Pedicle Health Dictionary

Pedicle: From 2 Different Sources


A narrow tube of tissue formed by folded skin which links a piece of tissue used for surgical grafting to its site of origin. A pedicle graft is used by the surgeon – usually a reconstructive/ plastic surgeon – when the site under repair is unsuitable for an independent graft, usually because the blood supply at the recipient site is inadequate. (See RECONSTRUCTIVE (PLASTIC) SURGERY.)

A pedicle is also found occurring between a tumour and its tissue of origin, and the term is used in anatomy to refer to any slim tubular process.

Health Source: Medical Dictionary
Author: Health Dictionary
n. 1. the narrow neck of tissue connecting some tumours to the normal tissue from which they have developed. 2. (in plastic surgery) a narrow folded tube of skin by means of which a piece of skin used for grafting remains attached to its original site. A pedicle graft is used when the recipient site is unsuited to take an independent skin graft (for example, because of poor blood supply). See also flap; skin graft. 3. (in anatomy) any slender stemlike process.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Flap

A section of tissue (usually skin) separated from underlying structures but still attached at its distal end by a PEDICLE through which it receives its blood supply. The free end may then be sutured into a new position to cover a defect caused by trauma or excision of diseased tissue. A free ?ap involves detachment of a section of tissue, often including bone and muscle, to a distant site where the artery and vein supplying it are anastomosed to adjacent vessels and the tissue is sutured into place. (See RECONSTRUCTIVE (PLASTIC) SURGERY.)... flap

Fetus

The name given to the unborn child after the eighth week of development. Humans, like all animals, begin as a single cell, the OVUM, in the ovary (see OVARIES). After FERTILISATION with a SPERMATOZOON, the ovum becomes embedded in the mucous membrane of the UTERUS, its covering being known as the decidua. Increase in size is rapid, and development of complexity is still more marked. The original cell divides repeatedly to form new cells, and these become arranged in three layers known as the ectoderm, mesoderm and endoderm. The ?rst produces the skin, brain and spinal cord, and the nerves; the second the bones, muscles, blood vessels and connective tissues; while the third develops into the lining of the digestive system and the various glands attached to it.

The embryo develops upon one side of the ovum, its ?rst appearance consisting of a groove, the edges of which grow up and join to form a tube, which in turn develops into the brain and spinal cord. At the same time, a part of the ovum beneath this is becoming pinched o? to form the body, and within this the endoderm forms a second tube, which in time is changed in shape and lengthened to form the digestive canal. From the gut there grows out very early a process called the allantois, which attaches itself to the wall of the uterus, developing into the PLACENTA (afterbirth), a structure well supplied with blood vessels which draws nourishment from the mother’s circulation via the wall of the womb.

The remainder of the ovum – which within two weeks of conception has increased to about 2 mm (1/12 inch) in size – splits into an outer and inner shell, from the outer of which are developed two covering membranes, the chorion and amnion; while the inner constitutes the yolk sac, attached by a pedicle to the developing gut of the embryo. From two weeks after conception onwards, the various organs and limbs appear and grow. The human embryo at this stage is almost indistinguishable in appearance from the embryo of other animals. After around the middle of the second month, it begins to show a distinctly human form and then is called the fetus. The property of ‘life’ is present from the very beginning, although the movements of the fetus are not usually felt by the mother until the ?fth month.

During the ?rst few days after conception the eye begins to be formed, beginning as a cup-shaped outgrowth from the mid-brain, its lens being formed as a thickening in the skin. It is very soon followed by the beginnings of the nose and ear, both of which arise as pits on the surface, which increase in complexity and are joined by nerves that grow outward from the brain. These three organs of sense have practically their ?nal appearance as early as the beginning of the second month.

The body closes in from behind forwards, the sides growing forwards from the spinal region. In the neck, the growth takes the form of ?ve arches, similar to those which bear gills in ?shes. From the ?rst of these the lower jaw is formed; from the second the hyoid bone, all the arches uniting, and the gaps between them closing up by the end of the second month. At this time the head and neck have assumed quite a human appearance.

The digestive canal begins as a simple tube running from end to end of the embryo, but it grows in length and becomes twisted in various directions to form the stomach and bowels. The lungs and the liver arise from this tube as two little buds, which quickly increase in size and complexity. The kidneys also appear very early, but go through several changes before their ?nal form is reached.

The genital organs appear late. The swellings, which form the ovary in the female and the testicle (or testis) in the male, are produced in the region of the loins, and gradually descend to their ?nal positions. The external genitals are similar in the two sexes till the end of the third month, and the sex is not clearly distinguishable till late in the fourth month.

The blood vessels appear in the ovum even before the embryo. The heart, originally double, forms as a dilatation upon the arteries which later produce the aorta. These two hearts later fuse into one.

The limbs appear at about the end of the third week, as buds which increase quickly in length and split at their ends into ?ve parts, for ?ngers or toes. The bones at ?rst are formed of cartilage, in which true bone begins to appear during the third month. The average period of human gestation is 266 days – or 280 days from the ?rst day of the last menstrual period. The average birth weight of an infant born of a healthy mother (in the UK) is 3,200 g (see table).

The following table gives the average size and weight of the fetus at di?erent periods:

(See also PREGNANCY AND LABOUR.)... fetus

Torsion

Twisting. The term is applied to the process in which organs, or tumours, which are attached to the rest of the body by a narrow neck or pedicle, become twisted so as to narrow the blood vessels or other structures in the pedicle. (See TESTICLE, DISEASES OF.)

Torsion is also the term applied to the twisting of the small arteries severed at an operation, by which bleeding from them is stopped.... torsion

Advancement

n. the detachment by surgery of a muscle, musculocutaneous flap, or tendon from its normal attachment site and its reattachment at a more advanced (anterior) point while preserving its previous nerve and blood supply. The technique is used, for example, in the treatment of squint and extensively in plastic surgery to cover large defects (see also pedicle).... advancement

Infarction

n. the death of part or the whole of an organ that occurs when the artery carrying its blood supply is obstructed by a blood clot (thrombus) or an *embolus. For example, *myocardial infarction, affecting the muscle of the heart, follows coronary thrombosis. A small localized area of dead tissue produced as a result of an inadequate blood supply is known as an infarct. Infarcts also arise when venous outflow from an organ or tissue is obstructed, as occurs when the ovary or testis twist on their vascular pedicles (stalks), or when the sigmoid colon twists in *volvulus.... infarction

Ligature

n. any material – for example, nylon, vicryl, or wire – that is tied firmly round a blood vessel to stop it bleeding or around the base of a structure (such as the *pedicle of a growth) to constrict it.... ligature

Skin Graft

a portion of healthy skin cut from one area of the body and used to cover a part that has lost its skin, usually as a result of injury, burns, or operation. A skin graft is normally taken from another part of the body of the same patient (an *autograft), but occasionally skin may be grafted from one person to another as a temporary healing measure (an *allograft). The full thickness of skin may be taken for a graft (see flap) or the surgeon may use three-quarters thickness, thin sheets of skin (see split-skin graft), or a pinch skin graft. The type used depends on the condition and size of the damaged area. The skin graft may be free or attached by a *pedicle.... skin graft

Tram Flap

transverse rectus abdominis myocutaneous *flap: a piece of tissue (skin, muscle, and fat) dissected from the abdomen, between the umbilicus and pubis, and used to reconstruct the breast after mastectomy. The flap of tissue is dissected along with its blood supply and moved into its new position on this pedicle.... tram flap



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