Pirogov's triangle and its practical significance. Topographic anatomy of the submandibular triangle. Pirogov's triangle and its applied meaning See the meaning of Pirogov's Triangle in other dictionaries
PIROGOV TRIANGLE, trigonum lingua-1e, a small triangular space in the lateral part of the suprahyoid region of the neck, formed from below (behind) by the tendon of the digastric muscle (m. digastricus), the superior hypoglossal nerve (n. hypoglossus), passing obliquely and together with the lingual vein, and inside (front) - the outer (posterior) edge of the maxillary-hyoid muscle (m. mylo-hyoideus). The bottom of the triangle is occupied by the hypoglossus muscle (m. hyo-glossus). This triangle is the surest path to the lingual artery (a. lingualis; Pirogov) (see figure). It is possible to accurately on-i determine the stroke of the tongue. arteries and lies the practical significance. t. Pirogov's triangle is part of the medial wall of the submandibular region; To achieve it surgically, the patient must be placed with his head thrown back strongly and turned in the opposite direction. With an incision starting at the anterior edge of the sternocleidomastial muscle in the middle of the distance between the lower jaw and the hyoid bone, the skin and subcutaneous tissue with superficial fascia, the subcutaneous muscle of the neck (m. platysma myoides) and the first aponeurosis of the neck, which forms here the anterolateral wall of the bed (capsule) of the submandibular salivary gland; to penetrate deep into the gland, it is separated and tilted upward, the thin fascial medial wall of its bed is exposed, the edges are easily separated by blunt means, after which a small layer of fiber lining the gland is exposed. Upon removal of the fiber, the intermediate tendon of the digastric muscle, attached here to the small horns of the hyoid bone, and both bellies of the muscle are visible, with the posterior belly partially covered by the stylohyoid muscle (m. stylohyoideus), attached to the large horn of the hyoid bone. of the hyoid bone there is 1 obliquely upward and inwardly a thin hyoglossus muscle (m. hyo-glossus), along its lateral surface the hypoglossal nerve passes in the form of a white, shiny, round formation in cross-section and below it is the lingual vein (v. lingualis). If you cut across or push apart bluntly along the fibers of the hyoglossus muscle immediately above the hyoid bone, then the Pirogov’s Triangle is found and isolated in the tissue behind the muscle; 1 -sh. stylo-hyoideus; 2-posterior abdomen m. digastrici; 3-m. hyo-glossus; 4-p. hypoglossus; 5- anterior abdomen of t. digastrici; V- t. mylo-hyoideus; 7 -a. maxillaris ext. ■strongly pulsating lingual artery and, if necessary, is immediately ligated. The described relationship between the artery and the named formations is so precise that tying it in this place is relatively easy. But there may be cases of either a significant reduction in the size of the already small triangle or even its complete absence, which makes it very difficult to find the lingual artery. The base of the P. t. is directed upwards towards the hypoglossal nerve, and the apex downwards towards the hyoid bone._ Dimensions of the triangle? 1 are small, its height—the distance from the hypoglossal nerve to the hyoid bone—is on average about one centimeter. P. t. is very small in the case when the hypoglossal nerve and hyoid bone come close to each other; then the hypoglossal nerve passes too close to the tendon of the digastric muscle. P. t. may be completely absent if the tendon of the named muscle is held at the hyoid bone by a wide and longer tendon loop than usual; as a result of this, the tendon of the digastric muscle will rise upward, and the hyoid bone will move away by 3-4 eat and will pass either over the hypoglossal nerve or above it. When approaching the lingual artery, in this case it is necessary to artificially create a Pirogov triangle by pulling the tendon of the digastric muscle down.A. Sirotkin.5. Pirogov's triangle.
Pirogov's triangle is used as an internal landmark when accessing the lingual artery (a. lingualis). It is bounded by the hypoglossal nerve above, the tendon of the digastric muscle below and behind, and the free posterior edge of m. mylohyoideus - in front. The bottom of the Pirogov triangle is formed by m. hyoglossus, along the upper (deep) surface of which there is a lingual artery, and along the lower surface there is a vein. To access the lingual artery for the purpose of ligating it, for example, with a deep cut of the tongue, it is necessary to dissect the deep layer of the 2nd fascia and separate the fibers of the hyoglossus muscle. Lingual artery , a. lingualis arises from the external carotid artery at the level of the hyoid bone, 1-1.5 cm above the superior thyroid artery.
