Тopographic аnatomy of sternocleidomastoid region and lateral triangle of the neck. Anatomic physiological background and technique of vagosympathetic block according to О. V. Vyshnevskiy icon

Тopographic аnatomy of sternocleidomastoid region and lateral triangle of the neck. Anatomic physiological background and technique of vagosympathetic block according to О. V. Vyshnevskiy




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НазваТopographic аnatomy of sternocleidomastoid region and lateral triangle of the neck. Anatomic physiological background and technique of vagosympathetic block according to О. V. Vyshnevskiy
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WORKSHOP 8


Тopographic аnatomy of sternocleidomastoid region and lateral triangle of the neck. Anatomic physiological background and technique of vagosympathetic block according to О.V. Vyshnevskiy.


  1. Identify the projection of common carotid artery:

  2. What runs between I and II fascia of the neck in sternoclavicular mastoid region?

  3. What is identified on the front wall of common carotid artery?

  4. What is identified beneath IV fascia of the neck in front and outside from v.jugularis interna and a. carotis communis in the middle third of sternocleidomastoid region?

  5. Identify the branches of cervical plexus:

  6. Where is superior cervical sympatic ganglion of sympatic trunk identified?

  7. Where is the middle cervical ganglion of sympatic trunk identified?

  8. Where is intermediate cervical ganglion of sympatic trunk identified?

  9. Where is inferior cervical ganglion of sympatic trunk identified?

  10. What is observed at cervical osteochondrosis resulted from compression of vertebral аrtery and sympathetic plexus?

  11. What is the Barre- Lieou syndrome characterized by?

  12. What is observed at irritation of sympatic fibers in the cervical region?

  13. What is Petit’s syndrome characterized by?

  14. What is observed when sympatic trunk of the neck is damaged?

  15. What is Horner-Claude Bernard’s syndrome characterized by?

  16. Where is the solution of Novocain injected at vagosympathetic block according to O. V. Vishnevskiy?

  17. What is spatium antescalenum limited by in front and externally?

  18. What is spatium antescalenum limited by in front and medially?

  19. What is spatium antescalenum limited by from behind?

  20. What is spatium antescalenum composed of?

  21. What is the projection of n. phrenicus on the skin?

  22. What runs medially from n. phrenicus on anterior surface of m. scalenus anterior?

  23. What runs in front of n. phrenicus?

  24. What is scalene vertebral triangle limited by externally?

  25. What is scalene vertebral triangle limited by medially?

  26. What is scalene vertebral triangle limited by from below?

  27. What is scalene vertebral triangle limited by from the front?

  28. Identify the apex of scalene vertebral triangle:

  29. Identify the composition of scalene veretebral triangle:

  30. Identify the injection site of the needle to perform conductive anesthesia of cervical plexus:

  31. What runs medially from truncus thyreocervicalis crossing a. subclavia?

  32. What runs laterally from truncus thyreocervicalis crossing a. subclavia?

  33. What is identified at the base of truncus thyreocervicalis?

  34. Identify the branches of subclavian аrtery in scalene vertebral triangle:

  35. What is posted behind and medially to a. vertebralis?

  36. Identify the branches of truncus thyreocervicalis:

  37. What is the anterior wall of spatium interscalenum composed by?

  38. What is the posterior wall of spatium interscalenum composed by?

  39. What is the inferior wall of spatium interscalenum composed by?

  40. What is identified in spatium interscalenum?

  41. Identify the branches of a. subclavia in spatium interscalenum:

  42. Identify the branches of truncus costocervicalis:

  43. Name the author of brachial plexus anesthesia:

  44. Identify the place of injection and direction of the needle at the block of brachial plexus:

  45. What nerve crosses external surface of internal jugular vein in the upper third of sternocleidomastoid region?

