Introduction into the dissection course · • area radicularis (dermatome) –skin area supplied...
Transcript of Introduction into the dissection course · • area radicularis (dermatome) –skin area supplied...
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Introduction
into the dissection course
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Organization rules – main poitns
• Entry into the dissection room is only allowed for staffand students of the Second Faculty of Medicine.
• Before entering the dissection room is necessary to take white coat and change shoes.
• Eating, drinking or smoking is prohibited inside ofdissection room!!!
• Taking pictures or videos is strictly prohibited!!!
• We recommend to use gloves.
• Autopsy waste, gloves and interchangeable blades ofscalpel is only thrown into each specially markedcontainers.
• Every injury is reported to the appropriate teacher.
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Cleaning
• Autopsy waste, gloves and interchangeable
blade of scalpel is only thrown into each
specially marked containers.
• Cleaning takes place continuously and then the
end of every day
• Each table is covered with a wet cloth and then
plastic sheet
• Pay attention to so called “urn bodies” – will be
explained later.
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Instruments – tweezers/forceps
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Instruments - scalpel
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Instruments - scalpel
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Instruments - scalpel
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Instruments - scalpel
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Instruments - scalpel
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Instruments
tweezers abnd scissorsanatomicaltweezers
straight blunt or straight sharp-blunt scissors
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Instruments – scapel
scalpel with changable blade
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Instruments – scapel
separate handle and changeable blade
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Instruments – scapel
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Instruments – scapel
wrongly fit blade
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Nástroje – skalpel
well fit blade
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Skin sections
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Veins of UL
• superficial system
• deep system
- accompany arteries
- doubled up to axilla
- frequent connections
around artery
- frequent valves
• v. subclavia
– small tributaries only
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Superficial veins of UL
• v. axillaris
– v. cephalica
– vv. thoracoepigastricae
– vv. costoaxillares
• v. brachialis (doubled)
– v. basilica
v. mediana cubiti + antebrachii
rete venosum dorsale manus
rete carpi dorsale
vv. intercapitulares
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Variations of connections of superficial veins within fossa
cubitalis
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Superficial veins of UL
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Veins of lower limb
• superficial system
– compartimentum saphenum
• deep system
- accompany arteries
- doubled up to fossa poplitea
- frequent connections
around artery
- frequent valves
• systema venosum laterale
(Albanesei)
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Vena saphena magna
• confluens venosus
subinguinalis
• valvula terminalis +
preterminalis
• v. s. m. accessoria
– ant., post., superficialis
• v. circumflexa femoris ant.,
post.
• runs with n. saphenus
• ultrasound: „Egyptian /
Cleopatra‘s eye“
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Ultrasound image of vena saphena
magna
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Confluens venosus subinguinalis
clinical term „Crosse“
= terminal portion of VSM bordered with valves
• v. epigastrica superficialis
• v. circumflexa ilium superficialis
• v. pudenda externa superficialis
• v. saphena magna accessoria anterior et
posterior
• crossectomy
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Topography of
VSM• compartimentu
m saphenum
• hiatus saphenus
• trigonum
femorale
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Vena saphena parva
• valvula terminalis + preterminalis
• v.s.p. accessoria superficialis
• extensio cranialis venae saphenae parvae (obsolete „v. femoropoplitea)
• runs with n. suralis
venae intersaphenae
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Venae perforantes
Transfascial connections = Perforators
• first drawn by
Leonardo da Vinci
• interconnect deep
(80% of blood) and
superficial systems
• contain valves
• insufficient valves
→ varices
• 6 groups according
to position
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Venae perforantes
• simple, double or multiple
• run with small artery and cutaneous nerve (Staubesand‘s triad)
• 6 groups: foot, ankle, leg, knee, thigh, buttocks
• eponyms: Cockett, Boyd, Dodd
• e.g.: venae perforantes cruris posteriores tibiales = Cockett‘s perforators– interconnect v.s.m. accessoria
posterior and venae tibiales posteriores
– 18.5, 13.5 a 7 cm proximal to sole
4-mm tibial perforator
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Sensory skin innervation
• area radicularis (dermatome)– skin area supplied by 1 radix spinalis (from 1
spinal segment)
• area nervina– skin area supplied by 1 peripheral sensory
nerve (usually from more spinal segments)
• area radicularis visceralis– Internal organ area supplied by
viscerosensory nerves of 1 spinal segment
• Head‘s zone– segmental projection of sensitivity from organs
to the certain skin areas
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Dermatom
e
skin area supplied
by one spinal
nerve (from one
spinal segment)
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Sensory
innervation
of upper
limb
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Sensory
innervation
of lower
limb
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Podkoží
HKSubcutanoues
layer of UL
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Kožní inervace HK
Skin innervation of UL
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Podkoží DK
Subcutanoues
layer of LL
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Kožní
inervace HK
Skin
innervation of
LL