Surgical anatomy of neck
Contents of lecture
Scopes of neck. Division of neck on a region. Fascias and cellulose spases of neck. Topography of vascular-nervous formations of neck. Topography of organs of neck. Topographycal-anatomic ground of operative interferences in area of neck. Cuts in area of neck. Treatment of neck’s wounds. Operations at inflammatory processes. Operation on muscles, vessels and nerves. Tracheostomy. Operations on a thyroid.
Plan of lecture.
1. Scopes of neck, division on a region.
2. Triangles of neck.
3. Fasciae of neck.
4. Cellulose spaces of neck.
5. Submandibulare triangle.
6. The Pyrogov’s Triangle.
7. Carotid triangle.
8. Topography of basic vascular-nervous bunch of neck.
9. Distinctions between external and internal carotids.
10. Branches of external carotid in a carotid triangle.
11. Topography of trachea.
12. Topography of neck part of pharynx.
13. Branches of neck interlacement.
14. Scopes of lateral triangle of neck, division of it on scapula-trapezoidal and scapular-clavicles triangles. 15. Layers of lateral triangle of neck.
16. Cellulose spaces of lateral triangle of neck.
17. Topography of neck part of diaphragmatic nerve.
18. Technique of tracheostomy.
19. Errors and complications at tracheostomy.
20. Features of operative access to neck part of esophagus. 21. Operations on a thyroid.
ANATOMICAL-TOPOGRAPHICAL FEATURES OF NECK AND
Topographical anatomy of neck (common data)
The region of neck differs by the difficult anatomic structure. Any doctor needs knowledge of topographical anatomy of neck, as this region has a row vitally important formations, interrelation between which must be taken into account at implementation of row of urgent measures (laryngotomy, tracheostomy, stop of bleeding and other). The practical value is had:
1) The outward reference points of region, which use at the inspection of patient for: a) Drafting of projection lines;
b) Determinations of location of organs of neck
2) Bulges of sterno-cleido-mastoid muscles which are a reference point for finding of general carotid. Palpation of region is more informing: a) On the middle of the skinning fold exposed at bending of head, the body of sublingual bone palpate under a lower maxilla, on each side from it it’s large Horn. A sublingual bone is a reference point at implementation of vagosympathetic blockage; b) Below the plates of thyroid cartilage, place of their connection, palpate to the sublingual bone (Adam's apple); c) In the middle of front surface of thyroid cartilage is mapped a glottis. d) A cricoids cartilage is felt directly ahead from thyroid. Deepening which corresponds to the thyroidocricoid copula palpate between them. Urgent laryngotomy is executed in this area; e) On the line conducted from the lower edge of cricoids cartilage downward to the jugular undercuting of breastbone, is mapped a trachea, a few left from it is mapped a esophagus; f) At the cutting edge of sterno-cleido-mastoid muscle according to the level of cricoids cartilage the transversal process of sixth neck vertebra palpate at back of region (carotid tubercle, tuberculum caroticum). Against this tubercle a general carotid is pinned at bleeding from its branches; g) At the level of upper edge of thyroid cartilage, is mapped the place of bifurcation general carotid; h) In the corner formed by the back edge of sterno-cleido-mastoid muscle and collar-bone, the pulsation of subclavian artery is determined. Here it cuddles to the first rib for the temporal stop of bleeding; i) It is mapped humeral interlacement on a neck on a line, connecting a point lying on the border of middle and lower third of sterno-cleido-mastoid muscle and middle of collar-bone. On 1,5-2 sm higher than middle collar-bones execute anesthesia of humeral interlacement;...