  46. What nerve crosses external surface of internal jugular vein in the middle third of sternocleidomastoid region?

  47. Where is thoracic lymphatic duct at the level of apertura thoracis superior identified?

  48. What is identified in front of thoracic duct?

  49. Identify the place of injection to perform conductive аnesthesia of cervical plexus:

  50. Identify the place of injection to perform vagosympathetic block:

  51. What runs between II and V fascia of the neck in tr. omotrapezoideum?

  52. What runs between III and V fascia of the neck in tr. omoclaviculare?

  53. What is identified beneath the V fascia in tr. omoclaviculare?

  54. What is posted medially from the first part of right subclavian artery?

  55. What is identified below the first part of subclavian artery?

  56. What is identified in front of the first part subclavian artery?

  57. What is identified behind the first part of right subclavian artery?



! Identify the projection of common carotid artery:

From sternoclavicular junction to the middle distance between the angle of mandible and mastoid process

#from jugular incissure to the angle of mandible

From jugular incissure to mastoid process

From sternoclavicular junction to the angle of mandible


! What runs between I and II fascia of the neck in sternoclavicular mastoid region?

v. jugularis externa, n. transversus colli, n. auricularis magnus, n. occipitalis minor, nn. supraclaviculares

#v. jugularis externa, n. transversus colli, n. auricularis magnus, a. cervicalis superficialis,

n. occipitalis minor

v. jugularis externa, n. transversus colli,

r. colli n. facialis, nn. supraclavicularis,

n. occipitalis minor

v. jugularis externa, a. cervicalis superficialis,

n. occipitalis minor, nn. supraclaviculares,

n. auricularis magnus


! What is identified on the front wall of common carotid artery?

radix superior n. hypoglossus, сardiac branches of vagus nerve, cardiac branches of sympatic trunk

#n. phrenicus, cardiac branches of sympatic trunk, radix superior n. hypoglossus

n. accessorius, cardiac branches of sympatic trunk

radix superior n. hypoglossus, сardiac branches of vagus nerve and sympatic trunk, a. cervicalis ascendens


! What is identified beneath IV fascia of the neck in front and outside from v.jugularis interna and a. carotis communis in the middle third of sternocleidomastoid region?

ansa cervicalis

#n. accessorius

n. transversus colli

a. et v. cervicalis superficialis


! Identify the branches of cervical plexus:

n. transversus colli, n. auricularis magnus, n. occipitalis minor, nn. supraclaviculares, n. phrenicus

#n. transversus colli, n. auricularis magnus, n. occipitalis minor, n. occipitalis major, nn. supraclaviculares

n. transversus colli, n. suprascapularis, n. auricularis

magnus, n. occipitalis minor, n. phrenicus

n. transversus colli, n. occipitalis minor, n. auricularis

posterior, nn. supraclaviculares, n. phrenicus


! Where is superior cervical sympatic ganglion of sympatic trunk identified?

on m. longus capitis at the level of transverse processes of II - IV cervical vertebrae behind internal carotid artery medially from n. vagus

#on m. longus colli at the level of transverse processes of II - IV cervical vertebrae behind internal carotid artery in front of n. vagus

on m. longus capitis at the level of transverse processes of II - IV cervical vertebrae behind internal carotid artery outside of n. vagus

on m. longus colli at the level of transverse processes of II - IV cervical vertebrae in front of internal carotid artery outside n. vagus

! Where is the middle cervical ganglion of sympatic trunk identified?

on m. longus colli at the level of VI cervical vertebra above the arch of a. thyreoidea inferior

#on m. longus capitis at the level of transverse processes of II - IV cervical vertebrae behind internal carotid artery

on m. longus colli at the level of VI cervical vertebra behind internal carotid artery medially from n. vagus

on m. longus capitis at the level of VI cervical vertebra in front of a. vertebralis


! Where is intermediate cervical ganglion of sympatic trunk identified?

