Operative surgery and topographic anatomy of the hand manual. Operative surgery and topographic anatomy
Educational literature
for medical students
OPERATIONAL
SURGERY
AND TOPOGRAPHICAL
ANATOMY
Edited by
Academician of the Russian Academy of Medical Sciences V.V. Kovanov
medical institutions and personnel policy
Ministry of Health of the Russian
Federations as a textbook for students
medical schools
Foreword
Operative surgery and topographic anatomy
mia is a dual applied science that studies
mutual arrangement of organs in various
in the fields of the human body and the ways and rules to perform
niya of surgical operations.
Of course, knowledge of topographic anatomy
necessary not only for the implementation of surgeons
medical treatment: prior to this, the surgeon must establish
make the correct diagnosis, accurately determine the location
occurrence of the pathological process. These
knowledge is also necessary for doctors of any other
specialty, because to get the right
understanding of the source of the pathological
process and ways of its further dissemination
niya need to clearly know the location of each
organ in relation to parts of the body, skeleton, other
gim organs, to imagine the depth of the location
organ, its relation to those passing nearby
large vessels and nerves, etc. In other words,
the doctor should without x-ray examination
niya as if "seeing the patient through".
Founder of topographic anatomy,
to the greatest Russian surgeon Nikolai Ivano
vich Pirogov (1810-1881) belong to the following
words: “The highest reward for me, I
I would consider the conviction that I managed to prove
our doctors that anatomy is not one
only the ABC of medicine, which can be without labor
warehouses, but that its study is also necessary
for a beginner to learn, as well as for those who
entrusted with the life and health of others "(from Sevasto
Polish letters and memoirs).
The need for such a science arose in connection with
with the rapid development of surgery at the end of XVIII -
early 19th century Despite some success,
achieved in surgery, has become increasingly necessary
gait in more extensive knowledge of anatomy
missions. It is no coincidence that before N.I. Pirogov with questions
applied (surgical) anatomy abroad
usually performed by surgeons who supervised
at the same time the departments of anatomy. Among them
such famous English surgeons and anatomists
XVIII-XIX centuries, as N. Thompson, W. Cowper,
A.R. Cooper, J. Hunter. In France, J. Petit read
course in anatomy and surgery in Paris, A. Velpeau
published a guide to surgical anatomy with
atlas; anatomy and surgery
Ch. Chassaignac, R. Sabatier, F. Chopart, L. Farabeuf.
In Italy, A. Scarpa headed the Department of Anatomy
and surgery in Pavia, a well-known surgeon in Germany
R. Volkmann was a good anatomist.
In Russia, the study of applied anatomy for
were taken by P.N. Savenko and especially I.V. Buyal-
sky (1789-1866) - a brilliant student and after
the teacher of the famous surgeon I.F. Bush, great
stucco diagnostician and virtuoso surgeon. At the same
time he was an excellent connoisseur of anatomy.
In 1833 he was elected head of the Department of Ana
volumes of the Medico-Surgical Academy, which
he led until 1844 I.V. Buyalsky left
after him the works that brought him world fame.
In 1828 he released "Anatomical and Surgical
tables explaining the production of dressings
large arteries drawn from life and you
engraved on copper, with a brief anatomical
kim description of these and an explanation of production
va operations. In 1835 and 1852 were published 2nd and
3rd part of tables. It was the first in Russia
ginal atlas of operative surgery. By
technique of execution and completeness of presentation of the atlas in
that time was unparalleled among the leadership
neither in Russia nor in Western Europe.
It should also be noted that I.V. Buyalsky
did a lot to create a surgical
domestic production tools. He
supervised the first in Russia Surgical Institute
tool factory.
However, most manuals, atlases and
sunkov of that time was, rather,
descriptive anatomy dataset, in some
in some cases distributed by regions. And
only N.I. Pirogov in classical works
united this disparate information into a new science,
having own goals, tasks and methodology
gyu. It was the genius of Pirogov who managed to combine
"live" surgery with "dead" anatomy.
Nikolai Ivanovich Pirogov - graduate
Faculty of Medicine, Moscow University,
which he entered in 1824 at the age of 14 and
graduated at the age of 18, in 1828. By this time, with
Dorpat University (Tartu) was organized
Professorial institute for the training of professors
litters from "natural Russians", having successfully completed
our universities and who have expressed a desire to dedicate
engage in scientific and pedagogical activities (about
the image of the current graduate school). N.I. Pirogov passed
special exams at the Academy of Sciences in St. Petersburg
ge and was enrolled in the Professor's Institute.
In Dorpat, N.I. Pirogov concentrated his
the focus is not so much on clinical surgery,
how much on anatomy and experimental surgery
gee. In 1829, he brilliantly completed a study
“What is observed during operations of bandaging pain-
of our arteries?”, having received a gold medal for it, and
in 1832 he defended his doctoral dissertation “Yavlya
Is there a ligation of the abdominal aorta for aneurysm
groin area is easy to do and safe
intervention."