Rice. 2. Schematic representation of the areas and triangles of the neck: 1 - scapuloclavicular triangle; 2 - scapular-trapezoidal triangle; 3 - sleepy triangle; 4 - scapular-tracheal triangle; 5 - submandibular triangle; 6 - retromandibular fossa; 7 - sternocleidomastoid muscle; 8 - omohyoid muscle; 9 - digastric muscle; 10 - trapezius muscle.
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1. Sterno-clavicular-mastoid region: boundaries, external landmarks, layers, fascia and cellular spaces, vessels and nerves. 2. Topography of the main vascular-nervous bundle of the neck (course, depth, relative position of vascular-nervous elements, projection onto the skin of the carotid artery). 3. Rapid access to the carotid artery.
1. Sterno-clavicular-mastoid region: boundaries, external landmarks, layers, fascia and cellular spaces, vessels and nerves.
Borders: The sternocleidomastoid region corresponds to the position of the muscle of the same name and reaches the mastoid process at the top, and the clavicle and manubrium of the sternum at the bottom.
External landmarks: The main external landmark is the sternocleidomastoid muscle itself, which covers the medial neurovascular bundle of the neck (common carotid artery, internal jugular vein and vagus nerve).
Layers: The skin of this area is thin and easily folded together with the subcutaneous tissue and superficial fascia. Near the mastoid process it is dense, the subcutaneous one is moderately developed. Between the superficial fascia (1st) and the superficial plate of the fascia of the sternocleidomastoid region of the neck (2nd) are the external jugular vein, superficial cervical lymph nodes and cutaneous branches of the cervical plexus of spinal nerves.
Vessels and nerves: Common carotid artery, internal jugular vein, vagus nerve.
At the middle of the posterior edge of the sternocleidomastoid muscle, the exit site of the sensory branches of the cervical plexus is projected. The Pirogov venous angle, as well as the vagus (medially) and phrenic (lateral) nerves are projected between the legs of this muscle.
2. Topography of the main vascular-nervous bundle of the neck (course, depth, relative position of vascular-nervous elements, projection onto the skin of the carotid artery).
There are two large vascular-nerve bundles in the neck: the main and subclavian.
The main neurovascular bundle of the neck consists of the common carotid artery, internal jugular vein, and vagus nerve. It is located in the neck in the area of the sternocleidomastoid (sternocleidomastoid) muscle and the carotid triangle. Thus, the main vascular-nerve bundle along the carotid artery has two sections: the 1st section in the area of the sternocleidomastoid muscle, the 2nd section in the carotid triangle. In the area of the sternocleidomastoid muscle, the neurovascular bundle lies quite deep, covered by the muscle, the 2nd and 3rd fascia. The sheath of the bundle is formed by the parietal leaf of the 4th fascia and, in accordance with Pirogov’s laws, has a prismatic shape, with spurs the sheath is fixed to the transverse processes of the cervical vertebrae.
Higher up, the main neurovascular bundle is located in the carotid triangle. The depth of the neurovascular bundle differs in that it is not covered by muscle and third fascia. With the head thrown back, the pulsation of the carotid artery is clearly visible on the neck, and with palpation the pulse here can be determined even with a significant decrease in blood pressure.
The relative position of the neurovascular elements: A vein lies in front and outward of the artery, and the vagus nerve is located between the vein and artery and posteriorly.
Projection onto the skin of the carotid artery (a. carotiscommunis)
The head is turned in the opposite direction and pulled up:
Left common carotid artery is projected from the middle of the distance between the apex of the mastoid process and the angle of the lower jaw to the middle of the distance between the legs of the sternocleidomastoid muscle.
Right common carotid artery is projected from the middle of the distance between the apex of the mastoid process and the angle of the lower jaw to the sternocleidomastoid joint.
Pirogov triangle (trigonum linguale; N.I. Pirogov)
a section of the superolateral part of the neck, bounded below and behind by the digastric tendon, above by the hypoglossal nerve and lingual vein, in front by the outer (posterior) edge of the mylohyoid muscle; site of choice for the lingual artery throughout.
