Parosteal Lipoma of the Rib
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Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
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Thoracic vertebrae were nine in number showed they were freely movable, except that the last two showed fused with each other. There was a gradual increase in its length of the body from first to last after which the length reduced. The dorsal spinous process was plate like. The ventral spinous was well developed in the first two. The transverse process were broad plate like with their lateral borders beared the fovea costales transversalis which is articulated with tuberculum costae of its corresponding rib. The lumbosacral mass was formed by last two fused thoracic, six lumbar, tenth sacral and first coccygeal vertebrae. the dorsal and ventral scaral foramina were nine in number. The transverse process of the last two thoracic, lumbar and sacrum were fused with the medial surface of ilium coccygeal vertebrae were five in number of which the last three were fused and the last coccygeal vertebrae was boat shaped. The ribs were ten pairs. The first, second, third, ninth and tenth were floating ribs. The fourth, fifth, sixth and seventh and eighth were true ribs with a vertebral and a sternal.
Lumbosacral joint
Thoracic vertebrae
Sternum
Spinous process
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The thorax is the region of the body commonly known as the chest between the neck and the abdomen. The thoracic cavity is the hollow in the thorax that is occupied by the thoracic viscera, the heart and its associated vessels in the midline, and the lungs laterally. The thoracic viscera are enclosed by the bony and muscular thoracic cage. The bony components of the cage are the 12 thoracic vertebrae posteriorly, the 12 pairs of ribs and their anterior cartilaginous extensions, the costal cartilages that meet the sternum anteriorly. The intercostal muscles fill the intercostal spaces between the ribs and are involved in ventilation. Another muscle involved in ventilation is the diaphragm, a sheet of muscle that separates the thoracic from the abdominal cavity. If you are not familiar with the basic outline and arrangements of the circulatory and respiratory systems, refer back to Chapters 4 and 5 before reading this section. A good way to appreciate where these structures lie in relation to each other is to examine their surface anatomy, the position of internal organs related to features that can be observed or palpated (felt) on the surface of the body. Relating surface anatomy to deeper structures is a clinical skill essential not only to the study of the thorax, but also of structures in the head and neck important in dental practice. In the clinical examination of the living subject, the position of the internal thoracic organs is defined with reference to a set of vertical and horizontal lines running through the surface of bony landmarks. The significant vertical lines are shown in Figure 9 .1 as the: 1. Mid-sternal line—in the median plane anteriorly; 2. Mid-clavicular line—through the midpoint of the clavicle; 3. Mid-axillary line—midway between the anterior and posterior axillary folds, formed from skin overlying muscles. If you raise your arm while looking into a mirror, the two folds are obvious; they can also be palpated very easily even with clothes on. 4. Median posterior line—in the median plane anteriorly. The horizontal position can be defined with reference to the ribs or, less easily, the vertebrae.
Thorax (insect anatomy)
Sternum
Thoracic cavity
Diaphragm (acoustics)
Surface anatomy
Shoulder girdle
Thoracic wall
Muscles of respiration
Intercostal space
Gross anatomy
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There was hardly any mo r p hological difference between monkeyand man in the Serratus posterior inferior. In other words, this muscle located in the lower part of the dorsal thoracic region, arises from the lower thoracic vertebrae, upper lumbar vertebrae and the lumbodorsal fascia below, and inserts into the ribs by digitations.1) The upper limit of the area of origin was the eighth thoracic: vertebra in monkey and the ninth thoracic vertebra in man. The extent of the area of origin was greater in monkey than in man.2) At the insertion, digitations were formed which attach to the lower edge of the ribs and some extended to the dorsal surface of the rib.The area of insertion was located between the lateral edge of the Iliocostalis and the costal origin of the Obliquus abdominis externus. The location and number of digitations most frequently were symmetrical. The ribs into which this muscle inserted were most frequently the eighth to 12th ribs in monkey and the ninth to 12th ribs in man, while the number of digitations was five in monkey and three to four in man.Furthermore, the highest and lowest digitations were poorlydeveloped in comparison with other digitations.3) The highest digitation of this muscle and the lowest digitation of the Serratus posterior superior were usually separated by two to three intercostal spaces in monkey and by four to five intercostal, spaces in man.4) Examination of the relation with other muscles showed that the digitations which insert into the ninth and upper ribs in monk ey overlie the Intercostalis externus, but the digitations which attach to lower ribs than the tenth were located beneath the Intercostalis. externus. In man, however, even the digitations that insert into the lower ribs overlapped the Intercostalis externus.In monkey, various patterns which sugg e st a close relation between this muscle and the Intercostales externus and internus,, Obliquus abdominis externus or the Obliquus abdominis internus were seen.5) The digitation formed at the insertion into the ribs is, as in the case of the Serratus posterior superior, not always a single insepa rable muscle but may consist of a number of areas forming the structural unit (muscle sheets) and such muscle sheets (unit areas)sometimes formed layers, but the layer formation is poor and not distinct in comparison with of the Serratus posterior superior.According to the combination of such structural u n its (muscle sheets), it was possible to make a classification into five types, or a total of 10 types including further subdivisions. In monkey and man the most frequent type was that in which there is separation into three muscle sheets and arranged in two layers.6) The nerve supply was by the branch of the intercostal nerve and as a rule by the same branch as that innervating the Intercostalis externus. Occasionally, it may be supplied by the same branch as that to the Intercostalis internus and in rare cases there may be digitations which are innervated by the same branch as that supplying both the Intercostales externus and internus.
Intercostal nerves
Vertebra
Thoracic vertebrae
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The nationally-recognized Susquehanna
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