In May 1833 N.I. Pirogov went to Ger
mania for improvement. Continuing on
pay special attention to anatomy and operational chi
rurgia, he perfectly mastered the surgical
technique, being engaged in the Berlin clinic
K. Grefe and in Göttingen with B. Langenbeck. In 1835
N.I. Pirogov returned to Russia, being
ren in obtaining the Department of Surgery in the Moscow
university. Upon learning that this department provided
to his friend at the Professor's Institute
F.I. Inozemtsev, N.I. Pirogov agreed to
stay in Dorpat at the University Surgical
clinic of his teacher I.F. Moyer.
Already the first operations carried out by N.I. Pi-
horny, struck those present with
perfection of surgical technique and unseen
noah in the Derpt clinic by the speed of execution.
I.F. Moyer chose him as his successor, and in
March 1836 N.I. Pirogov was approved in due
professor of theoretical and practical
surgery, and a year later received the title of ordinary
professor.
During his 5-year professorship
in Dorpat University N.I. pyro
gov did a lot for the development of theoretical and
practical medicine, education of doctors. AT
1837 he completed his first classical
work "Surgical anatomy of arterial
fishing and fascia”, for which the Russian Academy
Sciences awarded the scientist the Demidov Prize. He
described the position of the arteries and their surrounding layers
the way the surgeon sees them during the operation. blah
Thanks to this study, we finally approved
there was a provision according to which the practical
surgery cannot develop without knowledge of anatomy
missions. N.I. Pirogov for the first time in history installed
the most important interactions for surgical practice
wearing blood vessels and fascia. princes
the pial provisions contained in this capi
labor, predetermine the main methods
cal problems of topographic and surgical
anatomy as an educational and scientific discipline. Ra
bots N.I. Pirogov was the beginning of
fascial formations in the human body
both in Russia and abroad. interest in this
The problem has not been resolved to date.
Under the leadership of N.I. Pirogov and under the influence
taking it scientific papers in Dorpat it was written
In October 1840 N.I. Pirogov was appointed
Petersburg Medical and Surgical
which academy. In March 1841, he began to
the duties of a professor of hospital chi
surgical clinic, pathological and surgeons
Anatomy and Chief Physician of the Surgical
departments of the second Military Land Hospital.
In St. Petersburg, N.I. Pies are many and whole
strivingly engaged in science, led the croup
clinic, lectured on clinical chi
rurgia, topographic and pathological anatomy
mi, continued to lead Scientific research in
"Full Course in Applied Human Anatomy"
body, with drawings (anatomy descriptive
physiological and surgical). Completeness
research and originality, this work did not have
unparalleled in the world medical literature.
For this work, N.I. Pirogov was again awarded
Demidov Prize.
In 1846, a book by N.I. Pirogov
"Anatomical images of the human body,
assigned primarily to judicial
whose. With an atlas. From 1852 to 1859, Il
lustered topographic anatomy of races
saws carried out in three directions through
frozen human body. Atlas, attached
attached to it, consisted of 216 tables with explanatory
text in Latin. For this work
N.I. Pirogov was also awarded Demidov
sky prize. All three original works appeared
the culmination of many years of research carried out
N.I. Pirogov.
Freezing the corpse made it possible to preserve
thread organs in their natural, undisturbed
position, so the study of cuts made in
three planes, allows you to get a representation
about the true mutual arrangement of organs.
For the first time in the world, N.I. Pirogov studied on sections
topography of organs not only in the state of morpho
logical statics, but also with certain physio
logical positions: maximum bending,
extension, adduction, abduction, etc. Filling
before freezing the stomach or bladder
corpse with water, and the intestines with air, he specified the topo
graphics internal organs. N.I. Pirogov studied
displacement of the heart, observed with pleurisy, change
change in the position of the abdominal organs in ascites,
injecting fluid into the pleural or peritoneal cavity.
Thus, in his research N.I. pyro
gov was not limited to the study of anatomical
relationships between organs and tissues healthy person, he
first applied the experiment on a corpse, studying with
relationship of pathologically altered formations.
In this matter, he is also a fundamental
com new, anatomical and physiological direction
research in topographic anatomy.
The cutting method was applied by N.I. Pyrogo
vym and to develop the question of optimal up to
stupas to various organs, in particular for
bases of a new extraperitoneal method of exposure
of the common and external iliac arteries.
