home-Children's fashion-Drawn eyes. Drawing the human eye

Drawn eyes. Drawing the human eye

A breast biopsy, which is performed using a puncture (puncture) with special needles, makes it possible to accurately diagnose most diseases of this organ. This study is practically safe and does not cause serious complications. After manipulation, there is no deformation of the organ, so it is used in most patients with breast diseases, especially if a malignant tumor is suspected.

What is the difference between a puncture and a biopsy?

A puncture is a type of biopsy, along with an excisional one, which is performed by cutting the gland tissue. This concept also refers to the procedure for taking material (puncture), and biopsy refers to a diagnostic method, that is, biopsy is a broader concept.

Types of research

To obtain material, different types of puncture biopsy of the breast are used:

  • fine-needle aspiration - used to obtain a suspension of cells with their subsequent cytological examination;
  • core biopsy with a larger diameter needle using a biopsy gun or a vacuum biopsy system (such methods allow you to obtain a “column” of tissue and examine their histological structure).

Advantages over excisional biopsy

An excisional biopsy involves a surgeon using a scalpel to remove a suspicious area of ​​breast tissue. Compared to this method, diagnostic puncture has a number of advantages:

  • there is no need to visit the surgeon before the intervention and for a follow-up examination, thus, the time required for diagnosis is reduced;
  • since up to 80% of biopsies are performed for the breast, removing a larger volume of tissue is impractical and can lead to its deformation;
  • scars formed after a surgical (excisional) biopsy may later be mistaken for pathological formations on a mammogram and will lead to the need for repeated examination;
  • examination of surgically obtained material takes longer, which causes additional stress for the patient;
  • the cost of the study is approximately 2 times lower;
  • puncture or other benign formation often makes it possible to avoid surgical intervention.

Indications

At what size of tumor is a breast puncture performed?

As soon as the formation becomes noticeable on a mammogram or ultrasound, the issue of manipulation can already be decided. The cyst is usually punctured when its size is from 1 to 1.5 cm.

Can a puncture cause cancer?

No, it cannot, mechanical removal of part of the tissue does not lead to malignant degeneration of surrounding cells. If the needle gets into a malignant tumor, then there is a minimal probability that cancer cells will “reach out” after it. This has no clinical significance.

What does this analysis show?

It is prescribed for suspected benign tumors or malignant neoplasms and is necessary to determine treatment tactics and the extent of necessary surgical intervention.

Taking a puncture of the breast

Indications:

  • the presence of a formation in the gland tissue detected by mammography or ultrasound;
  • multiple lesions;
  • violation of the internal structure of the organ;
  • detection of microcalcifications;
  • outside the lactation period;
  • deformation of the nipple area or the surface of the skin of the organ.

Volumetric formation of the gland

Any large lesion in women over 25 years of age requires a biopsy. If a calcified fibroadenoma, lipoma, fat necrosis, or a scar after surgery is detected, no further diagnosis is prescribed.

The study is performed:

  • in younger women, if ultrasound reveals a lesion without obvious signs confirming its benignity;
  • in cases where a suspicious formation is visible on a mammogram, but it is not detected on an ultrasound.

Violation of the organ structure

Distortions of the normal structure of the ducts and glandular tissue may be the first signs. They are associated with a malignant process in 10-40% of cases. Many of these disorders are poorly visible on ultrasound and therefore require puncture under X-ray control. If the result is cells with atypia, further surgical biopsy is necessary. In case of structural abnormalities, at least 10 tissue samples are required to assess the condition of the gland.

Microcalcifications

These are small areas of calcified tissue that have a very high density on the mammogram and stand out clearly against the background of surrounding structures. All of them require an X-ray-guided study, but a fine-needle biopsy is not indicated in this case. Vacuum aspiration can be used to suction the suspicious area.

Cyst aspiration

To remove simple cysts that cause discomfort in the patient, a fine-needle puncture under ultrasound guidance is indicated. Asymptomatic cysts do not require removal unless they are accompanied by abnormal ultrasound findings.

These signs include:

  • thickened wall or internal partitions;
  • wall deposits;
  • heterogeneous internal structure;
  • no amplification of acoustic shadow.

