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Surgical Anatomy of the Neck
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Laura Warner, Christopher Jennings, John C. Watkinson
The arterial blood supply is from branches of the facial artery anteriorly and the occipital artery posteriorly. The nerve supply to digastric reflects its embryological origins from the first and second branchial arch; the posterior belly is supplied by a branch of the facial nerve, the nerve to digastric and the anterior belly is supplied by the nerve to mylohyoid, from the maxillary division of the trigeminal nerve. The digastric muscle depresses the chin to assist in mouth opening and elevates the hyoid during swallowing.
The Spinal Cord and the Suboccipital Triangle
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
As stated previously, the occipital artery is a branch of the external carotid artery. Its course and distribution have also been described. The profunda cervicis arises from the costocervical trunk - a branch of the subclavian artery - at the root of the neck. The profunda cervicis ascends in the neck, dorsal to the transverse processes, deep to the semispinalis cervicis and capitis. In its course, it anastomoses with branches of the vertebral artery and the occipital artery.
Resection of carotid body tumors
Published in Sachinder Singh Hans, Alexander D Shepard, Mitchell R Weaver, Paul G Bove, Graham W Long, Endovascular and Open Vascular Reconstruction, 2017
Mitchell R. Weaver, Daniel J. Reddy
The procedure is performed under general anesthesia and once induced, if mandibular subluxation is planned, it is performed at this time. A roll is placed under the patient’s shoulders and the neck is extended and rotated slightly to the contralateral side, before performing sterile prepping and draping of the skin. The authors’ standard approach is through a longitudinal anterior sternocleidomastoid incision, like that for a carotid endarterectomy. Once the tumor is visualized, assessment of the carotid artery is performed and dissection is typically directed to achieve control of the common carotid artery (CCA) proximally and then the ECA and ICA distal to the tumor. The vagus nerve should be identified proximally along the CCA and followed distally. The vagus nerve and adjacent noninvolved cranial nerves are separated from the tumor and protected by dissecting through the tumor pseudocapsule. Distal exposure can be facilitated with standard techniques, such as division of the posterior belly of the digastric muscle, taking care not to injure the glossopharyngeal nerve that is then mobilized. Ligation and division of the occipital artery will assist with this. The next maneuver is division of the stylohyoid muscle groups. If further exposure is required, styloidectomy and mastoidectomy are described but carry with them an increased risk of morbidity with cranial nerve injury. During dissection of the ECA, one needs to be aware of the hypoglossal nerve anteriorly and the superior laryngeal nerve posteriorly. In exposing the ICA, one must be aware of several nerves, including the mandibular branch of the facial nerve, proximal hypoglossal nerve, distal vagus nerve, pharyngeal branch of the vagus nerve, spinal accessory nerve, and glossopharyngeal nerve.
Treatment of intractable epistaxis in patients with nasopharyngeal cancer
Published in Annals of Medicine, 2023
Xiaojing Yang, Hanru Ren, Minghua Li, Yueqi Zhu, Weitian Zhang, Jie Fu
The primary blood supply to the posterior wall of the nasopharynx and pharyngeal recess area is provided by the ascending pharyngeal artery. This artery arises from the external carotid artery, with some branches originating from the ICA or occipital artery [37]. The pterygoid artery, a secondary branch of the pharyngeal artery from the internal maxillary artery, supplies blood to the front of the nasopharynx, front of the pharyngeal crypt, and cartilage of the Eustachian tube. If the ascending iliac artery is absent, it can be replaced by a descending branch of the ascending pharyngeal artery. The branches of the maxillary artery from the external carotid artery are distributed on the top and posterior walls of the nasopharynx, the side walls of the nasopharynx, and the nasal floor near the posterior nostril of the nasal cavity [38]. The superficial blood supply of the pharyngeal recess of the nasopharynx is primarily through the branches of the external carotid artery and ascending pharyngeal artery. Nasopharyngeal bleeding can occur due to rupture of the ascending pharyngeal recess.
Corticosteroids reduce vascular ultrasound sensitivity in fast- track pathways (FTP): results from Coventry Multi-Disciplinary FTP for cranial Giant Cell Arteritis
Published in Scandinavian Journal of Rheumatology, 2023
J Pinnell, C Tiivas, P Mehta, S Dubey
This pathway is reliant on three teams working together to deliver the service: vascular ultrasound, ophthalmology, and rheumatology. We have not come across other examples of such team working for the delivery of GCA pathways, but there are multiple advantages with this approach. The traditional models suffer from an inability to scan other blood vessels, including carotids, particularly for patients presenting with amaurosis fugax or features suggesting TIA. Occipital artery involvement is another area where the vascular team may have an advantage (30). Furthermore, it becomes problematic when individuals are on leave, and this puts serious constraints on the service. The recent publication of a Getting It Right First Time (GIRFT) document, which is part of an aligned set of programmes within National Health Service (NHS) England and NHS Improvement, also emphasizes that the GCA service should not be run single-handedly (31). Our pathway received a commendation from British Society for Rheumatology (BSR) in 2018 as part of best practice awards. We also perform carotid artery scanning for patients with unilateral visual loss, which is not part of other FTPs.
Fraxetin protects rat brains from the cerebral stroke via promoting angiogenesis and activating PI3K/Akt pathway
Published in Immunopharmacology and Immunotoxicology, 2022
Yuhuan Cui, Meihong Liu, Li Zuo, Haiyan Wang, Jian Liu
The Sprague Dawley rats were randomly separated into three average groups including sham group, model group, and fraxetin-50 group. After anesthesia by intraperitoneal injection of 50 mg/kg pentobarbital sodium, all rats were prepared for establishing ischemia and reperfusion rat models. Specifically, rats were put on a heat pad (XR-YLS-20A, XinRun Information Technology Co. Ltd, Shanghai, China) to maintain body temperature at 37 °C and placed at decubitus supine position. Next, their right common carotid artery (CCA) was exposed and separated carefully. Then the CCA was ligated at the more proximal side through a right paramedian incision. The external carotid artery (ECA) was also ligated. The occipital artery and the pterygopalatine artery were coagulated. Ischemia was produced by advancing the tip of a rounded 3-0 suture (SXMD2B408, Ethicon, New Brunswick, NJ) into the ICA through the ECA. After placement for 2 h, the intraluminal suture was secured with suture tied around the ECA. Reperfusion was produced by withdrawal of the intraluminal suture. In the sham group, the ECA was surgically prepared for the insertion of the filament, but the filament was not inserted [26]. After 24-h reperfusion, the rat samples were evaluated through multiple experiments. The fraxetin was intragastrically administrated with a dosage of 50 mg/kg/d for 14 d in fraxetin-50 group. The ischemia and reperfusion operations were carried out 1 h after the last intragastrical administration of fraxetin.