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The Gallbladder (GB)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
The posterior auricular, occipital, and superficial temporal veins communicate to drain the region caudal to the ear. Blood from this extracranial plexus of veins courses inside the cranium to the sigmoid sinus by means of the mastoid emissary veins. Because emissary veins lack valves, these vessels can transmit both blood and pus through the skull, allowing extracranial sources of infection to enter the intracranial cavity. This fact reinforces the need to follow clean needling practices and to avoid deep scalp insertion as well as traversing infected sites. Figure 11-55 examines the spatial relationship between GB 20 and the occipital artery while Figure 11-56 exposes the presence of deep cervical veins along the potential course of a needle inserted at GB 20. (Not shown are the lateral internal jugular lymph nodes and the deep occipital lymph nodes that exist in the region.24) The deep cervical veins ascend the dorsal surface of the vertebral bodies and are vulnerable to damage with dorsal approaches to cervical spinal surgery.25 When possible and prudent, nonsurgical approaches to neck pain should be tried before highly invasive maneuvers.
The ENT history and examination
Published in Rogan J Corbridge, Essential ENT, 2011
It is important to ensure that the examination is systematic and methodical to avoid missing a small or second mass. Exactly which system is used does not matter as long as all regions are palpated. The following is a suggested method (Figure 1.14): Start at the mastoid tip, and work forward to feel the post- and pre-auricular lymph nodes; from here, move forward to feel the parotid followed by the submandibular region. The hands meet under the chin in the midline; now move down the midline, feeling in turn each lobe of the thyroid gland and the isthmus. From the suprasternal notch, follow up the anterior border of the sternomastoid muscle back to the mastoid tip once more. Now follow the posterior border of the sternomastoid muscle down to the clavicle; move laterally along the clavicle and to the anterior border of the trapezius muscle, palpating the posterior triangle as you go; follow right round to the midline posteriorly. Feel the cervical spine up to the skull base and note any occipital lymph nodes. Finally move forwards along the skull base to finish once more at the mastoid tip.
Characterization of two distinct lipomas: a comparative analysis from surgical perspective
Published in Journal of Plastic Surgery and Hand Surgery, 2018
Hak Chang, Seong Oh Park, Ung Sik Jin, Ki Yong Hong
Anatomical studies of lymphatic system in superficial layer of the head and neck showed that the majority of lymphatic fluid from the frontoparietal and occipital areas is drained to the retroauricular and superficial occipital lymph nodes [24]. Based on the anatomical features of the lymphatic system, we can postulate a link between lipoma ASCs and the lymphatics at the posterior neck. We hypothesized that neck hyperextension may cause repetitive and temporary lymphatic retention, and aggravate chronic inflammation at the posterior neck, resulting in the development of non-encapsulated lipomas. Thus, the mechanical characteristics of posterior neck such as mobility and compressibility of the surrounding tissues could affect the formation of non-encapsulated lipoma and postoperative seroma. Further studies are needed to address this hypothesis.