Vacuum biopsy system for breast core biopsy

Contraindications

A puncture biopsy is not informative in all patients. It is not prescribed in the following cases:

  • obvious benignity of the formation, which requires only regular mammography;
  • lesions located deep in the gland, close to the chest wall or in the armpit area;
  • the size of the lesion is less than 5 mm, while the lesion can be completely removed during the study, and if it turns out to be cancer, further determination of the location of the tumor will be difficult; such a study is possible only with modern stereotactic equipment, and the site of removal of the nodule is marked with a metal bracket.

Other diseases and conditions:

  • inability to remain still for 30-60 minutes;
  • severe pain in the neck, shoulders or back caused by any reason;
  • Parkinson's disease;
  • blood clotting disorders;
  • carried out during menstruation;
  • acute infectious diseases.

How to prepare?

If the patient is taking anticoagulants or antiplatelet drugs, such as Aspirin or Warfarin, it may be necessary to gradually reduce the dose of the drug in advance and then stop it for a while. Before this, you must consult with the specialist who prescribed the medicine and take a blood test for coagulation (coagulogram).

It is undesirable to carry out manipulation in the first 5 days of the cycle (during menstruation). It is necessary to wash and dry the mammary glands and remove jewelry. Special diet There is no need to comply; you can have breakfast in the morning.

Equipment for puncture and its types

The choice of research method largely depends on the equipment available in the medical institution.

Stereotactic puncture (core biopsy)

The device operates on the principle of triangulation. The location of the lesion is determined using a series x-rays taken at different angles. Next, the exact position of the formation is calculated by computer processing, and the biopsy device is placed at the desired point on the skin under X-ray control.

During the procedure, the patient can be in two positions:

  • lying on your stomach, with your chest lowered into a special hole on the X-ray table;
  • sitting, as during a mammogram.

The position is chosen depending on the location of the tumor and physical capabilities patients.

Fine needle puncture

The procedure is performed with a thin, small-diameter needle, which is less painful and safer, especially for women with bleeding disorders. The main disadvantages are lower diagnostic accuracy. Erroneous conclusions about the absence of cancer occur in 1-30% of cases. On the other hand, with a fine-needle biopsy of a fibroadenoma or lipoma, the result may be false positive. Puncture of a breast cyst is used when a cavity filled with liquid content is detected on a mammogram or ultrasound.

The patient is lying on her back with her arms raised or on her side, with her hands behind her head.

In any case, if the data from the study and mammography do not correspond, a core biopsy or surgical intervention is required.

How is a breast puncture performed?

The procedure is performed without anesthesia; less often, it requires the injection of a small amount of anesthetic into the tissue or superficial anesthesia with an anesthetic cream. The puncture is carried out either by one doctor or by an assistant, for example, for ultrasound control.

The puncture site is limited with sterile napkins, the skin is disinfected and a needle attached to a 10-20 ml syringe is inserted, or a biopsy machine is used. With a stereotactic biopsy, this entire process takes place while simultaneously scanning with X-rays, and if a puncture of the mammary gland is performed under ultrasound guidance, the doctor applies a sensor that shows the passage of the needle. The number of punctures depends on the goal, the number and size of the lesions. Doctors try to do as few punctures as possible to reduce the likelihood of complications.

After the procedure, the puncture site is treated with alcohol, and a sterile gauze pad is applied. After 2-3 days, the hole after the puncture heals completely. Until this point, it is advisable to constantly wear a support bra, and you can apply cooling compresses.

Possible complications

Is breast puncture dangerous?

Serious complications after core biopsy are observed in only 2 women out of 1000. These include hematomas (bleeding into tissue) and inflammation. Extremely in rare cases There may be bleeding from the puncture site. Approximately 5% of patients experience dizziness and fainting, which are quickly eliminated.

Milder consequences of breast puncture develop in 30-50% of patients:

  • pain that lasts up to 2 weeks after the procedure;
  • noticeable bruising on the skin;
  • emotional stress.

If there is pain in the mammary gland after a puncture, the use of conventional painkillers is acceptable. If such sensations persist for more than 2 weeks, you should consult a doctor.