Anterior surface of vertebral аrtery at the level of VII cervical vertebra

#behind vertebral аrtery at the level of the I rib head

behind internal carotid artery at the level of the I rib head

in front of a. subclavia at the level of the I rib head


! Where is inferior cervical ganglion of sympatic trunk identified?

in scalene vertebral triangle at the level of the I rib head behind vertebral artery and a. subclavia medially to truncus thyreocervicalis

#in scalene vertebral triangle at the level of VII cervical vertebra in front of vertebral аrtery laterally to truncus thyreocervicalis

in spatium antescalenum at the level of the I rib head in front of a. vertebralis laterally to truncus thyreocavicalis

in scalene vertebral triangle at the level of the I rib head in front of a. vertebralis medially to truncus thyreocervicalis


! What is observed at cervical osteochondrosis resulted from compression of vertebral аrtery and sympathetic plexus?

Barre- Lieou syndrome

#Foix syndrome

Horner’s syndrome

Willaret’s syndrome


! What is the Barre- Lieou syndrome characterized by?

Aches and parasthesia in the head and neck, dizziness, tinnitus, reduced eyesight

#aches and parasthesia in the head and neck, torticollis, ptosis, midriasis

Aches and parasthesia in the head and neck, anisocoria, exophtalm, reduced eyesight

Aches and parasthesia in the head and neck, dizziness, ptosis, exophtalm


! What is observed at irritation of sympatic fibers in the cervical region?

Petit’s syndrome

#Barre-Lieou’s syndrome

Willaret’s syndrome

Foix syndrome


! What is Petit’s syndrome characterized by?

exophtalm, midriasis, dilatation of palpebral fissure

#enophtalm, miosis, constriction of palpebral fissure

Exophthalm, miosis, dilatation of palpebral fissure

exophthalm, torticollis, midriasis


! What is observed when sympatic trunk of the neck is damaged?

Horner-Claude Bernard’s syndrome

#Foix syndrome

Willaret’s syndrome

Barre-Lieou’s syndrome


! What is Horner-Claude Bernard’s syndrome characterized by?

miosis, constriction of palpebral fissure, enophtalm, hyperemia of face, bradicardia

#midriasis, dilatation of palpebral fissure, hyperemia of face, bradicardia

miosis, exophtalm, tachicardia, dilatation of palpebral fissure, hyperemia of face

midriasis, constriction of palpebral fissure, retraction of the pupil, tachycardia


! Where is the solution of Novocain injected at vagosympathetic block according to O. V. Vishnevskiy?

In the cellular tissue surrounding superior cervical ganglion of sympatic trunk, truncus symphaticus, n. vagus

#in the cellular tissue surrounding inferior cervical ganglion of sympatic trunk, Vieussens loop, n. phrenicus

In the cellular tissue surrounding superior cervical ganglion of sympatic trunk, n. phrenicus, cervical plexus

In the cellular tissue surrounding superior cervical ganglion of sympatic trunk, cervical plexus, n. vagus, n. phrenicus


! What is spatium antescalenum limited by in front and externally?

m. sternocleidomastoideus, m. omohyoideus

#m. sternohyoideus, m. sternothyreoideus

m. scalenus anterior, m. omohyoideus

m. sternocleidomastoideus, m. scalenus anterior


! What is spatium antescalenum limited by in front and medially?

m. sternohyoideus, m. sternothyreoideus

#m. sternocleidomastoideus, m. omohyoideus

m. sternocleidomastoideus, m. sternohyoideus

m. sternohyoideus, m. scalenus anterior


! What is spatium antescalenum limited by from behind?

m. scalenus anterior

#m. scalenus medius

m. scalenus posterior

m. longus colli


! What is spatium antescalenum composed of?

bulbus v. jugularis interna, v. subclavia, sinister ductus thoracicus, v. vagus, a. carotis communis,

n. phrenicus, a. cervicalis, ascendens, a. suprascapularis, a. cervicalis superficialis

#bulbus v. jugularis interna v. subclavia

v. jugularis interna, v. subclavia, n. phrenicus,

a. cervicalis ascendens, a. suprascapularis


! What is the projection of n. phrenicus on the skin?

