blue boxes Flashcards
Risks of hyoid fracture
frequently seen in people who are strangled. Hyoid body depresses into thyroid cartilage. May result in aspiration pneumonia.
Paralysis of Platysma
Due to injury of the cervical branch of the facial N. Neck skin looks like slack folds.
Where will an infection between the deep cervical fascia and the muscular part of pretrachial fascia (surrounding the hyoid bone) spread?
usually will not spread beyond the superior edge of the manubrium of the sternum.
Where will an infection between the investing fascia and the visceral pretrachial fascia spread?
it can spread into the thoracic cavity anterior to the pericardium.
retropharyngeal abcess
may be caused by abscess posterior prevertebral deep cervical fascia that penetrates the fascia and enter the retropharyngeal space to produce a bulge in the pharynx.
- dysphagia
- dysarthria
Where can head infections spread?
inferiorly posterior to esophagus –> posterior mediastinum
anterior to trachea –> anterior mediastinum
retropharyngeal space –> superior mediastinum
congenital torticollis
contraction or shortening of cervical ms that causes twisting neck and slanting head.
- mostly commonly result from fibrous tissue tumor that develops before or shortly after birth
- head tilt toward, rotate away from side of tumor
- if tumor before birth –> breech delivery is common
spasmodic torticollis
aka cervical dystonia start in adulthood
-sustained turning/tilting/flexing/extending of the neck
where do you put a central line in?
R or L subclavian V
what does a right cardiac catheterization check for
used to measure pressures in the right chambers of the heart
how do you put in a right cardiac catherter?
- through the IJV > right brachiocephalic V > SVC > right side of heart (THIS IS THE PREFERRED METHOD)
- EJV > subclavian V (difficult bc of angle)
what happens if you sever an EJV? +S&S
if cut along post border of SCM > held open by deep cervical fascia > air sucked in bc (-) intrathoracic P
-churning noise in thoracic
-cyanotic
-venous air embolism –> R side of heart –> dyspnea
Tx: hold closed until can suture
what happens if you cut the phrenic nerve, phrenic nerve block, phrenic N crush?
- the corresponding half of the diaphragm is paralyzed
- temporary paralysis pf one side of the diaphragm (use for lung aspiration)
- surgically crush the nerve with forceps (use for diaphragmatic hernia repair)
what type of nerve block would you use during neck surgery?
cervical plexus nerve block
don’t preform on pts with cardiac/respiratory disease bc phrenic nerve will also be blocked
what type of nerve block would you use for anesthesia of upper extremity?
supraclavicular brachial plexus block - inject superior to midpoint of clavicle
what can cause “waiter’s tip” position?
fx of middle 3rd of sternum can lead to suprascapular N injury
-loss of lateral rotation of the humerus at shoulder
lesions of CN XI can be caused by
(spinal accessory nerve)
- penetrating trauma
- surgical
- tumors at cranial base or cervical LN
- Fx of jugular foramen
lesion of CN XI can lead to…
- atrophy of trapezius m
- unilateral trap: unable to elevate/retract shoulder
- drooping of shoulder
what is the most common iatrogenic nerve injury
CN XI injury
what happens if you ligate the ECA?
blood flows backward into the A from the ECA from the other side
- after ligation the descending branch of the occipital A provides the main collateral circulation (anastomosing with vertebral and deep cervical As)
carotid triangle boundaries
sternocleidomastoid muscle, the omohyoid muscle, the digastric muscle with the stylohyoideus.
Above which tooth will the parotid duct enter the mouth?
above the 2nd molar
What duct runs through the sublingual gland?
the submandibular duct
How many openings does the submandibular gland have into the mouth?
2, one on each side of the lingual frenulum
