Sometimes - For Moving Seed More Dissect -

Sometimes - for moving seed more dissect - internal slanting and cross-section muscles, in a crack place seed in a direction-. Under seed sew muscles so that they densely adjoined to it, but did not squeeze it. Further strengthen a wall in area the channel. Edge of a vagina of a direct muscle together with the connected sinew of internal slanting and cross-section muscles file to to a sheaf. Further the top rag together with internal slanting and cross-section - muscles file to lobkovo-podvzdoshnomu and to to a sheaf-. These seams should remove to a limit seed in the party (if muscles earlier have not been crossed). The bottom rag the external slanting muscle, spent under seed , fix over the top rag -. Again formed " the channel" with seed - should pass through myshechno-aponevrotichesky a layer in a slanting direction behind beforehand and from within so that its internal and external apertures have not appeared opposite each other. Seed stack on and over it - sew hypodermic and a skin.

Lymphatic Vessels Of Cervical Department Of A Gullet

Lymphatic vessels of cervical department of a gullet take away a lymph to and to deep cervical lymph nodes. From chest department of a gullet lymph outflow occurs in , , lymph nodes. For the bottom third of gullet - lymph nodes are lymph nodes, knots in the field of left gastric and arteries the Part of lymphatic vessels of a gullet opens directly in a chest lymphatic channel. These can explain in certain cases earlier occurrence a metastasis, than metastasises in lymph nodes a gullet. Branches of wandering nerves form forward and back textures on a gullet surface. The fibres forming a nervous texture intermuscular and depart from them in a gullet wall. A cervical part of a gullet returnable nerves, chest branches of wandering nerves and a fibre of a sympathetic nerve, bottom branches a nerve. The parasympathetic department of nervous system - carries out regulation of motor function of a gullet and physiological . The role of sympathetic nervous system in gullet physiology definitively is not found out.

The Reasons Of A Sharp Stomach The Following.

The reasons of a sharp stomach the following. 1. Damages of bodies of a belly cavity. 2. Sharp inflammatory diseases of bodies of a belly - cavity, including a peritonitis. 3. Punching of hollow body. 4. Mechanical intestinal impassability. 5. Sharp infringements the arterial and venous - blood circulation, conducting to a heart attack of intestines and a gangrene, accompanied by dynamic intestinal impassability. 6. Internal bleedings in a gleam of a gastroenteric path and in a cavity . 7. Sharp inflammatory processes in uterus appendages, - extra-uterine pregnancy, , legs or tumours , uterus or tumour knot . The basic clinical signs of a sharp stomach: a belly-ache-, an anaemia, a shock (the scheme 1). The following enters into methods of primary research of the patient. The anamnesis: time and the beginning of occurrence of a pain (sudden, - gradual), pain localisation; and the phenomena-; temperature; the diseases of bodies of a belly cavity transferred in the past and operation on stomach bodies Survey: the compelled position of the patient; the anxiety of the patient, changes a pose; , block; dehydration signs (the pointed features, dryness of mucous membranes of an oral cavity); pallor, a jaundice, allocation (vomiting, a chair, blood).

With The Beginning Of Feeding Milk Is Belched

With the beginning of feeding milk is belched and arrives in a mouth . The stenosis can be as a result of a hypertrophy of a muscular - cover, presence in a wall of a gullet fibrous or - rings, formations by a mucous membrane of thin membranes. Small stenoses long time proceed and are shown only at reception of rough food. At the - expressed stenosis it is marked , during time and after meal. Gradually occurs razviti - gullet expansions, food weights are late in it and - are exposed to rotting, there is a putrefactive smell from a mouth. Congenital bronho - fistulas (the section "Inflammatory diseases of a trachea" see). Gullet doubling - rare anomaly. The gleam - can be isolated or to have the message with the basic channel of a gullet. The gleam isolated is filled by a secret allocated their mucous, sometimes they look like , in other cases are informed with a trachea or a bronchial tube. In process of growth symptoms a gullet and respiratory ways develop, at patients develops , there is a cough, a short wind.

Are Most Often Observed Hernias (75 %), Then

Are most often observed hernias (75 %), then femoral (8 %), umbilical (4 %), postoperative (12 %) hernias-, 1 % is made by all other forms of hernias. At men - happen hernias, at women - femoral and umbilical is more often-. In an origin of hernias many factors, as local, and the general matter. Local factors: features of an anatomic structure of area hernias. To them carry the channel through which at men passes seed , the femoral channel through which take place femoral vessels, area of a navel and a white line of a stomach where there are free intervals from muscles. The general factors promoting formation of a hernia, divide on contributing and making. Contributing factors: a heredity, age (a weak belly wall at children of the first year of a life, an atrophy of fabrics of a belly wall at old people), a floor (features of a structure of a basin and the big sizes of a femoral ring at women, the big weakness areas at men), features of a constitution, fatness degree (a fast weight loss), frequent childbirth, a trauma of a belly wall, postoperative hems, a paralysis of nerves, a belly wall.