There is a single observation of a complication in which, during a core biopsy, a milk fistula formed in a nursing woman, which healed within 2 weeks. A case of the development of a large hematoma in a patient with a blood clotting disorder is also described. This hemorrhage “camouflaged” the biopsy area in which the cancerous tumor was diagnosed. After 3 months, the hematoma resolved, and it became possible to perform surgery. Cases of puncture of the chest wall with the formation of pneumothorax are also described - in 1 out of 10 thousand cases.

Is it painful to have a breast puncture?

Biopsy with fine needle practically does not cause discomfort or any complications. Local anesthesia may be used for core biopsy.

Diagnostic value of the study

The accuracy of the results depends on the accuracy of the manipulation, careful histological analysis and their agreement with the results or.

Probability of accurate diagnosis with core biopsy:

Why is a repeat puncture prescribed?

The problem is cases of discrepancy between the results of biopsy and mammography. If radiography has every reason to suspect a malignant tumor, and the puncture gives a “benign” result, it is necessary to either repeat the core biopsy or perform surgical intervention. If the results do not match, in 47% of cases, patients end up with a malignant tumor.

In addition, there are cases when the lesion is accompanied by cancer cells and benign lesions. Sometimes the analysis reveals only a benign component. Therefore, there are risk groups that require either regular puncture or surgical biopsy:

  • atypical ductal hyperplasia or ductal atypia, which is often adjacent to a malignant tumor or degenerates into it;
  • radial scars in the gland tissue;
  • fibroepithelial neoplasms, when differential diagnosis between fibroadenoma and leaf-shaped tumor is difficult;
  • lobular in situ;
  • cases where, after puncture of the mammary gland, the size of the tumor increased.

Decoding the results

Normal breast tissue contains:

  • connective tissue cells and fibers;
  • fat lobules;
  • epithelium lining the milk ducts.

Adipose tissue predominates over connective tissue; atypical (that is, potentially malignant) cells are absent. The norm in the conclusion of a core biopsy is 97% to exclude any diseases.

In case of benign processes, the pathologist will find in the biopsy a large number of connective tissue, epithelium with degenerative changes, other cells atypical for the normal picture. At the same time, he can give an opinion about the possible presence of such diseases:

  • cystic fibroadenomatosis (what used to be called);
  • fibroadenoma (benign tumor);
  • intraductal papilloma (like a polyp in the duct);
  • fat necrosis;
  • ductectasia, plasmacytic mastitis (dilation of the ducts).

When a cyst is punctured, the color of the resulting contents is also assessed. If the normal color of the biopsy tissue is pink, then the cyst is characterized by white, bloody or even green fluid. If you suspect the development of an infectious process, you can culture the resulting contents and identify the microorganisms that caused the suppuration.

The presence of red blood cells in a breast puncture is not a sign of a malignant tumor. They can enter the material when a vessel or, for example, the wall of a cyst or adenoma is damaged.

If atypical cells or cells with signs of malignancy are found in the sample, the pathologist may suggest the following diagnosis:

  • adenocarcinoma;
  • cystosarcoma;
  • intraductal carcinoma;
  • medullary cancer;
  • colloid cancer;
  • lobular carcinoma;
  • sarcoma;

If a malignant breast tumor is suspected, its tissue is examined for the presence of estrogen receptors (ER) and progesterone receptors (PR). This is important for determining further treatment tactics.

How long to wait for the result?

It all depends on its complexity and type of manipulation. This usually takes from 3 to 5 days. When studying for ER and PR, as well as for BRCA testing, the turnaround time for the analysis can be from 7 to 10 days.

The results are interpreted by a mammologist taking into account all other data. You should not interpret the findings yourself.

And also, it is advisable to first study another lesson -.

See the structure of the eye in the picture below.

Eyelashes should be thick at the root and thin at the tips.

How not to draw eyelashes, see below.

Draw the outline of the eye with light lines. Then use a 2H pencil to draw eyelashes. Each eyelash looks like a comma, only upside down. Draw from the contour of the eye while reducing the pressure on the pencil by bending the line, the line will become thinner. With a slight movement of the brush, tear the pencil off the paper when you finish drawing the eyelash.

Using a 2B pencil, draw more eyelashes so that they are thick. draw the outline of the iris, pupil and highlight.

