lymphatic duct is located differently in relation to the left stellate node. It is located above him (36 cases), below him (5 cases), lateral (8 cases). In one case, the branches of the sympathetic cervical trunk looped around the arc. In addition, situations should be identified when lymphatic ducts autonomously flow into the venous angle, draining certain regional areas of the head, neck and chest. Thus, a clear knowledge of the features of the architectonics and topography of the thoracic lymphatic duct will reduce the risk of intraoperative damage to the latter.
Literature
- Briskin B.S., Yatsenko A.P., Filonov A.V., Fukalova G.I. Lymphosorption in the treatment of patients with hepatic insufficiency and jaundice. Grekov. - 1986. - v.136 - №1. - with. 40-45.
- Kukushlin A.A., Menshikov V.M., Petrov I.I. Experience of drainage of the lymphatic duct and lymphosorption // Bulletin of surgery im. Grekov. - 1990 .-- v. 144. - No. 4. - with. 17-26.
- Lopatkin N.A., Lopukhin Yu.M. Efferent methods in medicine. - M .: Medicine, 1989 .-- 174p.
- Lopukhin Yu.M., Molodenkov M.N. Hemosorption // Efferent therapy - v.2. - No. 4. - M. - 1996 .-- p. 12-14.
- Lubotsky D.N. Fundamentals of Topographic Anatomy. - M .: Medgiz., 1953 .-- 320s.
- Panchenkov R.T., Vyrenkov Yu.E., Yaresha I.V., Uretaev B.M. Lymphosorption. - M .: Medicine, 1982 .-- 240p.
- Khakimov G.A., Shishkina N.I. Lymphosorption in the complex of preoperative preparation of patients with obstructive jaundice // Healthcare of Tajikistan. - 1988. - No. 5. - p. 33-36.
Pirogov venous angle (N.I. Pirogov)
1. Small medical encyclopedia. - M .: Medical encyclopedia. 1991-96 2. First aid. - M .: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M .: Soviet encyclopedia. - 1982-1984.
See what "Pirogov's venous angle" is in other dictionaries:
- (N.I. Pirogov) see Venous angle ... Comprehensive Medical Dictionary
Comprehensive Medical Dictionary
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