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Head and Neck Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Warrenkevin Henderson, Hannah Jacobson, Noelle Purcell, Kylar Wiltz
Sternocleidomastoid has two heads. The sternal (medial) head originates from the manubrium, and the clavicular (lateral) head originates from the medial third of the clavicle (Standring 2016). The two heads join and insert into the mastoid process and the superior nuchal line (Standring 2016).
How to revise a failed occipital cervical fusion
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Joshua T. Wewel, Mazda K. Turel, Joseph E. Molenda, Vincent C. Traynelis
When occipital screws are being replaced, care must be taken to choose appropriate sites for new screw placement, preferably below the superior nuchal line along the occipital ridge. If screws must be placed superior to the superior nuchal line, dural venous structures and bleeding may be encountered. If bleeding is encountered during screw placement, it is best to continue with placement of the screw. Minor penetration of a screw into a venous sinus does not appear to cause any harm. The real risk of occipital screws is a posterior fossa hematoma, which can occur following a minor cerebellar surface vein or artery injury. Any patient who does not awaken promptly from surgery should be immediately evaluated with a CT, and if there is a posterior fossa hematoma, it should be evaluated absolutely as quickly as possible.
Head and neck
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
The neurosurgical literature indicates that helmets provide effective protection against moderate to severe head trauma likely to result in severe disability or death.110 However, there is a lack of civilian and military data on helmet efficacy against concussion. Sone et al.110 have suggested that patients wearing a helmet do not have better relative clinical outcomes and protection against concussion than do patients who are not wearing one. A systematic review of military head injuries found no evidence of behind helmet blunt trauma in the openly accessible literature since composite helmets were adopted as standard issue.108 The authors discuss the difficulties that arise in attempting to compare international civilian and military data across the decades, in particular due to issues concerning the exact definition and anatomical boundaries of the ‘head’. Calls to address this lack of standardisation have been made for at least 25 years.109 From a military perspective, the ‘head’ is considered to be the area covered by the combat helmet, which is designed to protect the brain and brainstem.111,112 The anatomical landmarks of the ‘head’ should therefore include the nasion, external auditory meatus and superior nuchal line.111 The establishment of internationally accepted standards must be considered a priority for future research. The morbidity from mild brain injury and concussion has only recently been established and further research is ongoing to optimise the protection afforded by the combat helmet.
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
Respiratory dysfunction in patients with chronic neck pain: systematic review and meta-analysis
Published in Disability and Rehabilitation, 2023
Ibai López-de-Uralde-Villanueva, Tamara del Corral, Rodrigo Salvador-Sánchez, Santiago Angulo-Díaz-Parreño, José-Javier López-Marcos, Gustavo Plaza-Manzano
Studies were included in the systematic review and meta-analysis if they met the following criteria: (1) has a cross-sectional design or longitudinal design (cohorts or case and control studies); (2) includes human adult patients (≥18 years of age) with CNP [any self-reported pain, discomfort or soreness in the anatomical region of the neck (between the spine of the scapula and the superior nuchal line) of at least 3 months duration] [3]. In addition, patients had to have pain at the time of assessment, regardless of whether they had undergone treatment in the previous months; (3) reports a measure of respiratory function [transcutaneous partial pressure of arterial carbon dioxide [PtcCO2], maximal inspiratory pressure (MIP; Standard Error of the Measurement (SEM) = 6–17 cmH2O [15,16]), maximal expiratory pressure (MEP; SEM = 15–21 cmH2O [15]), vital capacity (VC), maximum voluntary ventilation (MVV), tidal volume, inspiratory capacity, forced vital capacity (FVC; SEM = 0.29 L [16]), peak expiratory flow (PEF; SEM = 0.82 L [16]), forced expiratory flow from 25% to 75% (FEF25–75), forced expiratory volume during the first second (FEV1; SEM = 0.20 L [16]), forced expiratory ratio (FEV1/FVC), or expiratory reserve volume (ERV)]; and (4) compares the respiratory function variables of CNP participants with a pain-free healthy control group. Studies involving patients with neck pain associated with a severe local condition (tumor, fractures, myelopathy, paralysis, etc.), systemic disease, and/or concomitant musculoskeletal pain were excluded from this systematic review and meta-analysis.