365bet娱乐

Apalapa Etymology鈥擳his is the combination of two word Ap+lapa. Ap means negative meaning as in Apakeerthi [apakirti], apaswara. Lapa means to talk. 1. Due to the injury the patient may be unable to talk. 2. Another meaning is to conceal the truth. Injury to this area will be very difficult to reach the exact diagnosis. During the haemothorax stage it will not be that easy to diagnose and by the time a diagnosis is reached pus formation might have occurred. 3. A part between the shoulder and the rib. Description Situation of the marma is below shoulder joint and above the lateral aspect of chest. According to 176

Vaghbata it is between prishta vamsam (vertebral column) and uras (chest). This is a sira marma and is Kalanthara pranahara and of half anguli in extent. According to Vaghbata it is Sadya pranahara. According to Susruta, Apalapa marma is situated below the Amsa koota above the parswa bhagha, if injured will have a gradual death due to conversion of rakta into pooya. Its bhuta structure is Agni and Jala. Adhidevatha is Isvara. Surface Anatomy Long thoracic nerve and lateral thoracic artery Intercostobrachial nerve Internal thoracic artery and veins Superior thoracic artery Internal intercostal muscle External intercostal muscle Pectoralis minor muscle Digitations of serratus anterior muscle External intercostal muscles External intercostal membranes anterior to internal intercostal muscles Lateral cutaneous branches of intercostal nerves and arteries Rectus abdominis muscle and sheath Internal abdominal oblique muscle Transversus thoracis muscle Anterior intercostal branches of internal thoracic artery Intercostal nerve Superior epigastric arteries and veins Musculophrenic artery and vein Transversus abdominis muscle Plate No. 19: The anatomical area of Apalapa 177

The corresponding area of this marma on anterior thoracic wall situated towards the region of axilla, on the right and the left corner of the chest. It approximately falls on the uniting border of deltoid and pectoralis muscles below the straight line drawn from acromian joint. Anatomical structures corresponding to this marma 鈽� Axillary Art and its branches. Axillary Vein. 鈼� Brachial Plexus with its branches 鈽� Lymphatic vessel in the axilla 鈽� The deltoid branch of thoraco acromial artery 鈽� Long Thoracic nerve forming the middle wall of axilla Discussion 鈽� Inter costal artery Subclavian vein The word apalapani is used in the plural form. They are situated in the thoracic cavity. Hence it should be inferred as apalapani as innumerable branches of bronchioles that lie concealed within the lung mass. Injury to this marma may lead to sepsis secondary to haemorrhage and endanger life in course of time. From the above description it is inferred that this marma is somewhere around mid axillary line. 178

Susruta further explains this as Kalanthara pranahara marma, meaning there is a time lapse. This might be due to time taken for the conversion of rakta into pooya. For this invariably raktasrava should occur. The collection of pus in the pleural cavity is termed as Empyema. Empyema is occasional complication of penetrating wounds in the chest. This may occur secondary to pneumonia and haemothorax. Empyema is always secondary to infection in the neighboring structures, usually lungs. The principal pulmonary infections in the neighbouring structures, liable to produce empyema are the specific and suppurative pneumonia, and tuberculosis. Extra pulmonary causes are extremely rare, but this condition may follow an infected penetrating wound of chest wall. A haemothorax may become infected or a subphrenic nerve may rupture through the diaphragm. Tamil varma sastra The equivalent Tamil marma is very much difficult to fine however the Adappakalam could be considered more similar. Adappakalam is situated within four angulas (10 cms) distance from the pelvis to the rib cage. This get injured if hit from a distance of 70 cms. The hands and legs will become stiff and numb. 179

Lohitha is seen two angula below the Poonellu (I rib). If injured the patient faints. He should be retrieved by pressing the marma by name Atbhutha seen at the joint of the axilla.