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

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thesubscapular, are to be ligated and cut. As a rule, we preserve the latter vessel althoughits sacrifice may be necessary in order that the tissues surrounding it may be removed. The veins accompanying these arteries, except the cephalic vein, are tied near theirterminations and cut. The anterior thoracic (external and internal) nerves have beensevered in reflecting the pectoral muscles. With the completion of the foregoing dissection as far outward as the origin of thesubscapular artery it remains to remove the fascia and fat surrounding this vessel andits branches. The dissection begins above the teres minor muscle, is carried downwardremoving the fascial covering of the muscle, the teres major, subscapularis, latissimus 592 THE BREAST dorsi, and serratus magnus muscles. In cleansing the latter, care must be taken topreserve the external thoracic nerve (nerve of Bell) which runs over it in the line ofthe mid-axilla. The middle or long subscapular nerve which supplies the latissimus
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Fig. 212.—The pectoralis minor muscle has been elevated on the finger; the cephalic vein is seenabove the tip of the finger. The cephalic vein and the acromiothoracic vessels are seen piercing thecosto-coracoid membrane which has been pierced by the finger in elevating the muscle. The longthoracic and the acromio-thoracic arteries lie posterior to the finger so that there is little danger of wound-ing them when the pectoralis minor muscle is detached from the coracoid process of the scapula. dorsi muscle must be preserved. This is not difficult to do if gauze dissection isadbered to in cleansing the costal surface of the muscle. Having finished the dissection of the axilla the lower part of the field of operation isexposed by continuing the reflection of the skin flaps. The incisions outlined on the CARCINOMA 593 skin in the manner described above are deepened until the deep pectoral fascia is ex-posed. Dissection of the lateral flap is made first and exposes the lower digitations o

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