At The Healthy Person In The Conditions Of

At the healthy person in the conditions of rest within an hour it is allocated about 50 ml of gastric juice. Production of gastric juice in connection with - digestion process - and as a result reactions of an organism to action of harmful factors (mental and physical) increases-. The secretion of gastric juice connected with food intake, conditionally divide into three phases: brain , gastric and intestinal. Ability of gastric juice to damage and digest living tissues - is connected with presence of hydrochloric acid and . In a stomach of the healthy person, aggressive properties kislotno-pepticheskogo the factor of gastric juice are eliminated thanks to neutralised action food, a saliva, the alkaline slime, thrown in a stomach contents, and as a result influences . Protect fabrics of a stomach and a duodenal gut from gastric juice a protective barrier of a mucous membrane, the local fabric resistance, the integrated system of the mechanisms stimulating and braking secretion of hydrochloric acid, a motility of a stomach and a duodenal gut.

It Allows To Differentiate - Disease From Other

It allows to differentiate - disease from other aetiology. And a pain it is possible to stop a heartburn change of position of a body of the patient, food intake, alkaline waters, soda, weak solutions hydrochloric or - organic acids (at in a gullet of pancreatic or alkaline intestinal juice). The frequent complaint is the empty - eructation. Eventually patients have symptoms dis-fagii which are caused in the beginning by functional infringements-, and then the expressed inflammatory hypostasis of a mucous membrane - and development of cicatricial changes in a gullet. Cicatricial - narrowing of a gullet leads to heartburn reduction, the basic - symptoms of disease become , pains, . If disease arises against a stomach ulcer, a hernia apertures of a diaphragm, a cholecystitis, etc. in a - clinical picture symptoms of the basic disease can prevail-. In the absence of timely treatment and disease progressing there can be complications . The Most frequent complication is the bleeding. The latent bleedings find out almost constantly, expressed (with vomiting or -) - is rare.

On The Left Lateral Area Are Projected: Descending

On the left lateral area are projected: descending a gut, a part of loops of a small intestine, the left kidney with . In area are projected, small intestine loops, a bladder, a uterus. H right podvzdoshno-pahovuju area are projected: a blind gut with - a shoot, final department guts, right , the - right appendages of a uterus, right vessels. On left podvzdoshno-pahovuju area are projected: a gut, left , the left appendages of a uterus, left vessels. Projections of bodies of a belly cavity to stomach walls depend on a constitution and vary with the years the patient. RESEARCH METHODS One of the basic symptoms of diseases of bodies of a belly cavity is the belly-ache. Revealing of a kind and a pain origin gives the important instructions on certain diseases. It is necessary to find out: the pain beginning (sudden, gradual), pain development in time (initial and later localisation, , change of intensity and character of a pain), symptoms accompanying a pain (, the phenomena, rise in temperature of a body, change of a pulse rate and - arterial pressure) By origin distinguish pains , somatic and .

Conditionally Allocate Four Stages Of Clinical Displays -

Conditionally allocate four stages of clinical displays - of disease: I stage - sharp (the period sharp -); II stage - a stage chronic (a stage of "imaginary well-being"); III stage - a formation stage with 2 - 3 to 2 - 3 years (organic narrowing - of a gullet); IV stage - a stage of late complications (a gleam obliteration, punching of a wall of a gullet, cancer development). On weight of defeat in a sharp stage allocate three degrees - of a burn of a gullet: easy (first), average weight (second) and heavy (third). The first degree of a burn results from intake of a small amount of caustic substance in small concentration or hot food. Blankets on or a smaller site of a gullet are thus damaged. The second degree of a burn is characterised by more extensive on all depth of a mucous membrane. The third degree of a burn - grasps a mucous membrane-, and muscular layers, extends on and the next bodies. Defeat of a gullet by acid or alkali can - be accompanied by defeat of a stomach, duodenal and initial department of a lean gut with occurrence of sites and - their punching that conducts to peritonitis development in the sharp period-, and also to cicatricial deformations of a stomach subsequently.

Treatment: To The Majority Of Patients With Not

Treatment: to the majority of patients with not complicated - a gullet ulcer spend conservative treatment a diet (a table 1, 1, ""), a fractional food, , enveloping, astringents, preparations, - vitamins, sedative therapy To the period clinical - symptoms and ulcer scarring spend physiotherapeutic treatment. All patient recommend to avoid the positions promoting occurrence zheludochno-pishchevodnogo of a reflux. At an ulcer bleeding spend therapy, coagulation - of a bleeding vessel through At presence a gullet good effect give , in the Spring and recommend carrying out of preventive courses of treatment Surgical treatment it is shown in the absence of effect from conservative therapy, in the presence of disease complications (the punching, not stopping plentiful bleeding, - extended , absence of effect from ), a combination of an ulcer of a gullet to insufficiency , a hernia diaphragm apertures, the congenital or got - short gullet in the autumn--. Make on Nissenu in a combination with selective or at rough anatomic changes a resection of a gullet with .