1. Small medical encyclopedia. - M.: Medical encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. Encyclopedic Dictionary of Medical Terms. - M.: Soviet Encyclopedia. - 1982-1984.
See what a “Pirogov triangle” is in other dictionaries:
PIROGOV TRIANGLE- PIROGOV TRIANGLE, trigonum lingua 1e, a small triangular space in the lateral part of the suprahyoid region of the neck, formed from below (behind) by the tendon of the digastric muscle (m. digastricus), from above by the hypoglossal nerve (n. hypoglossus), passing ...
- (trigonum linguale; N.I. Pirogov) a section of the superolateral part of the neck, bounded below and behind by the tendon of the digastric muscle, above by the hypoglossal nerve and lingual vein, in front by the outer (posterior) edge of the mylohyoid muscle; place of choice for... ... Large medical dictionary
I Neck (collum) Part of the body, the upper limit of which is a line passing along the lower edge of the lower jaw, the lower edge of the external auditory canal, the apex of the mastoid process, the superior nuchal line and the external occipital protrusion; lower... ... Medical encyclopedia
PLASTINES- PLASTEINES, the name given by Zavyalov to sediments obtained in a thermostat by the action of chymosin on concentrated solutions. products of peptic protein digestion. The phenomenon itself was first described by A. Danilevsky. P.’s education takes place… Great Medical Encyclopedia
This article is proposed for deletion. An explanation of the reasons and the corresponding discussion can be found on the Wikipedia page: To be deleted/October 27, 2012. While the process is being discussed... Wikipedia
CAROTIS ARTERIA- CAROTIS ARTERIA. Contents: Anatomy and embryology............382 Pathological anatomy................4J9 Clinic................. ...410 Anatomy. Common carotid artery (a. ca rotis communis) (Fig. 1 and 2) with its external and internal branches... ... Great Medical Encyclopedia
Lingual nerve. Topography of the lingual nerve. Pirogov's triangle. Topography of the Pirogov triangle. Walls of a Pirogov triangle. Submandibular lymph nodes.
In the same space, but upward from the duct of the submandibular gland, between m. hyoglossus and m. mylohyoideus, located lingual nerve, n. lingualis, giving off branches to the submandibular salivary gland (Fig. 6.6).
Thus, in the gap between m. hyoglossus and m. mylohyoideus pass starting from the bottom, n. hypoglossus, v. lingualis, ductus submandibularis, n. lingualis.
Pirogov's triangle. Topography of the Pirogov triangle. Walls of a Pirogov triangle.
Pirogov triangle used as an internal reference when accessing a. lingualis. He is limited hypoglossal nerve above, the tendon of the digastric muscle below and behind, and the free posterior edge of the m. mylohyoideus - in front.
Bottom of the Pirogov triangle forms m. hyoglossus, along the upper (deep) surface of which there is a lingual artery, and along the lower surface there is a vein. To access the lingual artery for the purpose of ligating it, for example, with a deep cut of the tongue, it is necessary to dissect the deep layer of the 2nd fascia and separate the fibers of the hyoglossus muscle.
Submandibular lymph nodes.
Submandibular lymph nodes, nodi submandibulares, are located under the superficial plate of the 2nd fascia of the neck or above it. They are also present in the thickness of the gland, which makes it necessary to remove not only the lymph nodes, but also the salivary gland during metastases of cancerous tumors (for example, the lower lip).
Lymph into the submandibular lymph nodes flows from the medial part of the eyelids, external nose, mucous membrane of the cheek, gums, lips through chains of nodes running along the facial artery. Lymph from the floor of the mouth and the middle part of the tongue also flows into the submandibular nodes.
Connection of fiber of the submandibular triangle with the oral cavity along the gland duct, as well as the outflow of lymph from the superficial parts of the face explain the fairly frequent development of submandibular phlegmon. Further spread of the purulent-inflammatory process practically does not occur due to the isolation of the cellular space of this triangle.
