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a piercing of the wall of any cavity, vessel, hollow or parenchymatous organ, tumor, or infiltrate for purposes of treatment or diagnosis. Exploratory punctures are used to help accurately diagnose diseases either through analysis of the contents of a cavity—the pleural cavity, for example—and subsequent cytological, biochemical, and bacteriological examination or through microscopic, ultramicroscopic, cytochemical, and chromosomal study of cells obtained from pathologically altered organs. It is also used for measuring the pressure in the cavities of the heart, large blood vessels, and the cerebrospinal canal and for introducing into a cavity contrast materials or air (radiodiagnostics). Therapeutic punctures are used to extract pus, blood, air, or fluid from a cavity, wash the cavity, and introduce medicinal substances. Often both types of punctures coincide.
There are a number of common punctures. Veins are punctured in order to obtain blood for analysis and for bloodletting, injection of medication, or transfusion of blood. In the case of exudative pleuritis, the pleural cavity is punctured in order to remove air from the cavity and induce artificial pneumothorax. The abdominal cavity is punctured if ascites is present, and joints are punctured for therapeutic and exploratory purposes. Puncture of the cerebrospinal canal is performed for analysis of the cerebrospinal fluid or injection of medications or radiopa-que substances. The urinary bladder is punctured when there is urinary retention and it is impossible to introduce a catheter. Puncture is done with a syringe and a special needle or trocar, according to all the principles of asepsis and anesthesia.
REFERENCEDiagnosticheskaia i lerapevlicheskaia lekhnika. Edited by V. S. Maiata. Moscow, 1969.
A. N. SMIRNOV