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Anatomy of the Skull Base and Infratemporal Fossa
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
The muscles of the back of the neck are attached below this line. Each half of the occipital area is further subdivided by another concentric line – the inferior nuchal line – thus dividing this area into four. The two areas adjacent to the foramen magnum receive the rectus muscles, acting to extend and rotate the head, generally innervated by C1. The two areas between the nuchal lines receive semispinalis medially and superior oblique muscles laterally, giving lateral flexion to the head and also innervated by C1.
Head and neck
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Attachments for sternocleidomastoid muscle– origin: manubrium + medial third of clavicle– insertion: mastoid process of temporal bone + sup. nuchal line– nerve SS: spinal root of accessory n. (CNXI)– function: rotate head to ipsilat. side (act alone) + protrude head and assist in forced inspiration (act together)
Head
Published in Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden, Human Sectional Anatomy, 2017
Harold Ellis, Adrian Kendal Dixon, Bari M. Logan, David J. Bowden
This, in turn, is adherent to a tough aponeurosis, which is the aponeurotic sheet joining the occipital belly of occipitofrontalis (5) to the frontalis muscle. The former arises from the superior nuchal line, while the latter inserts into the fascia above the eyebrows. The occipital part is supplied by the auricular, and the frontal part by the temporal, branch of the facial nerve (VII). Paralysis of the facial nerve is followed by inability to wrinkle the forehead on the affected side. Beneath the aponeurosis lies a layer of loose areolar tissue, which again can be appreciated in these sections. It is in this plane that avulsion of the scalp can take place in tearing injuries and in which a flap of scalp can be turned down during surgical exposure of the skull. The final layer, the periosteum, is closely adherent to the skull.
Influence of clinical experience on accuracy and safety of obliquus capitus inferior dry needling in unembalmed cadavers
Published in Physiotherapy Theory and Practice, 2022
Gary A. Kearns, Troy L. Hooper, Jean-Michel Brismée, Brad Allen, Micah Lierly, Kerry K. Gilbert, Timothy J. Pendergrass, Deborah Edwards
The few publications (Bond and Kinslow, 2015; Escaloni, Butts, and Dunning, 2018; Fernández-de-las-peñas et al., 2020; Kamali, Mohamadi, Fakheri, and Mohammednejad, 2019; Sedighi, Ansari, and Naghdi, 2017) that investigated dry needling the suboccipital region have variability in detail and technique used. Two investigations (Escaloni, Butts, and Dunning, 2018; Fernández-de-las-peñas et al., 2020) used an inferior needle inclination while one (Sedighi, Ansari, and Naghdi, 2017) used a cranial needle inclination targeting the OCI. A second investigation (Bond and Kinslow, 2015) used a cranial needle inclination, but targeted the suboccipital musculature attaching to nuchal line as opposed to the OCI. Another investigation (Kamali, Mohamadi, Fakheri, and Mohammednejad, 2019) did not specify the specific suboccipital muscle or technique used. None attempted to investigate or report risks associated with dry needling the suboccipital region.
Bilateral greater occipital nerve block for headache after corrective spinal surgery: a case report
Published in Southern African Journal of Anaesthesia and Analgesia, 2018
Edmundo Pereira de Souza Neto, José Luis Martinez, Kathryn Dekoven, Francoise Yung, Sandra Lesage
BGON block was performed while monitoring the patient’s blood pressure, pulse oximetry, and three-lead electrocardiogram. Intravenous access was obtained beforehand. The BGON block was done by an anaesthesiologist experienced in scalp nerve blocks (EP Souza Neto) using the method which is based on the anatomical landmarks.7,8 A detailed description of the technique can be obtained elsewhere.7,8 Briefly, the greater occipital nerve is located approximately two-thirds of the distance on a line drawn from the centre of the mastoid to the external occipital protuberance. The greater occipital nerve is near to the occipital artery and can also be located by palpating the occipital artery. The occipital region was prepped in a sterile manner. The external occipital protuberance was palpated and a needle was inserted between 1.5 cm and 2.5 cm lateral to the external occipital protuberance parallel to the superior nuchal line. Then 5 ml of ropivacaine (2 mg/mL) was injected on each side. No adverse effects during or after the block were recorded. Ten minutes after BGON block the patient was asked to stand upright. Her headache was no longer present. The patient was examined every day after the block until discharge and the headache never returned. The patient was discharged on the seventh postoperative day.
Occipital artery-anterior cerebral artery bypass with posterior auricular artery-middle cerebral artery bypass for stenosis of the internal carotid artery bifurcation
Published in British Journal of Neurosurgery, 2021
Ryoko Niwa, Toshikazu Kimura, Shunsuke Ichi
Several technical tips exist for achieving anastomosis using the OA and maintaining its patency. First, ensure avoidance of injury to the donor artery; for this purpose, we believe that dissection under a microscope is essential. Compared to the STA, the OA is more tortuous and has stiffer surrounding connective tissue, particularly in the galeal and intermuscular portion around the superior nuchal line, making dissection more difficult. Second, making intermittent surface markings on the donor artery with dye may be useful in preventing twisting. A long graft is prone to twisting, which can cause graft occlusion. Third, a gutter should be created to prevent donor artery compression, as the OA runs between the muscle and bone until it passes through the dura.11