PIROGOV TRIANGLE
(trigonum linguale; n. i. pirogov) a section of the upper lateral part of the neck, bounded below and behind by the tendon of the digastric muscle, above by the hypoglossal nerve and lingual vein, in front by the outer (posterior) edge of the mylohyoid muscle; the site of choice for ligation of the lingual artery throughout.
Medical terms. 2012
See also interpretations, synonyms, meanings of the word and what PIROGOV TRIANGLE is in Russian in dictionaries, encyclopedias and reference books:
- TRIANGLE in the Dictionary of Automotive Jargon:
- emergency sign... - TRIANGLE in the Directory of Constellations, Latin names.
- TRIANGLE in the Big Encyclopedic Dictionary:
- TRIANGLE MUSIC. in the Encyclopedic Dictionary of Brockhaus and Euphron:
or triangle - a metal percussion instrument of eastern origin with an indefinite sonority. Consists of a steel rod bent in the shape of a triangle. By … - TRIANGLE in the Encyclopedic Dictionary of Brockhaus and Euphron.
- TRIANGLE in the Modern Encyclopedic Dictionary:
- TRIANGLE in the Encyclopedic Dictionary:
polygon with 3 sides. Sometimes a triangle is also understood as a part of the plane limited by the sides of the triangle. If for some reason one is singled out... - TRIANGLE in the Encyclopedic Dictionary:
, -a, m. 1. Geometric figure - a polygon with three angles, as well as any object or device of this shape. Rectangular t... - TRIANGLE
TRIANGLE, self-sounding music. instrument - a steel rod bent in the shape of a triangle, which is struck with a stick. Used in orchestras and instruments. ensembles. ... - TRIANGLE in the Big Russian Encyclopedic Dictionary:
TRIANGLE (lat. Triangulum), constellation North. hemispheres of the sky; from the territory Russia is best seen in late summer, autumn and... - TRIANGLE in the Big Russian Encyclopedic Dictionary:
TRIANGLE, a part of a plane bounded by three straight segments (sides of a triangle), each having one common end in pairs (vertices of a triangle). The sum of all angles... - TRIANGLE in the Encyclopedia of Brockhaus and Efron.
- TRIANGLE in the Complete Accented Paradigm according to Zaliznyak:
triangular, triangular, triangular, triangular, triangular, triangular, triangular, triangular, triangular, triangular, triangular, ... - TRIANGLE in the Dictionary for solving and composing scanwords:
Ruler with an odd number... - TRIANGLE in the Russian Synonyms dictionary:
tool, polygon, letter, constellation, trigon, ... - TRIANGLE in the New Explanatory Dictionary of the Russian Language by Efremova:
1. m. 1) A geometric figure on a plane, bounded by three intersecting lines forming three internal angles.. 2) Any object of this shape. ... - TRIANGLE in the Complete Spelling Dictionary of the Russian Language:
triangle, … - TRIANGLE in the Spelling Dictionary:
triangle, ... - TRIANGLE in Ozhegov’s Dictionary of the Russian Language:
The name of the sergeant and petty officer insignia of this form on the buttonholes in the Red Army (from 1919 to 1943) triangle Colloq ... - TRIANGLE in the Modern Explanatory Dictionary, TSB:
part of the plane bounded by three straight segments (sides of a triangle), each having one common end in pairs (vertices of a triangle). The sum of all the angles of a triangle... - TRIANGLE in Ushakov’s Explanatory Dictionary of the Russian Language:
and (colloquially) trigon, triangle, m. 1. A geometric figure bounded by three mutually intersecting straight lines, forming three internal angles (mat.). Obtuse triangle. ... - TRIANGLE in Ephraim's Explanatory Dictionary:
triangle 1. m. 1) A geometric figure on a plane, bounded by three intersecting lines forming three internal angles.. 2) Any object such ... - TRIANGLE in the New Dictionary of the Russian Language by Efremova:
- TRIANGLE
I m. 1. A geometric figure on a plane, bounded by three intersecting lines forming three internal angles. 2. Any object of this shape. ... - TRIANGLE in the Large Modern Explanatory Dictionary of the Russian Language:
m. Constellation of the North... - PIROGOV'S BANDAGE in Medical terms:
see Pirogov bandage... - PIROGOV VEST BANDAGE in Medical terms:
see Pirogov bandage... - PIROGOV SPACE in Medical terms:
(n.i. pirogov) see Parony - Pirogova ... - PARONY-PIROGOV SPACE in Medical terms:
(f. parona, Italian surgeon of the 19th century; N.I. Pirogov, 1810-1881, Russian surgeon; synonym Pirogov space) cellular space in the lower third ... - PIROGOV'S LYMPH NODE in Medical terms:
Rosenmüller - see Pirogov - Rosenmüller lymphatic ... - PIROGOV CELLS in Medical terms:
Langhans - see Pirogov - Langhans ... - SOCIETY OF RUSSIAN DOCTORS IN MEMORY OF N.I. PIROGOV
Russian doctors in memory of N.I. Pirogov, Pirogov Society, founded in 1883 as the Moscow-Petersburg Medical Society; renamed in 1886... - LENINGRAD PRODUCTION ASSOCIATION RED TRIANGLE in the Great Soviet Encyclopedia, TSB:
production association "Red Triangle", the country's largest enterprise for the production of rubber products. Organized in 1962. Its members… - STALKER (MOVIE) in Wiki Quotation Book.