Use a 6B pencil to draw the pupil. Using a 2B pencil, draw the iris of the eye. For this we use . Please note that the top of the eye area is darker than the bottom, and the sides are also darkened. Use an eraser to create a light area at the bottom, then draw a few lines to create texture.

Using cross hatching create gradient transitions on the white of the eye, while the edges and upwards of the white should be darkened. Hatch the edges of the upper and lower eyelids; closer to the outer corner of the eye, the tone transition becomes darker. Draw a little fine lines to create blood vessels.

Eye. Without a doubt, this is a favorite subject of many artists! The human eye is undoubtedly a window into the human soul. But how to portray it?

To learn to draw eyes, first I will ask you to take a small mirror. I want you to keep this mirror next to you while you draw. I want you to be able to look at your own eyes at any time while you work through this lesson.

Mark Kistler learned this technique from a visit to DreamWorks with some alumni a few years ago. The animators were working on Shrek, and their work stations included several computers, monitors, drawing tablets, and, interestingly, two mirrors on either side of their desks. While the animators were working on various parts“Shrek,” he could watch them frown in the mirrors as they drew Shrek’s frowning face. Mark saw them holding hands different positions when drawing Shrek's hands. It was very interesting to see how world class artists brought Shrek to life. Now let's add life to your album - let's draw an eye.

1. While sitting at the table, look in the mirror. Stay for a few minutes...You are simply a miracle. Just take a look! These eyes! These lips, nose, ears, hair are just a great model to draw. You redrew da Vinci in, and now you will draw from the very ideal model eye on the planet - from yourself! Lightly trace the shape of the eye. In this tutorial we will draw an eye that resembles the shape of a lemon, with a small tear duct. When you draw a lot of eyes (and you will undoubtedly draw more than a hundred of them, because they are so fun to draw), you will notice how many various forms eyes of people on the planet. In this tutorial we use simple form lemon.

2. Look in the mirror and examine your left upper eyelid. Notice how the folds follow the shape of the eye. Draw the upper eyelid starting from the inner corner of the eye.

3. Draw a perfectly round circle of the iris, bending it slightly under the upper eyelid. We use the law of overlap. Remember that the iris is perfect circle, not an oval. Look in the mirror. Look closely at the thickness of the edge along the top of the lower eyelid. The interesting thing is that the smallest details, like this one, what you are looking for and drawing. These details really give the "wow" factor. Without them, your drawing will look unrealistic.

4. Look in the mirror. Look closer at the pupil in the center of the iris. Notice the perfect circumference of the circle. Notice the tiny flecks of highlight within the black circle. Draw a perfect round pupil in the middle of the iris. Draw a small circle inside for the highlight.

5. Look in the mirror. Take a closer look at your pupil again. Look at the black pupil and the light highlight. Draw this dark black pupil with a light highlight.

6. Look in the mirror. Look closely at the surface of the iris around the pupil. Take a closer look. And further. Just amazing game light, color, humidity, shape, such details! When you fill in the iris, make radial pencil strokes from the pupil and use lines of varying lengths, some short, some long. As you experiment with colored pencils, I would recommend you start with this tutorial.

7. Draw in your gorgeous eyebrow. Shape each hair separately, starting from the bridge of the nose and moving across the forehead. Moving away from the nose, draw more horizontal, fluttering lines. Start shading your eyes inside century

8. Look in the mirror. Take a close look at your eyelashes. Notice how your lashes are grouped in small groups of two or three rather than just one lash. Notice how the groups of eyelashes originate from the nearest edge of the upper eyelid. Notice how your eyelashes curl away from your eyelid, following the contour of your eye. Also pay attention to the location. Make sure you draw them on the very edge of the eyelid. Pay attention to the direction in which the eyelashes curl. Be careful not to draw too many eyelashes, and also not to draw them too vertically (otherwise you may end up with a "spider web" effect).

Next step - shading. This step makes the eye really appear on the page! There are five specific areas for shading. The first is right above your upper eyelid, the entire length eyeball. The next area is along the lower eyelid, above the aqueous line, directly on the eyeball. Shade lightly to begin with, then you can create a darker effect (if you shade too much, it will look like a very heavy gothic makeup, but maybe that's what you're going for?). The third area is the small crease at the top of your eyelids, the line that separates your movable eyelid from your upper fixed eyelid. The fourth area is the lower part of the eye socket, which is darker in the central corner near the nose and tear duct. This shadow is shaded and falls on the cheek.

