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12. OPERATIVE SURGERY OF THE NECK

Topics of the lesson: Operative access to neck vessels and organs. Openings at neck phlegmons. The vagosympothetic block according to Vishnevsky. The resection on thyroid gland. Larynx and trachea operations.

12.1. Give the definition. Tracheostomy is_

_

_

12.2. Write down the types of tracheostomy:

1. __

2. __

3. __

12.3. Point out, in what direction the incision for performing tracheostomy is made:

_

_

Write down the cellular spaces surrounding the trachea when performing tracheostomy (beside the subcutaneous tissue):

1. __

2. __

12.5. Fill in the table:

OPERATION: TRACHEOTOMY (TRACHEOSTOMY)

1. Surgical indications:

2. The levels of tracheal ring incision:

a) superior tracheostomy:

is performed_the isthmus

_

b) middle tracheostomy:

is performed _ the isthmus

_

c) inferior tracheostomy:

is performed _the isthmus

_

3. The position of a patient during the operation:

4. Types of pain relief:

5. The direction of tracheal ring incision:

a) b)

OPERATION: TRACHEOTOMY (TRACHEOSTOMY)

Inferior tracheotomy

6. Operative access:

a) to make an incision on_

by 2 inches starting from_using scalpel

b) to make an incision of the_ fascia

_

_space is opened

c) to make an incision of the_ fascia

To draw the_

_musclus bylaterally;

_

_space is opened

d) to pick off the trachea wall in the cellular tissue

to manipulate carefully - risk of injuring

_

_, and

arteries

e) to pick off the isthmus_

f) to draw the isthmus_

using blunt retractor;

7. Tracheostomy:

a) take and pull up_

using one-tooth clamps;

b) to make an incision_

to put an up to 1 cm stop on the scalpel to prevent

_

and_

_injuring;

c) to pull apart the edges

using_

d) to enter into the tracheal cavity

using_

e) in case of tracheostomy to suture

using_

f) to fix the tracheostomy tube_

using_

8. Breathing is controlled:

9. Gauze stripes are put over suture lines

12.6. What surgery is depicted in Fig. 12.1?_

_

Fig. 12.1. Surgery at larynx Which cartilages are marked in Fig. 12.1?

1 -_

2 -_

How is this surgery different from tracheostomy?_

_

_

12.7. Draw the incision line for accessing the cervical esophagus and the retrovisceral space.

Fig. 12.2. The position of the head

12.8. What medical device is illustrated in Fig. 12.3? What surgery is it intended for?_

_

_

_

Fig. 12.3. A medical device

12.9. What intraoperarive complications are possible when performing tracheostomy?

1. Hemorrhage from:_

2. Nerve damage:_

3__

4__

5__

12.10. What is thyroid resection?_

_

_

In what pathologies is it performed?,_

_

12.11. Access to what organ of submandibular triangle is illustrated in Fig. 12.4?

Fig. 12.4. Access to the submandibular triangle of the neck

Which vessels were found and ligated?

1 -_; 2 -_

Is it possible to keep them in the process of accessing? How?

_

What nerve might be injured when performing this kind of operative access?

4 -_

What rule is to be followed to prevent it?

_

_

_

12.12. What structures are depicted in Fig. 12.5?

Fig. 12.5. Surface landmarks of the neck

1 - v. __

_

2 - m. __

_

During what surgery is this point of surface landmarks' overlap used?

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