Pulmonary vision: internal thoracic artery (internal mammary artery)

The internal thoracic artery (internalthoracicartery), also known as internal mammary artery / internal mammary artery, is a pair of arterial trunks on the inner surface of the anterior chest wall and the most commonly used vessels for coronary artery bypass. The internal mammary artery originates from the inferior wall of the first segment of the subclavian artery and descends 1-2 cm outside the lateral border of the sternum. It resides on the deep surface of the upper 6-rib cartilage and intercostal muscles, transverse thoracic muscles and intrathoracic fascia. Shallow. From the 6th intercostal space, it is divided into two terminal branches, the superior abdominal artery and the muscular diaphragm artery. The former descends into the rectus abdominis sheath; the latter branches diagonally outward and downward from the back of the 7-9 costal cartilage, branching to the lower part of the pericardium and the diaphragm. Near the first rib, the pericardial and phrenic artery emanates from the internal thoracic artery, travels with the phrenic nerve through the anterior root of the lung, descends to the diaphragm between the pericardium and the mediastinal pleura, and branches out to the pericardium and pleura along the way. The internal thoracic artery descends the anterior intercostal branch and the perforating branch through the upper 6 intercostal spaces. The former runs laterally and coincides with the terminal branch of the intercostal artery and the end of its lateral accessory branch; the latter is distributed in the shallow anterior chest wall structure. The internal thoracic artery is accompanied by two veins, and the branches also have veins of the same name. The internal thoracic artery sends out the pericardial and phrenic artery blood supply organs: pericardium, mediastinal pleura, anterior mediastinal internal organs such as the thymus; the internal thoracic artery sends the anterior intercostal branch and perforating branch through the upper 6 intercostal spaces, and the blood supply organ has a chest The anterior wall includes the sternum and breasts; the internal thoracic artery sends out the upper abdominal wall blood supply organs have the upper abdominal wall; the internal thoracic artery sends out the muscular diaphragm arterial blood supply organs have the lower pericardium and the diaphragm muscles. The internal thoracic artery can also send out the vagal bronchial artery and communication branch to supply blood to the bronchus; in special cases, the terminal branches of the internal thoracic artery, such as the superior abdominal wall artery and the diaphragmatic artery, supply blood to the liver through branches. Therapeutic value Through the above we understand the vascular anatomy of the internal thoracic artery and the organs involved in blood supply, which provide the necessary theoretical basis for intravascular infusion chemotherapy and embolization through the internal thoracic artery. The literature reports interventional therapy through internal thoracic artery: interventional therapy for lung cancer, interventional therapy for massive hemoptysis, perfusion chemotherapy for breast cancer, perfusion chemotherapy for malignant thymoma, and interventional therapy for liver cancer.