Proposed by N.I. Pirogov bone-plasty
leg amputation opened new era in
the doctrine of amputations and served as an impetus for the
development of osteoplastic surgery at the end
Even at the very beginning of the work on the dissertation,
whose topic was ligation of the abdominal aorta,
N.I. Pirogov classically proved pain
the greatest value of animal experimentation for re
solutions practical issues medicine. Yes, going
from anatomy through animal experimentation to
clinic, N.I. Pirogov laid the foundations of modern
noah practical surgery, the basis for which is
operative surgery and topographic
anatomy. First Department of Operative Surgery
was created in the St. Petersburg Medical and Surgical
which academy in 1865.
A contemporary of N.I. Pirogov was
F.I. Inozemtsev (1802-1869) - first director
faculty surgical clinic of Moscow
University. It is during the period of work
F.I. Inozemtseva at the Department of Practical Surgery
GII was allocated an independent course of operational
Noah surgery with topographic anatomy. So
according to the Charter of Russian Universities, adopted
to that in 1863, Moscow University considered it necessary
walkers to organize the department of operational chi
rurgia with surgical (topographic) anatomy
mia and desmurgy.
Department of Operative Surgery and Topography
anatomy Faculty of Medicine Mos
Kov University was established in 1868. Per
Alexander became the head of this department
Petrovich Rastsvetov (1825-1902). A.P. flourishing
took an active part in the opening of the monument
N.I. Pirogov (in August 1897) opposite the wedge
ki faculty surgery, led at that time
the time of Alexander Alekseevich Bobrov.
In 1876, the department was headed by talented
vyy surgeon and teacher N.V. Vorontsovsky. Napi
sledge them "Guide to Operative Surgery"
(1876) reflected the level of development of the world and grew
Russian surgery in the 70s years XIX in. and contained
description of a number of original operations, in particular
ty plastic suturing of the cleft palate.
In 1885 he was elected head of the department
Alexander Alekseevich Bobrov (1850-1904) - you
topographic anatomist and surgeon, active
follower of N.I. Pirogov. A.A. Bobrov would
la compiled new program teaching opera
rative surgery and topographic anatomy.
For the first time, topographic anatomy was
delivered as a complete course. Thanks to his ushi
Liam in 1891, the department received a room in
new building on Devichye Pole, together with the department
rami of pathological anatomy and forensic copper
cynes. A museum was created at the department, equipped
educational premises.
A.A. Bobrov left a deep mark on the fatherland
vein and world surgery as a topographic anatomist,
experimenter and clinician. He is one of the
vyh performed osteoplastic trepanation
skulls, experimentally substantiated and introduced into the Kli
practice a new method of dealing with shock,
developed a blind suture technique for
echinococcectomy of parenchymal organs,
modified and anatomically and physiologically substantiated
method of hernia repair of inguinal hernias. A.A. Bobrov -
Anatomy" (1886) and "Guidelines for surgical
logical anatomy" (1892). Wonderful surgeon
practitioner, A.A. Bobrov paid much attention to the opera
Rative Surgery and Topographic Anatomy and
persistently propagated the thesis: “The path to surgery
logical clinic should be through the anatomical
cue theater, but a clinical surgeon who has not passed
anatomical school, can not be up to par
his calling."
In 1893 A.A. Bobrov became head of the faculty
Teta Surgical Clinic of Moscow
university instead of transferred to St. Petersburg
Eleninsky Institute for Improvement
doctors Nikolai Vasilyevich Sklifosovsky. On the
the post of head of the department was left by his student and
follower Pyotr Ivanovich Dyakonov (1855-
P.I. Dyakonov created big school topo-
graphic anatomists and surgeons, which included such
famous scientists like F.A. Rein, N.K. Lysenkov,
N.I. Napalkov, A.P. Gubarev and others. At this time
the museum of the department was replenished with a large number of
of topographic and anatomical preparations. in me
hom this was done thanks to the developed
N.K. Lysenkov's original method of preserving
anatomical preparations in pairs of conservative
substances, as a result of which the
tissue color and texture. Various Methods
preparation of topographic anatomical preparations
products were described in the "Quick Guide to
preparation of preparations according to topographic analysis
tomy" (1895). These methods are also used in
time. Edited by P.I. Dyakonova write
san also "A course of lectures on topographic analysis
tomy and operative surgery” in 2 volumes. In it
at the same time, an experiment was created at the department
tal department, in which the practical
chesky classes with students.
A.A. Bobrov and P.I. Dyakonov rendered huge
influence on the development of operative surgery and
topographic anatomy, in which they propa
promoted clinical direction, linked
surgical techniques with physiological and patho
logical processes.
P.I. Dyakonov founded the journal "Surgery", in
how A.P. helped him Chekhov, with whom P.I. Diaco
new was friendly. Subsequently, A.P. Chekhov
edited every new issue of the magazine.
