Superficial Structures of Neck: Cervical Regions Flashcards
What is torticollis?
Contraction/Shortening of the cervical muscles that produce twisting of the neck/slanting of the head.
Most common type of torticollis?
Fibrous Tissue Tumor in the SCM
Why is prenatal torticollis especially significant?
It may mandate that the child is a breech delivery.
How can torticollis develop in a difficult birth?
Infant’s head pulled too much, torn muscle fibers.
Hematoma may occur, develops into a fibrotic mass that entraps XI.
Another name for cervical dystonia?
Spasmodic torticollis
What is spasmodic torticollis?
Sustained turning, tilting, flexing of the neck with involuntary shifting. Occurs in adulthood.
How do you give a subclavian vein puncture?
Infraclavicular subclavian approach –
Thumb to Clavicle, Index on jugular notch
Start needle in skin under thumb, move tip toward tip of index until its in
How do you perform a right cardiac catheterization?
Puncture IJV to introduce catheter thru BC to the SVC. EJV can be used, but you don’t want to.
What can we learn from the prominence of the EJV?
More prominent vein indicated higher pressure. Gives indication of heart failure, SVC obstruction, or high intrathoracic pressure.
Consequences of a severed EJV?
Lumen held open by fascia. Air can get in, churning sound and eventual venous air embolism.
A subject with a CN XI lesion would display…
unilateral paralysis of the trapezious, difficulty turning head
Result of a phrenic nerve block?
Temporary paralysis of half of a diaphragm (for lung surgery)
Result of a phrenic nerve crush?
Weeks of paralyisis (like in a diaphragmatic hernia)
Where do you numb for a neck surgery?
Cervical Plexus– several points along SCM
Watch out for diaphragm paralysis
Result of suprascapular nerve damage?
Loss of lateral rotation of the humerus – goes to waiters tip position
When the ECA is ligated, who provides the main collateral circulation?
Occipital (anastamosing with the vertebral/deep cervical arteries.)
What structures are accessible in surgical dissection of the carotid triangle?
Carotid and branches, IJV, vagus, hypoglossal, cervical sypathetic
Risk of surgical dissection of the carotid triangle?
There are a bunch…but moore specifies damage to the vagus or recurrent laryngeal.
A partial occlusion of the ICA may cause…
Transient Ischemic Attack, Minor Stroke
How can you observe obstructions of blood flow in the carotid?
Doppler color study
What is a carotid endarterectomy?
Open artery and strip off arthrosclerotic plaque with the intima. Followed by clot inhibitors till healing is done.
CN at risk in carotid endarerectomy?
9, 10, 11, 12
Carotid pulse is felt with artery btw what structures?
Trachea and infrahyoid
If a person has carotid sinus hypersensitivity, what happens?
Pressure on sinus –> slowed HR, drop in BP, ischemia leading to faiting