Sini San for Intercostal Neuralgia and Flanking Pain

Click “Chinese Medicine Chen Liang” above, follow it to learn more exciting content! ! ! Probably the year before last, an old man who lived in the European City came to see me. She coughed for a few months, saw a lot of doctors, and performed various examinations, all of which were normal. One of the special phenomena I have always remembered is the pain and swelling of the chest and ribs on both sides when coughing. At that time, Sini powder was added with turmeric, turmeric, Xiangfu, etc., and after five days, the follow-up consultation was actually more than half. The idea of ​​Sinisan in treating cough and flank pain I learned from Mr. Chen Ruichun, especially the intercostal neuralgia and rib pain. By adding or subtracting Chinese medicine, the effect is often clear. I also treated a middle-aged woman who suffered from pain caused by the left flank that reached the corner of the table. The same idea was used, but with the addition of Sanqi powder for promoting blood circulation and removing blood stasis. Intercostal neuralgia belongs to the category of “flank pain”. Excluding hepatitis, chronic cholecystitis and traumatic pain, intercostal neuralgia is generally common. For general reasons, liver stagnation and qi stagnation will be considered, so use Sini San plus Xingqi Huoxue medicine. If the pain lasts longer, you can add Chuanxiong, peach kernel, and safflower to increase the strength of qi and blood circulation. Drugs for promoting blood circulation and removing blood stasis, such as peach kernels and Chuanxiong, are generally not used for a long time. Otherwise, it is easy to cause poor blood and blood, especially Chinese medicine with greater blood circulation power, such as Trigonum, Curcuma, Blood, and Leech, which may have no effect. Harmful. The use of Chinese medicine not only needs to know the benefits of using it, but also needs to know the disadvantages of using it. Everything has a degree problem. It is meaningless to leave things without saying “degrees”. For example, if a normal person’s hair is frozen, will it freeze, or will it become more and more hardy? Depends entirely on the degree, different people “degree” is completely different. I get sick afterwards, but the body’s ability to resist cold increases. (Refer to “The greater the quantity of medicine, the better”). Another example is that Mr. Wang Mianzhi once mentioned a problem in his speech about “Chaihu robbing liver and yin, and Pueraria decoction.” Shugan is too easy to hurt liver and yin. Medicine is to use your own bias to correct the bias of the body, to correct the bias, use the right, it is good. The more powerful the medicine, the greater the harm if you use it wrongly, which also means that the boundary of the medicine is very narrow or steep, and the buffer zone is very small. Gegen Shengjin is easy to hurt the stomach yin, so at this time, the medicine used to nourish the stomach and puerarin can be used together, and it can be supplemented in compatibility. The composition of Sini San is the recipe for reconciling the liver and spleen in the recipe of “Fangxue”, which is extracted from “Treatise on Febrile Diseases”. Composition of Sini San: Bupleurum, Radix Glycyrrhizae, Paeonia lactiflora, Fructus Aurantii. Sini powder, sparse liver and qi, harmonize spleen and stomach. Sinisan has a wide range of effects. It can not only treat intercostal neuralgia. Many diseases treated from the liver, such as hepatitis flank pain, breast lobular hyperplasia, lymphadenopathy, cholecystitis, kidney stones, lymphadenitis, stomach pain, etc. Have the opportunity to use. Some old injuries, soft tissue contusion, also have the opportunity to use, borrow from the experience of Mr. Chen Ruichun, and used to add turmeric, Chuanxiong, Xiangfu, peach kernel, green skin and so on. Teacher Huang Huang has a unique saying about Sini San, that is Sini San. It is a unique “square patient” triangle system. Such a person can simply make a sketch: thin Chinese character face, thick eyebrows, such as Li Xiangyang in the plain guerrillas. The Japanese have more Sini powder constitutions, Chinese character faces, more moderate figure, more square faces, subtle personality, easy to be depressed, not easy to get angry, so there are many suicides. If you take Sini San regularly and have a smooth ventilator, there will be fewer suicides. The face shape is two mandibular angles protruding + Sifang thin + cheeks without meat. The next development of Sini San may be Dachaihu constitution. These people are prone to cold limbs, abdominal pain or hot and cold, and their chests are full. For example, people with low blood pressure have cold limbs, mental depression, and dizziness. Especially young women have yellow complexions and poor appetite. Some people feel that they are weak and take tonic supplements, but they are not useful. There are also depression, menopause syndrome, neurosis and so on. Teacher Huang has a prescription of Fangzi Bawei Jieyu Soup, which is a formula derived from Sini San. I often use it to treat depressed mood. Fangzi face, depressed women’s insomnia, menstrual problems and other prescriptions, some are for people, Used for conditioning the body; some are right, such as Da Chai Hu Tang for treatment of cholecystitis, gallstones; … for example, licorice heart soup for mouth ulcers, Zhuling soup for urinary tract infection, Baoyuan soup for slow heartbeat … Many have problems with the size of the probability of use. When used correctly, they often make it easier to see a doctor. But it ’s not that there is a one-to-one correspondence, it ’s not that it ’s the side that sees the disease, nor is it