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Tracheostomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Kate Stephenson, Michelle Wyatt
The neck must be extended. A jellyroll or sandbag is placed under the shoulders, and an adhesive tape “chin strap” is applied and attached to the table on either side of the head to stabilize it. The occiput is supported by a head ring. The patient is tipped into a slightly head-up position (Figure 3.1).
Dermatology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
This is a very common flat pink lesion, present at birth. It is usually located on the forehead, eyelids, occiput, neck or midline of the back. It may be V-shaped on the forehead/occiput. Facial lesions fade, occipital tend not to. The lesions are not pathological so there is no active management needed.
Nasopharyngeal Carcinoma
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Raymond King-Yin Tsang, Dora Lai-Wan Kwong
The presence of neurological symptoms usually signals advanced disease. Headache is the most common neurological symptom and is present in up to 20% of patients. The headache is usually localized to the vertex or occiput and caused by the invasion of the clivus bone by the tumour. Facial pain and midface numbness can also be a presenting symptom, caused by tumour invasion into the pterygopalatine fossa and the branches of V2. Cranial nerve (CN) palsies are caused by extension of the tumour into the skull base or intracranially. Common cranial nerves to be involved at presentation are V2, V3 and VI. Involvement of CNIII and CNIV are indicative of cavernous sinus invasion by tumour. Rarely, patients present with ophthalmoplegia, decreased vision and proptosis caused by direct invasion of the tumour into the orbital apex. Trismus is rare unless the tumour has directly invaded the pterygoid muscles in the masticator space. Horner syndrome can occur if the tumour or metastatic lymph node encases the carotid vessels. This is an uncommon mode of presentation as the carotid sheath is a tough fascia that impedes direct tumour invasion. The presence of Horner syndrome is usually associated with other cranial nerve involvement like CNX and CNXI. Patients from endemic regions with isolated CN palsies should be investigated for the presence of NPC, either by imaging or by nasal endoscopy.
The effect of ball characteristics on head acceleration during purposeful heading in male and female youth football players
Published in Science and Medicine in Football, 2021
Kerry Peek, Marnee McKay, Allan Fu, Tim Meyer, Vincent Oxenham, Carrie Esopenko, Jaclyn Caccese, Jordan Andersen
A small number of head acceleration data exceeded the limits of the accelerometer, meaning that these data could not be used. Although this only affected 2% of the total number of recorded headers, the majority were seen with Ball 4 – the match ball. This possibly indicates that an accelerometer with a higher upper limit would be needed to record head accelerations from balls with greater pressure or delivered at speeds higher than the throw-ins used in our study. It also means that our comparison data between balls may be under-estimated as the highest head accelerations with Ball 4 were not recorded. Additionally, the head accelerations for Ball 4 are only representative of male players as no females headed this ball which is also likely to have impacted on our results. The placement of the motion sensor on the occiput rather than the centre of mass of the head may also limit the interpretation of results. The occiput was chosen as it was an easy anatomical marker to locate quickly between players. Additionally, all participants played for one club which might limit the generalisability of the results to other populations. A final limitation is that we did not capture heading technique or record ball speed following the header. These would make interesting additions to future studies to explore whether heading performance outcomes are affected by ball characteristics, sex, age and technique.
Ocular manifestations of giant cell arteritis
Published in Expert Review of Ophthalmology, 2019
David F. Skanchy, Aroucha Vickers, Claudia M. Prospero Ponce, Andrew G. Lee
Clinically, GCA has a broad spectrum of associated symptoms, with the most common being headache (70–90%), jaw claudication (40–60%), transient ischemic attack (4%), neck pain, scalp tenderness (including the temporal artery), and transient or constant visual disturbances (e.g. amaurosis fugax, AION, CRAO, and ophthalmoplegia or diplopia) [3,4,6,7,32,49–52]. Despite the classic presentation of headache and scalp tenderness localized to the temporal region, it may also present diffusely or localize to any part of the head, including the occiput [50]. Jaw claudication, manifesting as pain that increases while chewing, may lead to decreased food intake, weight loss, and weakness [2]. While not sensitive, it is a relatively specific symptom of GCA [2,8,51].
Spinal cord injury rehabilitation and pressure ulcer prevention after the 2005 South Asian Earthquake: a CBR case study from Pakistan
Published in Disability and Rehabilitation, 2019
Jawad Chishtie, Farrukh Chishtie, Karen Yoshida, Robert Balogh
The education focused on checking for pressure points and the importance of postural change in bed every two hours. Mirror use for self-examination was taught to persons with SCI, while they were also taught examination and confirmation in “good light” which usually meant day light in this remote region. The sites of examination included: the occiput (back of the head); around and behind the shoulders; the elbows; wrists; ischium; sacrum; trochanters; knees; “between buttocks”; ankles and heels. The most common sites in this paraplegic population observed included six main sites: sacral, ischial, heels, ankles, trochanters, and “between buttocks.” Persons with SCI were taught to pay particular attention to these sites.