13 topics with concise reviews: definitions, key facts, and class questions.
The neck is a complex anatomical region with a high density of vital structures. In this section, we cover classic surgical approaches and incisions, taking into account fascial spaces. You will study the technique of emergency interventions (tracheotomy and tracheostomy), as well as purulent surgery—opening of superficial and deep neck phlegmons, where an error in layer selection can lead to injury to major vessels.
A separate module is dedicated to neurovascular interventions and pain management. It includes algorithms for exposure of the carotid arteries, operations on the phrenic nerve, and regional anesthesia techniques: Vishnevsky's cervical vagosympathetic block, blocks of the sinocarotid zone, stellate ganglion, and brachial plexus. Surgery of internal organs—thyroid gland and cervical esophagus operations—is also covered.
During practical classes and exams, the topography of the fasciae in relation to the pathways of pus spread, the strict sequence of tracheostomy steps (and its complications), and Vishnevsky's block technique are tested most strictly. Study the material systematically: from projection lines and layers to the surgical technique itself.
Why are longitudinal incisions most commonly used for working with neck vessels?
This is directly due to the anatomy: major blood vessels and nerve trunks are located longitudinally in the neck. An incision along the edge of the sternocleidomastoid muscle allows for their safest exposure.
The needle is withdrawn 0.5 cm from the anterior surface of the spine in order to move its tip from dense tissues (muscles and periosteum) directly into the layer of loose connective tissue located posterior to the common fascial sheath.
The needle is withdrawn 0.5 cm from the anterior surface of the spine in order to move its tip from dense tissues (muscles and periosteum) directly into the layer of loose connective tissue located posterior to the common fascial sheath.
What is the difference in head position between these two blocks?
When performing a stellate ganglion block, the head must be turned to the opposite side, and a roll is placed under the scapulae. For the sinocarotid block, the standard position used for the vagosympathetic block is applied.
How long after the administration of novocaine into the tissue does anesthesia occur?
With proper injection of the anesthetic into the tissue surrounding the plexus, anesthesia occurs within 30 minutes.
In what direction does the phrenic nerve run along the anterior scalene muscle?
The nerve trunk runs obliquely: from the lateral margin of the anterior scalene muscle to its medial margin.
At what levels can the common carotid artery be exposed?
Access to the common carotid artery is performed in three zones: between the heads of the sternocleidomastoid muscle, in the omotracheal triangle, and in the carotid triangle.
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