Image from page 285 of "Regional anesthesia : its technic and clinical application" (1922)
Identifier: regionalanesthes00laba
Title: Regional anesthesia : its technic and clinical application
Authors: Labat, Gaston Mayo, William J
Subjects: Anesthesia, Local Local anesthesia
Publisher: Philadelphia and London : W. B. Saunders company
Contributing Library: West Virginia University Libraries
Digitizing Sponsor: LYRASIS Members and Sloan Foundation
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the bone. The extremity ofthat edge is the posterior superior iliac spine. In very lean patientsthe prominences of the framework can be recognized by sight; but theygradually become less salient with the increasing weight of the patientand finally disappear in fat people, in whom accuracy in defining land-marks greatly depends, as a rule, on the experience of the operator.When raising the wheal 1 cm. medial to and below the posterior superioriliac spine the correct margin should be allowed for the thickness of thesoft structures overlying the bone. The sacral cornu is defined with the sacral hiatus. The sacral hiatusis found by passing the tip of the index-finger along the midline of the 264 REGIONAL ANESTHESIA region, starting from the tip of the coccyx in the gluteal cleft, coursingupward toward the sacrum. A depression is felt at about the junctureof the coccyx with the sacrum, and bounded by the sacral comua oneach side and the fourth sacral spinous process on the midline a little
Text Appearing After Image:
Fig. 200.—Transsacral block. Tracing of the lateral rows of sacral foramina onthe skin surface: a, a, are the sacral cornua; b, b, the posterior superior iliac spine; c,c,the line tangent to the highest points of the iliac crests. higher up. These three prominences, easily palpable in the majorityof cases, are defined with great accuracy in lean patients. In the veryfat it is necessary to palpate with some pressure so as to locate thedepression of the hiatus, which lies generally slightly higher than theextremity of the gluteal cleft (page 280). BLOCKING OF SPINAL NERVES 265 The lateral rows of posterior sacral foramina may be traced on theskin in the following manner: A straight line is drawn across the backthrough the uppermost points of the iliac crests. On this line, whichpasses through the fourth lumbar spine or between the fourth andfifth, two points are taken, one on each side, 4 cm. distant from themidline of the back, and these points are Joined to the sacral comua(Fig. 200
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Image from page 285 of "Regional anesthesia : its technic and clinical application" (1922)
Identifier: regionalanesthes00laba
Title: Regional anesthesia : its technic and clinical application
Authors: Labat, Gaston Mayo, William J
Subjects: Anesthesia, Local Local anesthesia
Publisher: Philadelphia and London : W. B. Saunders company
Contributing Library: West Virginia University Libraries
Digitizing Sponsor: LYRASIS Members and Sloan Foundation
View Book Page: Book Viewer
About This Book: Catalog Entry
View All Images: All Images From Book
Click here to view book online to see this illustration in context in a browseable online version of this book.
Text Appearing Before Image:
the bone. The extremity ofthat edge is the posterior superior iliac spine. In very lean patientsthe prominences of the framework can be recognized by sight; but theygradually become less salient with the increasing weight of the patientand finally disappear in fat people, in whom accuracy in defining land-marks greatly depends, as a rule, on the experience of the operator.When raising the wheal 1 cm. medial to and below the posterior superioriliac spine the correct margin should be allowed for the thickness of thesoft structures overlying the bone. The sacral cornu is defined with the sacral hiatus. The sacral hiatusis found by passing the tip of the index-finger along the midline of the 264 REGIONAL ANESTHESIA region, starting from the tip of the coccyx in the gluteal cleft, coursingupward toward the sacrum. A depression is felt at about the junctureof the coccyx with the sacrum, and bounded by the sacral comua oneach side and the fourth sacral spinous process on the midline a little
Text Appearing After Image:
Fig. 200.—Transsacral block. Tracing of the lateral rows of sacral foramina onthe skin surface: a, a, are the sacral cornua; b, b, the posterior superior iliac spine; c,c,the line tangent to the highest points of the iliac crests. higher up. These three prominences, easily palpable in the majorityof cases, are defined with great accuracy in lean patients. In the veryfat it is necessary to palpate with some pressure so as to locate thedepression of the hiatus, which lies generally slightly higher than theextremity of the gluteal cleft (page 280). BLOCKING OF SPINAL NERVES 265 The lateral rows of posterior sacral foramina may be traced on theskin in the following manner: A straight line is drawn across the backthrough the uppermost points of the iliac crests. On this line, whichpasses through the fourth lumbar spine or between the fourth andfifth, two points are taken, one on each side, 4 cm. distant from themidline of the back, and these points are Joined to the sacral comua(Fig. 200
Note About Images
Please note that these images are extracted from scanned page images that may have been digitally enhanced for readability - coloration and appearance of these illustrations may not perfectly resemble the original work.