Just as Leonardo da Vinci used shading when he outlined the eyes of the Mona Lisa without hard dark lines, you should also use a very soft shading when shading the 3D eye. Make sure to shade and blend the fifth shading zone - the tiny "secret" shadows in the corners of the eye socket and eyelids.

LESSON 29: PRACTICAL TASK

I like draw eyes. The more you draw them, the more you enjoy them. The eyes are the most important element in drawing the face of a person, animal or magical creature. Draw a few more eyes in your sketchbook, a few by looking at yourself in the mirror, a few by watching tutorials on YouTube. There are incredible amateur lessons out there for you to enjoy.


Some people think that transferring an image onto a sheet of paper is highest art, which is inaccessible to the average person. Knowing the little tricks of skilled artists, everyone will know how to draw eyes with a pencil. The human visual organ consists of the eyeball, upper and lower eyelids. The eye is drawn in the shape of an elongated ellipse, with slight bends in the form of a drop near the nose.

The drawing technique consists of creating additional lines, on the basis of which each part of the organ will be drawn. First you need to draw 3 concentric circles. The first one should have a radius that is 3 times the radius of the middle circle.

The small circle is the pupil, the second is the iris, and the third will limit the eyelid and eyebrow line. Draw the line of the upper and lower eyelids in the form of an elongated ellipse. Top part should slightly cover the moving part of the eye. Just below the top arc great circle draw a line for the overhanging edge of the eyelid.

Let's draw some lines a little.

Draw a parallel line for the lower eyelid where the eyelashes grow. Highlight the pupil with black, leaving a highlight near it. To design the iris: draw lines of different lengths in the middle of the eye and shade them.

Now it's the turn of the century zone. Use light strokes to shade each line.

Draw a row of eyelashes on the upper eyelid.

We do the same with the bottom one.

All that remains is to finish drawing the eyebrow. It should start at the level of the nose and make a slight bend a little further than half of the eye. At the beginning of the line, draw several hairs; shade the area, carefully separating the hairs in some places.

The hardest part about drawing a realistic eye is:

Compliance with all proportions;

Drawing a realistic pupil of the eye;

Drawing eyelashes.

In this article we will teach you how to draw all these difficult moments.

Drawing realistic eyes is not an easy task. At the same time, we have to draw eyes quite often. We start drawing the eye with a pencil from the main lines (they should be thin, as we will erase them later). Look carefully at the image; when redrawing, observe all proportions, as this is very important. Our eye looks a little upward. Once you understand the basic principles, you will be able to draw the eye the way you need.

We outline the pupil along the contour with a pencil (darken the contour) - we do this with a transition. The pupil is the darkest place, and closer to the outside it becomes lighter and lighter. A very soft pencil is best for these purposes.

Now let's draw inner part large circle. It is very important that the stripes and spots are arranged in a circle. Look at the picture below and try to repeat all the lines and spots exactly as in the picture.

Next, we darken and shade the entire surface of the large circle - try to achieve the most realistic effect. Notice that some areas of the eyeball are darker and others are lighter. This effect needs to be reflected in your drawing.

Completely fill in the pupil with a pencil and remove the auxiliary circular lines.

Let's shade some parts of the eye to add volume.

Draw the lower eyelashes. Do it exactly as in our picture. The eyelash line does not have to be perfectly straight. Eyelashes begin to grow under the bottom auxiliary line, and not on her. If you are drawing an eye for the first time, it is best to repeat each eyelash. In the future, you will be able to draw eyelashes without visual cues.

Draw the upper eyelashes. Do it exactly as in our picture. The eyelash line does not have to be perfectly straight. The eyelashes begin to grow above the top guide line, rather than on it. Eyelashes are quite difficult to draw. Each eyelash is drawn separately - they will take a lot of time, but it is the well and believably drawn eyelashes that make drawing an eye with a pencil as effective as possible. For the best effect, sharpen the pencil and in this case preference should be given to a soft pencil.

We remove all the remaining hint lines so that the eye looks realistic. You should get something like this:

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