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Anatomy of Neck and Blood Supply of Brain
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
These are also termed as strap muscles (Figures 2.28–2.30), are located over the anterior aspect of the neck and include sternohyoid, sternothyroid, thyrohyoid and omohyoid muscles. They are long and flat muscles with a generic action of lowering the hyoid bone. The hyoid bone can be visualized after layer wise dissection of the supra and infra hyoid muscles (Figures 2.31and 2.32).
Autopsy of Asphyxiation, Suffocation and Neck Pressure Deaths
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Jayantha C. Herath, Michael S. Pollanen
The upper part of the initial Y-incision can be extended up to the tops of the shoulders [1] and reflect the triangular neck flap up over the face (Figures 10.8 and 10.9). The incision from the tops of the shoulders can be further extended up to the mastoid areas making a rhomboid-shaped flap. The anterior skin layer of the neck can be reflected with the platysma. After reflection of the skin and the platysma, the superficial layer of the strap muscles can be observed for injuries and photographed (Figure 10.10). The sternocleidomastoid muscles run along the sides of the neck with the carotid and jugular sheath just underneath. The paired sternohyoid muscles are located centrally. The lower attachments of each of the outer layer muscles can be cut and reflected upwards, leaving the upper attachments intact (Figure 10.11).
Surgical Anatomy of the Thyroid
Published in Madan Laxman Kapre, Thyroid Surgery, 2020
Ashutosh Mangalgiri, Deven Mahore
So, the relation of the strap muscles from within outward is sternothyroid, sternohyoid, superior belly of omohyoid, and part of sternomastoid. If we want to know the lateral, anterior, and inferior relation, laterally is the sternothyroid, anteriorly are the sternohyoid and the superior belly of the omohyoid, and inferiorly is the sternomastoid.
Narirutin-rich fraction from grape fruit peel protects against transient cerebral ischemia reperfusion injury in rats
Published in Nutritional Neuroscience, 2022
Paresh Patel, Kalyani Barve, Lokesh Kumar Bhatt
Rats were anesthetized by intraperitoneal injection of thiopentone (50 mg/kg) and fixed in a supine position. A midline incision was made to expose both common carotid arteries. Between the sternocleidomastoid and the sternohyoid muscles parallel to the trachea, a dissection was made. Each carotid artery was carefully separated, maintained, and freed from its adventitial sheath and vagus nerve. Global cerebral ischemia/reperfusion was induced by transient bilateral common carotid arteries occlusion (tBCCAO). The common carotid arteries were occluded with clamps for 30 mins followed by 24 h reperfusion. The skin was closed with stitches using waxed silk suture [20]. During the BCCAO, animals were observed for the following criteria: maintenance of dilated pupils, absence of a cornea reflex when exposed to strong light stimulation, and maintenance of rectal temperature at (37°C ± 0.5). Animals that did not match these criteria and showed seizures were excluded from study. Sham control animals received surgery, without BCCAO. After the completion of reperfusion period of 24 h, animals were assessed for neurological outcome and then sacrificed for biochemical and histological assessments.
Endotracheal Tube Electrode Neuromonitoring for Placement of Vagal Nerve Stimulation for Epilepsy: Intraoperative Stimulation Thresholds
Published in The Neurodiagnostic Journal, 2022
Gennadiy A. Katsevman, Darnell T. Josiah, Joseph E. LaNeve, Sanjay Bhatia
To our knowledge, only one other study has been published describing this neuromonitoring technique in the placement of VNS. Chiba et al. monitored both the vagus nerve and the ansa cervicalis via ETT electrodes on the vocal cords and EMG electrodes on the sternomastoid, sternohyoid, geniohyoid, and trapezius muscles, respectively (Chiba et al. 2019). They analyzed 30 patients for whom intraoperative neuromonitoring information was available; six points on the exposed vagus nerve were stimulated. The threshold of vocalis muscle contraction ranged between 0.05–0.75 mA (median 0.225 mA), compared to a range of 0.10–0.90 mA (mean 0.34 mA) in the present study when stimulating a fully dissected vagus nerve. As the authors state, further monitoring experience is necessary to establish stimulation thresholds and protocols. Our study provides additional stimulation thresholds at various surgical time points, such as opening of the carotid sheath, after full dissection of the vagus nerve, after tenting of the nerve in preparation for electrode placement, and after electrode placement (Table 2). Future studies can assess whether patients who required a higher threshold for intraoperative stimulation need increased post-operative VNS stimulation settings. Additionally, future investigations can compare the amount of cross-contamination in compound muscle action potentials (CMAPs) between the ansa and vagus nerves to better refine potential thresholds at which there may be false-positive results.
Voice rehabilitation after total laryngectomy with the infrahyoid musculocutaneous flap
Published in Acta Oto-Laryngologica, 2021
Changjiang Li, Yi Fang, Haitao Wu, Min Shu, Lei Cheng, Peijie He
Incisions of total laryngectomy and cervical lymph node dissection were designed in advance (Figure 1(a)). After completion of the ipsilateral modified radical or selective neck dissection, an infrahyoid musculocutaneous flap was harvested from the contralateral side to ensure the safety of the flap [5]. The harvesting did not technically interfere with the extent of the neck dissection. Four patients who had lymph node metastasis underwent ipsilateral modified radical lymph node dissection, while the remaining 14 patients underwent selective neck dissection. The infrahyoid musculocutaneous flap harvested was composed of the sternohyoid muscle, the superior belly of the omohyoid muscle, and the sternothyroid muscle. The flap was oval-shaped in the vertical position, and the skin paddle was fitted and included in the incision made for unilateral or bilateral neck dissection. The medial edge of the flap was set at the midline; the upper edge, at the level of the incisura cartilago thyreoidea; the lower edge, at inferior margin of cricoid cartilage; and the lateral edge, at a distance of 3 cm from the midline. A trachea was opened and a ‘U-shaped’ tracheal flap was created between the third and fourth tracheal rings, under the thyroid isthmus. The length of the pronunciation tube created was about 4–5 cm.