Gueneau de Mussy point, fossa supraclavicular minor, between crura of sternoclavicular mastoid muscle

#in spatium antescalenum

in spatium interscalenum

in trigonum scalenovertebrale


! What runs medially from n. phrenicus on anterior surface of m. scalenus anterior?

a. cervicalis ascendens

#a. suprascapularis

a. cervicalis superficialis

a. thyreoidea inferior


! What runs in front of n. phrenicus?

a. suprascapularis, a. cervicalis superficialis

#ansa subclavia

a. cervicalis ascendens, a. suprascapularis

ansa cervicalis


! What is scalene vertebral triangle limited by externally?

m. scalenus anterior

#m. scalenus medius

m. scalenus posterior

m. sternocleidomastoideus


! What is scalene vertebral triangle limited by medially?

m. longus colli

#m. sternocleidomastoideus

m. sternohyoideus

m. omohyoideus


! What is scalene vertebral triangle limited by from below?

Cervical pleura

#clavicle

Breast bone

m. scalenus anterior


! What is scalene vertebral triangle limited by from the front?

V fascia of the neck

#m. scalenus anterior

m. sternocleidomastoideus

m. sternohyoideus


! Identify the apex of scalene vertebral triangle:

tuberculum caroticum

#cervical pleura

m. sternocleidomastoideus

m. omohyoideus


! Identify the composition of scalene veretebral triangle:

a. subclavia, medial, intermedial and inferior ganglia of sympatic trunk, v.vertebralis, left sternal lymphatic duct

#a. et v. subclavia, medial, intermedial and inferior ganglia of sympatic trunk, v. vertebralis, ductus thoracicus

a. subclavia, v. jugularis interna, a. carotis communis,

n. vagus, medial, intermedial and inferior ganglia of truncus sympaticus

v. jugularis interna, v. subclavia, ductus thoracicus,

n. vagus, n. phrenicus


! Identify the injection site of the needle to perform conductive anesthesia of cervical plexus:

Middle posterior margin of m. sternocleidomastoideus

#middle anterior margin of m. trapezius at Gueneau de Mussy’s point

between crura of sternocleidomastoid muscle


! What runs medially from truncus thyreocervicalis crossing a. subclavia?

n. vagus

#n. phrenicus

v. jugularis interna

ductus thoracicus


! What runs laterally from truncus thyreocervicalis crossing a. subclavia?

n. phrenicus

#n. vagus

v. jugularis interna

a. thyreoidea inferior


! What is identified at the base of truncus thyreocervicalis?

ansa subclavia

#ansa cervicalis

glomus caroticum

ductus thoracicus


! Identify the branches of subclavian аrtery in scalene vertebral triangle:

a. vertebralis, truncus thyreocervicalis,

a. thoracica interna

#a. vertebralis, a. cervicalis ascendens,

a. cervicalis superficialis

a. vertebralis, a. transversa colli, a. thoracica interna

truncus thyreocervicalis, a. transversus colli,

a. thyreoidea inferior


! What is posted behind and medially to a. vertebralis?

ganglion stellatum

#v. vertebralis

ganglion cervicale intermedium

n. laryngeus reccurens


! Identify the branches of truncus thyreocervicalis:

a. thyreoidea inferior, a. cervicalis ascendens,

a. cervicalis superficialis, a. suprascapularis

#a. thyreidea superior, a. thoracica interna,

a. vertebralis, a. cervicalis superficialis

a. vertebralis, a. thyreoidea inferior, a. cervicalis superficialis, a. superscapularis

a. transversa colli, a. thyreoidea inferior,

a. suprascapularis, a. thoracica interna


! What is the anterior wall of spatium interscalenum composed by?

m. scalenus anterior

#m. scalenus medius

m. scalenus posterior

m. sternocleidomastoideus


! What is the posterior wall of spatium interscalenum composed by?

m. scalenus medius

#m. scalenus posterior

m. scalenus anterior

m. sternocleidomastoideus


! What is the inferior wall of spatium interscalenum composed by?

