The costocervical trunk arises from the upper and back part of the subclavian artery, behind the scalenus anterior on the right side, and medial to that muscle on the left side.
Passing backward, it splits into the deep cervical artery and the supreme intercostal artery (highest intercostal artery), which descends behind the pleura in front of the necks of the first and second ribs, and anastomoses with the first aortic intercostal (3rd posterior intercostal artery).
As it crosses the neck of the first rib it lies medial to the anterior division of the first thoracic nerve, and lateral to the first thoracic ganglion of the sympathetic trunk.
![theatlantic:
What We Know Now About How to Be Happy
Are “happy” people set up differently to begin with? For example, their physiologies seem to be different from those of less happy people, with lower levels of the stress hormone cortisol, reduced inflammatory biomarkers, and even changes in the wiring of the brain. All of these differences might make happy people better able to deal with the adverse events that life throws at them, and less likely to feel the effects of stress, which takes a toll on everybody’s health. The happiness-health relationship is at the very least a two-way street.
But what is happiness in the first place? Is it about seeking out activities that make us feel good - indulging a fancy car or going out for a satisfying dinner - or does it have to do with a deeper sense of personal satisfaction over the course of a lifetime?
Read more. [Image: skippyjon/Flickr]](http://25.media.tumblr.com/tumblr_m46iyyAW3u1qcokc4o1_500.jpg)
What We Know Now About How to Be Happy
Are “happy” people set up differently to begin with? For example, their physiologies seem to be different from those of less happy people, with lower levels of the stress hormone cortisol, reduced inflammatory biomarkers, and even changes in the wiring of the brain. All of these differences might make happy people better able to deal with the adverse events that life throws at them, and less likely to feel the effects of stress, which takes a toll on everybody’s health. The happiness-health relationship is at the very least a two-way street.
But what is happiness in the first place? Is it about seeking out activities that make us feel good - indulging a fancy car or going out for a satisfying dinner - or does it have to do with a deeper sense of personal satisfaction over the course of a lifetime?
Read more. [Image: skippyjon/Flickr]
(via fyeahmedlab)
Abdominal aortic aneurysm is a localized dilatation of the abdominal aorta exceeding the normal diameter by more than 50 percent, and is the most common form of aortic aneurysm. Approximately 90 percent of abdominal aortic aneurysms occur infrarenally, but they can also occur pararenally or suprarenally. Abdominal aortic aneurysms occur most commonly in individuals between 65 and 75 years old and are more common among men and smokers.
Abdominal aortic aneurysms are commonly divided according to their size and symptomatology. An aneurysm is usually defined as an outer aortic diameter over 3 cm (normal diameter of the aorta is around 2 cm). If the outer diameter exceeds 5.5 cm, the aneurysm is considered to be large.
The vast majority of aneurysms are asymptomatic. However, as abdominal aortic aneurysms expand, they may become painful and lead to pulsating sensations in the abdomen or pain in the chest, lower back, or scrotum.The risk of rupture is high in a symptomatic aneurysm, which is therefore considered an indication for surgery.The complications include rupture, peripheral embolization, acute aortic occlusion, and aortocaval (between the aorta and inferior vena cava) or aortoduodenal (between the aorta and the duodenum) fistulae. On physical examination, a palpable abdominal mass can be noted. Bruits can be present in case of renal or visceral arterial stenosis.
The clinical manifestation of ruptured AAA usually includes excruciating pain of the lower back, flank, abdomen and groin. The bleeding usually leads to a hypovolemic shock with hypotension, tachycardia, cyanosis, and altered mental status. The mortality of AAA rupture is up to 90%. 65–75% of patients die before they arrive at hospital and up to 90% die before they reach the operating room.The bleeding can be retroperitoneal or intraperitoneal, or the rupture can create an aortocaval or aortointestinal (between the aorta and intestine) fistula.Flank ecchymosis is a sign of retroperitoneal hemorrhage, and is also called Grey Turner’s sign.
Daguerreotype of Dr. Louis T.J. Auzoux and paper-mache model, c. 1860
Meningitis-purulent exudate.
Pulling the muscle of the lower arm causes tightening of the tendons of the hand.
Cross section of an artery and vein
