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) |
| |
2. The levels of tracheal ring incision: |
a) superior tracheostomy: | is performed_the isthmus _ |
| is performed _ the isthmus _ |
c) inferior tracheostomy: | is performed _the isthmus _ |
3. The position of a patient during the operation: | |
| |
5. The direction of tracheal ring incision: | |
OPERATION: TRACHEOTOMY (TRACHEOSTOMY) |
|
| |
a) to make an incision on_ | by 2 inches starting from_using scalpel |
b) to make an incision of the_ fascia | |
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_ | |
| |
| |
| |
| to put an up to 1 cm stop on the scalpel to prevent _ and_ _injuring; |
c) to pull apart the edges | |
d) to enter into the tracheal cavity | |
e) in case of tracheostomy to suture | |
f) to fix the tracheostomy tube_ | |
8. Breathing is controlled: | |
9. Gauze stripes are put over suture lines | |
12.6. What surgery is depicted in Fig. 12.1?_
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Fig. 12.1. Surgery at larynx Which cartilages are marked in Fig. 12.1?
1 -_
2 -_
How is this surgery different from tracheostomy?_
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12.7. Draw the incision line for accessing the cervical esophagus and the retrovisceral space.
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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?_
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_
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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?
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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?
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What nerve might be injured when performing this kind of operative access?
4 -_
What rule is to be followed to prevent it?
_
_
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12.12. What structures are depicted in Fig. 12.5?
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Fig. 12.5. Surface landmarks of the neck
1 - v. __
_
2 - m. __
_
During what surgery is this point of surface landmarks' overlap used?