I rib

#m. scalenus anterior

clavicle

m. sternocleidomastoideus


! What is identified in spatium interscalenum?

a. subclavia, plexus brachialis

#v. subclavia, n. vagus

a. et v. subclavia, plexus brachialis

v. jugularis interna, n. vagus, a. carotis communis


! Identify the branches of a. subclavia in spatium interscalenum:

truncus costocervicalis

#truncus thyreocervicalis

a. transversus colli

a. vertebralis, a. thoracica interna


! Identify the branches of truncus costocervicalis:

a. cervicalis profunda, a. intercostalis suprema

#a. cervicalis superficialis, a. suprascapularis

a. cervicalis ascendens, a. cervicalis superficialis,

a. transversa colli

a. cervicalis profunda, a. cervicalis superficialis


! Name the author of brachial plexus anesthesia:

Kulenkampff

#Lukashevich

Oberst

Brown

! Identify the place of injection and direction of the needle at the block of brachial plexus:

The needle is conducted above the middle of the clavicle medially and downward directly to the II thoracic vertebra

#the needle is conducted 1 - 1,5 сm below the middle of the clavicle laterally and downward

The needle is conducted above the middle of the clavicle laterally and downward

The needle is conducted 1 - 1,5 сm below the middle of the clavicle medially and downward


! What nerve crosses external surface of internal jugular vein in the upper third of sternocleidomastoid region?

n. accessorius

#n. hypoglossus

n. laryngeus superior

ansa cervicalis


! What nerve crosses external surface of internal jugular vein in the middle third of sternocleidomastoid region?

radix inferior plexus cervicalis

#radix superior plexus cervicalis

n. hypoglossus

n. accessorius


! Where is thoracic lymphatic duct at the level of apertura thoracis superior identified?

Left margin of the gullet behind a. subclavia

#behind the gullet in front of a. subclavia

In front of a. subclavia, a. carotis communis,

v. jugularis interna

right margin of the gullet behind a. subclavia


! What is identified in front of thoracic duct?

a. carotis communis, v. jugularis interna, n. vagus

#a. et v. vertebralis

Cervical pleura, a. et v. subclavia

a. carotis interna, v. jugularis interna, купол плеври


! Identify the place of injection to perform conductive аnesthesia of cervical plexus:

Erb’s point

# Gueneau de Mussy’s point

In the middle posterior margin of sternocleidomastoid muscle

In the middle anterior margin of sternocleidomastoid muscle


! Identify the place of injection to perform vagosympathetic block:

Angle created by the crossing of external jugular vein with posterior margin of sternocleidomastoid muscle

#in the middle of anterior margin of sternocleidomastoid muscle

Еrb’s point

Gueneau de Mussy’s point


! What runs between II and V fascia of the neck in tr. omotrapezoideum?

a. et v. cervicalis superficialis, branch of cervical plexus, n. accessorius

#a. et v. suprascapularis

a. et v. subclavia, plexus brachialis

a. et v. cervicalis ascendens, n. phrenicus


! What runs between III and V fascia of the neck in tr. omoclaviculare?

a. et v. suprascapularis

#a. et v. cervicalis ascendens

n. accessorius

n. phrenicus, a. cervicalis ascendens


! What is identified beneath the V fascia in tr. omoclaviculare?

a. et v. subclavia, pl. brachialis

#a. et v. suprascapularis

a. et v. cervicalis superficialis

a. et v. suprascapularis, a. et v. cervicalis superficialis, n. accessorius


! What is posted medially from the first part of right subclavian artery?

trachea, a. carotis communis

#v. jugularis interna

Cervical pleura

n. vagus


! What is identified below the first part of subclavian artery?

cupola of pleura

#I rib

clavicle

v. subclavia


! What is identified in front of the first part subclavian artery?

Pirogov’s venous angle, n. vagus, n. phrenicus

#a. carotis communis, n. vagus, v. jugularis interna

v. subclavia, n. vagus, truncus sympathicus

cervical pleura


! What is identified behind the first part of right subclavian artery?

n. laryngeus reccurens

#Pirogov’s venous angle

n. vagus, n. phrenicus

Trachea





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