- SEAL OF SOLOMON in the Dictionary Index of Theosophical Concepts to the Secret Doctrine, Theosophical Dictionary:
- Symbolic double triangle adopted by T.O. and many Theosophists. Why it should be called the "Seal of Solomon" remains a mystery, unless... - GEOMETRIC SYMBOLS in the Directory of Characters and Cult Objects of Greek Mythology:
a class of mythopoetic signs, identical in form to geometric elements and widely used in the mythological and religious spheres, as well as more... - SHCHERBAKOV ALEXEY IVANOVICH
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Pirogov (Nikolai Ivanovich, 1810 - 1881) is one of the greatest doctors and teachers of the present century and to this day the most ... - OSTROGORSKY VIKTOR PETROVICH in the Brief Biographical Encyclopedia:
Ostrogorsky, Viktor Petrovich - teacher and writer (1840 - 1902). Graduated from the Faculty of History and Philology of St. Petersburg University. While still a student I was among... - OBERMILLER ALEXANDER LEONTIEVICH in the Brief Biographical Encyclopedia:
Obermiller, Alexander Leontievich - life surgeon (1828 - 1892). Graduated from the Medical-Surgical Academy. During the Sevastopol campaign, an active employee of Pirogov, and ... - KADE ERAST VASILIEVICH in the Brief Biographical Encyclopedia:
Kade (Erast Vasilievich) - famous surgeon (1817 - 1889); After completing the course at Moscow University, he was sent for advanced training to... - DOBROLUBOV NIKOLAY ALEKSANDROVICH in the Brief Biographical Encyclopedia:
Dobrolyubov, Nikolai Alexandrovich - the most famous Russian critic after Belinsky, the main representative of the method of journalistic consideration of literary works. The short story turned out sadly... - BOTKIN SERGEY PETROVICH in the Brief Biographical Encyclopedia:
Botkin, Sergei Petrovich, is the brother of the previous ones, a famous clinician and public figure (1832 - 1889). His father and grandfather are famous... - BERTESON IOSIF VASILIEVICH in the Brief Biographical Encyclopedia:
Bertenson, Joseph Vasilyevich, - doctor and hygienist, honorary life physician (1833 - 95). He received his medical education at the University of Dorpat. After 4 years... - MAJOR KOVALEV in the Literary Encyclopedia.
- COLOR MEASUREMENTS in the Great Soviet Encyclopedia, TSB:
measurements, methods of measuring and quantifying color. Together with various methods of mathematical description of the color of color and. constitute the subject of colorimetry. IN … - PIROGOV NIKOLAY NIKOLAEVICH in the Great Soviet Encyclopedia, TSB:
Nikolai Nikolaevich (11/7/1843, St. Petersburg, - 11/16/1891), Russian physicist. Son of N.I. Pirogov. He was educated at home, then attended lectures in Heidelberg, ... - PIROGOV NIKOLAY IVANOVICH in the Great Soviet Encyclopedia, TSB:
Nikolai Ivanovich, Russian scientist, doctor, teacher and public figure, corresponding member...
