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Updated: May 27, 2025
When a tourniquet cannot conveniently be applied, or when its presence interferes with the carrying out of the operation as, for example, in amputations at the hip or shoulder the hæmorrhage may be controlled by preliminary ligation of the main artery above the seat of operation for instance, the external iliac or the subclavian.
Heath had a case of injury to the external iliac artery from external violence, with subsequent obliteration of the vessel. When the patient was discharged no pulse could be found in the leg. Dismukes reports a case in which the patient had received 13 wounds, completely severing the subclavian artery, and, without any medical or surgical aid, survived the injury two hours.
A careful consideration of the position in which the swelling first appeared, of the direction in which it has progressed, of its pressure effects, and of the condition of the pulses beyond, may help in distinguishing between aortic, innominate, carotid, and subclavian aneurysms. Skiagraphy is also of assistance in recognising the vessel involved.
They consist of slender, thin-walled tubes, which resemble veins in structure, and, like the veins, have valves. They differ from veins, however, in being more uniform in size and in having thinner walls. Thoracic duct. 2. Right lymphatic duct. 3. Left subclavian vein. 4. Right subclavian vein. 5. Superior vena cava. 6. Lacteals. 7. Lymphatic glands.
Intra-thoracic complications, such as pleurisy or pneumonia, are not infrequent when there are adhesions to the chest wall and pleura. Rupture may take place externally, into the shoulder-joint, or into the pleura. Extirpation of the sac is the operation of choice, but, if this is impracticable, ligation of the third part of the subclavian may be had recourse to.
When the governor got home, the wound was examined. It had bled a good deal in the boat, and it was doubtful whether the subclavian artery might not be divided. On moving the spear, it was found, however, that it might be safely extracted, which was accordingly performed. Apprehension for the safety of the party who had gone to Broken Bay, now took place.
After the aorta leaves the left ventricle it rises towards the neck, but soon turns downwards, making a curve known as the arch of the aorta. From the arch are given off the arteries which supply the head and arms with blood. These are the two carotid arteries, which run up on each side of the neck to the head, and the two subclavian arteries, which pass beneath the collar bone to the arms.
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