More Than In 50 % Of Cases The

More than in 50 % of cases the foreign matter freely passes on a gullet and through other departments of a gastroenteric path and leaves a natural - way. Sharp foreign matters (needles, nails, the fish and meat bones, etc.) jam in initial department of a gullet, large subjects are late in places of physiological narrowings of a gullet (at level tracheas, over ). The foreign matter delay in a gullet is promoted by its pathological changes (a tumour, good-quality , , etc.), and also a spasm muscles in reply to irritation of a mucous membrane a foreign matter. Clinic and diagnostics: symptoms depend on character - of a foreign matter, level of its delay in a gullet, a damage rate of a wall of a gullet. Patients have sensation of fear, sensation of constraint, pressure or a sore throat, in area poles or behind a breast. These sensations amplify at a saliva, a liquid. A frequent symptom is which is caused not only a foreign matter, but also development of a spasm of muscles of a gullet and an inflammatory hypostasis of its mucous membrane.

The Violent Reposition Of The Restrained Hernia Made

The violent reposition of the restrained hernia made by the patient, is observed seldom. In medical institutions violent reposition of a hernia is forbidden At violent reposition of the restrained hernia there can be damages of a hernial bag and contents of a hernia up to rupture of a gut and it to development of a peritonitis and an intrabelly bleeding-. The peritonitis, an intrabelly bleeding are indications to emergency operation the operation Purpose - audit of bodies of a belly cavity, a bleeding stop, removal of a source of a peritonitis, a belly cavity (sm "Peritonitis"). At violent reposition the hernial bag can be displaced in space together with the contents restrained in area of a neck of a hernial bag. At a separation in the field of a neck of a hernial bag there can be an immersing of the restrained loop of a gut together with a restraining ring in a belly cavity or in space. Important in due time to distinguish imaginary board of a hernia as at the patient the phenomena of intestinal - impassability and a peritonitis can quickly develop-.

Most Often Happen In Chest Department Of A

Most often happen in chest department of a gullet. Pathological anatomy: glotochno-pishchevodnye develop slowly, drinks are formed in a back wall, is direct over an input in a gullet, more often in the field of a triangle of Lane - Gakkermana where the muscular cover drinks is presented by weak muscular bunches - drinks, is more rare - in the field of a triangle of Lajmepa limited from above m.cricopharyngeus, and from sides - - longitudinal muscular fibres than a wall. The major importance in formation has perstnevidno-pharyngeal muscles (infringement of disclosing - top in reply to swallowing). go down downwards between a back wall of a gullet and a backbone, can be displaced under lateral muscles of a neck. Their size is various, they have a wide mouth. The wall does not contain muscular - fibres, usually not with surrounding fabrics, - its internal surface is covered by a mucous membrane drinks, on it there can be superficial erosion or hems. settle down on a forward or left lateral wall of a gullet is more often, their diameter seldom exceeds 1 - 2 the Bottom see is usually directed upwards and with the - next bodies, the wall has a structure of a wall of a gullet.

At Detection A Blind Gut Make Median And

At detection a blind gut make median and carry out a resection of the right half of thick gut with imposing . Operation finish plastic arts of hernial gate. At bladder walls the resection of a bladder with - imposing is necessary-. In hard cases - also impose . The sixth stage - the restrained epiploon separate sites without formation of the big general . With massive an epiploon probably and occurrence - as a result of this bleeding from vessels of an epiploon of century a belly cavity. The seventh stage - at a choice of a method of a plasticity of hernial gate it is necessary to prefer the most simple. For example, at small slanting hernias at young men it is necessary to apply a way Zhirara - Spasokukotsky - Kimbarovsky, at straight lines and difficult hernias - ways Bassini and Postempsky. At the restrained hernia complicated by a phlegmon of a hernial bag, operation should be begun with median (the first stage) for danger reduction a belly cavity contents of a hernial bag. During time make a resection of a gut within viable fabrics.

Occasionally Develops - A Cancer. From Other Malignant

Occasionally develops - a cancer. From other malignant tumours - of a gullet it is necessary to note , consisting of ferruterous both elements, and (a cancer and sarcoma combination). The international classification of a cancer of a gullet provides the - tumour characteristic on system TNM. - a primary tumour TIs - . THAT - is not present display of a primary tumour. 1 - The tumour involves less than 5 sm of length of a gullet, without causing gleam narrowing. There is no circular defeat of walls of a gullet. Vnepishchevodnogo - distribution of a tumour is not present. 2 - A tumour more than 5 sm on length of a gullet. The tumour of any size - causing narrowing of a gullet. A tumour extending on all walls - of a gullet. Vnepishchevodnogo distribution of a tumour is not present. - the tumour extends on the next structures. N - lymph nodes NO - lymph nodes are not palpated. N1 - Mobile lymph nodes on the defeat party. N1a - The increased lymph nodes do not contain metastasises. N1b - The increased lymph nodes contain metastasises.