Since 1902, the department was headed by a student P.I. Dya
Konova Fedor Alexandrovich Rein, continuing
who worked on equipping the department. In 1911 he
Textbook. - 4th ed., add. - M .: Medicine, 2001. - 408 p. - (Educational literature
for medical students). - ISBN 5-225-04710-6 (OCR).
In the fourth edition of the textbook (the third was published in 1995), topographic anatomy is presented taking into account the possibility self-study by her students. The textbook contains data from both domestic and foreign authors. The general principles of operation in a particular area, the features of operational equipment,
methods of reconstructive operations, tools. Typical operations, techniques are described in detail, topographic anatomical and functional substantiation of the stages of the operation is given.
For medical students.
Recommended by the Department of Educational Medical Institutions and Personnel Policy of the Ministry of Health Russian Federation as a textbook for medical students.
Content:
Preface.
List of abbreviations.
Introduction.
Topographic anatomy of the upper limb
Shoulder girdle (shoulder girdle).
Shoulder, braehium.
Elbow region, regio cubiti.
Forearm, antebrachium.
Brush, mantis.
Topographic anatomy of the lower limb
Gluteal region, regio glutca.
Hip joint, articulatio coxae.
thigh, femur.
Knee, genu.
Knee joint, articulatio genus.
Calf, cms.
Ankle joint, articulatio talocruralis.
Foot, pes.
Topographic anatomy of the head
Brain section of the head.
The facial region of the head.
Superficial lateral region of the face, regio facialis lateralis superficialis.
Topographic anatomy of the neck
Anterior region of the neck, regio cervicis anterior.
Fascia and cellular spaces of the anterior region of the neck.
Suprahyoid part of the neck, pars suprahyoidea.
Sublingual part of the neck, pars infrahyoidea.
Larynx, larynx.
Trachea, trachea.
Throat, pharynx.
Esophagus, esophagus.
Thyroid and parathyroid glands, glandula thyroidea and glandulae parathyroideae superior et inferior.
Topographic anatomy of the chest
The walls of the chest cavity.
Mammary gland, glandula mammaria.
Diaphragm, diaphragma.
Topography of the chest cavity.
Topographic anatomy of the abdomen
General characteristics.
The peritoneal cavity, or peritoneal cavity, cavitas peritonei.
Division into floors.
The upper floor of the abdominal cavity.
The lower floor of the abdominal cavity.
Lumbar region and retroperitoneal space.
Topographic anatomy of the pelvis and perineum
Bones, ligaments and muscles of the pelvis.
Topography of the organs of the male pelvis.
Topography of the organs of the female small pelvis.
Topography of the perineum, regio perineais.
Male genital area, pudendum masculinum.
The female genital area, pudendum feminium.
General operative surgery. Equipment, tools. Pain relief
The subject of operative surgery.
tissue separation technique.
Surgical instruments.
Pain relief. Operations on limbs
Bone operations.
Operations on the joints.
Operations on muscles and tendons.
Vascular operations.
Operations on the nerves.
Operative access to the arteries and nerves of the upper limb.
Operative access to the arteries and nerves of the lower limb.
Primary treatment of wounds of the extremities.
The doctrine of amputations.
Technique of amputations and exarticulations on the upper limb.
Technique of amputations and exarticulations on the lower limb.
Operations for purulent processes on the extremities.
Operations on the head
Operations on the vault of the skull.
Facial operations.
Neck operations
Exposure of the arteries in the neck.
Tracheotomy, tracheotomy.
Tracheostomy, tracheostomy.
Operations on the cervical esophagus.
Operations on the thyroid gland.
Operations for abscesses and phlegmon of the neck.
Operations on the chest wall and organs of the chest cavity
Operations on the mammary gland.
Puncture of the pleural cavity.
Primary treatment of a penetrating wound of the chest wall.
Operations on the organs of the chest cavity.
Operations on the heart.
Operations on the esophagus.
Diaphragm operations.
Operations for hernias of the abdominal wall
Groin hernias.
Femoral hernias.
Sliding hernias.
Umbilical hernias.
Hernias of the white line of the abdomen.
Hernia repair with strangulated hernias.
Operations on the abdominal organs
Surgical accesses and general rules of abdominal surgery.
Revision (examination) of the abdominal organs.
General remarks about operations on the gastrointestinal tract.
Operations on the organs of the retroperitoneal space
General remarks. Surgical access to the kidneys and ureters.
Operations on the kidneys and ureters.
Operations on the organs of the small pelvis and perineum
General principles of operations on the pelvic organs and the methodology for performing some operations.
Internal Organ Transplant (Overview)
Overcoming tissue incompatibility.
Kidney transplant.
Liver transplant.
Heart transplant.
Transplantation of endocrine glands.
Name: Operative surgery and topographic anatomy
Kovanov V.V.
The year of publishing: 2001
The size: 63.3 MB
Format: pdf
Language: Russian
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