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Anatomy and differential diagnosis in head and neck surgery
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
The occipital triangle is bordered by the posterior border of the sternomastoid muscle towards the mastoid tip, then along the anterior border of the trapezius, along the clavicle back to the sternomastoid. The subclavian (or supraclavicular triangle) is found within the posterior triangle, bounded by the inferior belly of omohyoid, the posterior border of sternocleidomastoid and the clavicle [1].
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The posterior triangle of the neck is bounded by the clavicle, sternocleidomastoid and trapezius. This triangle is divided by the inferior belly of the omohyoid muscle into the supraclavicular triangle inferiorly and the occipital triangle superiorly.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
The borders are the anterior border of trapezius, the middle third of clavicle and the posterior border of SM. The posterior belly of omohyoid subdivides into an upper occipital triangle and a lower supraclavicular triangle. The investing fascia forms the roof whilst the floor is composed of the prevertebral fascia (see above).
Differences in cervical kinesthesia between amateur athletes with and without a history of contact sport participation
Published in Brain Injury, 2021
Kelly Cheever, Jane McDevit, W. Geoffrey Wright, Ryan Tierney
Headache and dizziness were reported at baseline by 645 and 34% of athletes with a history of contact sport participation while only 30% and 5% of those with no history, respectively. This result may be more meaningful when compared to previous findings which found preseason S/S scores such as headache and dizziness have been reported as among the strongest predictors of future concussion (19). Several concussion like symptoms such as cervicogenic headache, dizziness, pain at the sub occipital triangle, and muscle weakness may be indicative of cervical pathology which can be masked and misdiagnosed (28). Further research is necessary to explore the role symptoms such as headache, dizziness and neck pain play on moderating the role CJPE may play in future injury risk in athletes who experience frequent head impacts as part of contact and limited contact sport participation.
Vertebral artery injury caused by glass remnants in the neck: A case report
Published in Acta Oto-Laryngologica Case Reports, 2019
Keisuke Mizuno, Shogo Shinohara, Yoshihiro Omura, Hirotoshi Imamura, Masashi Shigeyasu, Tetsuhiko Michida, Kiyomi Hamaguchi, Shinji Takebayashi, Keizo Fujiwara, Yasushi Naito
The management of patients with VA injury has been controversial. However, recently, endovascular management of VA injuries has been preferred because of the difficulties in the surgical management of VA [3]. V1 usually presents fewer challenges to the surgeon as it is readily exposed in the neck [8]. V2 is extremely difficult to expose, especially with active bleeding, as these parts of the artery are completely concealed within the bony tunnel formed by the foramina transversaria. V3 is situated in the deep and unfamiliar sub-occipital triangle [9]. Head and neck surgeons do not deal with V4; intervention angiography or surgery by a neurosurgeon should be considered. Because of these difficulties, surgery is not always the best option. Thus, endovascular management is a good option.
Effectiveness of spinal mobilization and postural correction exercises in the management of cervicogenic headache: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2023
Another common impairment seen in CGH is a muscular imbalance that includes weakness as well as lack of endurance in upper cervical flexors (Jull, Barrett, Magee, and Ho, 1999; Watson and Trott, 1993) and tightness in the upper trapezius, levator scapulae, scalenes, sub-occipital extensors, and pectoralis muscles (Jull, Barrett, Magee, and Ho, 1999; Zito, Jull, and Story, 2006). There is the presence of fascial connections between sub-occipital muscle and cervical dura known as myodural bridges. These myodural bridges merge with meningo-vertebral ligaments and insert into the posterior aspect of the dura mater (Sillevis and Hogg, 2020). Sub-occipital muscles are prone to tightness (Janda, 1994). Tightness of sub-occipital muscles may directly affect the positioning of the dura and can be hypothesized to play a role in the development of CGH (Sillevis and Hogg, 2020). This was also stated in previous literature that there is a specific pattern of muscular imbalance present in patients suffering from cervical dysfunction, including those with CGH. This pattern of muscle tightness and weakness is known as an upper crossed syndrome, which produces typical changes in posture and motion. The most common postural impairment associated with the upper crossed syndrome is rounded shoulders, increased kyphosis, and forward head posture (FHP) (Janda, 1994). FHP is the most common cause of CGH (Farmer, Snodgrass, Buxton, and Rivett, 2015; Watson and Trott, 1993). It has also been established that upper crossed syndrome is associated with CGH (Moore, 2004). There was a study that stated that increased kyphosis is a causative factor in the development of FHP. FHP acts as a mediator between thoracic kyphosis and neck dysfunction, resulting in reduced mobility (range of motion) and neck pain, which area key clinical feature in the diagnosis of CGH (Moustafa, Shousha, and Harrison, 2021). The characterization of FHP is decreased craniocervical angle, the extension of the occiput and upper cervical spine, flexion of the mid and lower cervical spine (Martinez-Merinero et al., 2021). This causes a decrease in the area of the sub-occipital triangle, which further leads to compression of the greater occipital nerve or C2 nerve root within the sub-occipital triangle. This can be a possible mechanism behind the pathophysiology of headaches associated with FHP (Kalmanson et al., 2019). Therefore, working on these muscular imbalances through postural correction exercises (PC) may be beneficial for patients suffering from CGH.