By Frank Sellke MD, Pedro J. del Nido MD, Scott J. Swanson MD
For entire, authoritative insurance of each point of thoracic and cardiac surgical procedure, flip to the exceptional counsel present in Sabiston and Spencer surgical procedure of the Chest, ninth Edition. Now in full-color for the 1st time, Drs. Frank W. Sellke, Pedro J. del Nido, and Scott J. Swanson’s standard-setting two-volume set is meticulously prepared that you should speedy locate specialist details on open and endoscopic surgical suggestions played within the working room. With its comprehensive insurance of thoracic in addition to grownup and pediatric cardiac surgery, this ninth version is a necessary source not just for all thoracic surgeons, but in addition for physicians, citizens, and scholars curious about illnesses of the chest.
- Find what you would like speedy with brief, targeted chapters divided into 3 significant sections: grownup Cardiac surgical procedure, Pediatric Cardiac surgical procedure, and Thoracic Surgery.
- Benefit from the wisdom and services of world specialists who supply a finished view of the full specialty.
- Master all of an important present wisdom and methods in cardiac and thoracic surgery―whether for area of expertise board evaluate or daily surgical practice.
- Visualize difficult surgical thoughts and methods and navigate the textual content extra successfully because of an all-new, full-color design.
- Stay modern with revised or all-new chapters including severe take care of War-related Thoracic surgical procedure; Neuromonitoring and Neurodevelopment results in Congenital center surgical procedure; and caliber development: Surgical Performance.
- Keep abreast of cutting-edge issues such as endovascular stenting and cell-based treatments, in addition to the newest recommendations in imaging and prognosis, minimally invasive cardiothoracic surgical procedure, and percutaneous devices.
- Sharpen your surgical abilities with entry to 21 procedural video clips online, together with three new movies protecting Surgical Technique-VATS Sympathetic Block; Open pneumothorax; and quantity II fix of thoracoabdominal aortic aneurysm.
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Additional info for Sabiston and Spencer Surgery of the Chest: 2-Volume Set, 9e
The fibers run downward and backward, similar to the internal intercostal muscles. The subcostal muscles lie in the paravertebral gutter, are better developed inferiorly, and cross more than one space. The transversus thoracis was formally called the sternocostalis, a more appropriate name. Digitations arise from the sternum bilaterally to the costal cartilages of ribs 2–6. The intercostalis intimi muscles also traverse more than one space and are better developed in the lower lateral spaces. 8 TABLE 1-1 -- Attachments and Innervation of the Muscles of the Thoracic Wall Muscle Proximal attachments Distal attachments Innervation Pectoralis major sternocostal head Half of sternum, costal cartilages 1–6, aponeurosis of external obliquus muscle Lateral lip of intertubercular sulcus of humerus Medial pectoral nerve (C8–T1) Pectoralis major clavicular head Medial half of clavicle Lateral lip of intertubercular sulcus of humerus Lateral pectoral nerve (C5, 6, 7) Pectoralis minor Ribs 3–5 Coracoid process of scapula Medial pectoral nerve Subclavius First rib Medial clavicle Nerve to subclavius (C5–6) Deltoid Lateral third of clavicle, acromion, and spine of scapula Deltoid tuberosity of humerus Axillary nerve (C5–6) Serratus anterior Angles of superior 10 ribs Medial border of scapula Long thoracic muscle nerve (C5, 6, 7) Supraspinatus Supraspinous fossa of the scapula, fascia of trapezius Greater tubercle of the humerus Suprascapular nerve (C5) Infraspinatus Infraspinous fossa Greater tubercle of the humerus Suprascapular nerve Subscapularis Costal surface of the scapula Lesser tubercle of the humerus and its crest Upper (C5–6) and lower (C5, 6, 7) subscapular nerve Latissimus dorsi Spinous processes of T7–12, L1–5, S1–3 vertebrae, posterior part of iliac crest, lower 3–4 ribs Crest of the lesser tubercle and floor of the intertubercular groove of the humerus Thoracodorsal nerve (C6–7) Serratus posterior inferior Spines of C6–T2 vertebrae Angles of ribs 2–5 Segmental intercostal nerves Serratus posterior superior Spine of T11–L2 vertebrae Lower border of ribs 9–12 Segmental intercostal nerves Trapezius Ligamentum nuchae, external occipital protuberance, thoracic vertebral spinous processes Lateral one third of clavicle, acromion process along spine of scapula Spinal accessory nerve Levator scapulae Transverse process of C1, 2, 3, 4 cervical vertebrae Medial border of scapula, superior angle to base of scapular spine Dorsal scapular nerve (C5) Rhomboid major and minor Spinous processes of C7–T5 and supraspinous ligaments Medial border of scapula up to the inferior angle Dorsal scapular nerve (C5) Teres major Lower lateral border of the scapula Crest of the lesser tubercle of the humerus Lower subscapular nerve (C5, 6, 7) Teres minor Mid to upper lateral border of the scapula Greater tubercle of the humerus Axillary nerve (C5–6) Figure 1-6 Spatial organization of the thoracic wall on the right side.
The superior segmental bronchus to the lower lobe arises from the posterior wall of the bronchus intermedius as it terminates into the basal stem bronchus that sends off segmental bronchi to the medial, anterior, lateral, and posterior basal segments. The medial basal segment arises anteromedially while the lateral basal and posterior basal most often arise as a common stem. The longer left principal bronchus appears to bifurcate into the upper lobe bronchus that arises anterolaterally and the lower lobe bronchus continues posteromedially.
A, Axial contrast-enhanced chest CT demonstrates contrast located in a pouch (arrows) beside the descending aorta (arrowhead) consistent with traumatic injury and pseudoaneurysm. B, Aortogram confirms CT finding of aortic transection (arrows). Figure 2-4 Tracheal rupture after motor vehicle accident in a patient with no respiratory symptoms and a chest radiograph demonstrating pneumomediastinum. 5-mm collimation) show pneumomediastinum and discontinuation of the trachea (arrows). Figure 2-5 Focal stenosis of the right mainstem bronchus from invasive aspergillosis.