The human body is a precision instrument assembled by nature. No surgery on any part of the body should be taken lightly.
The blood vessels and nerves in the superficial fascia can be divided into anterior, lateral and posterior groups according to their locations.
The anterior group includes the trochlear artery and vein and trochlear nerve 2 cm from the midline, and the supraorbital artery and vein and supraorbital nerve 2.5 cm from the midline. The supratrochlear artery and supraorbital artery are branches of the ophthalmic artery. If they are reconnected, they must be removed.
The ophthalmic artery is connected, located on the forehead.
The lateral group includes two groups, preauricular and postauricular. The preauricular group contains the superficial temporal artery and vein and auriculotemporal nerve, and the postauricular group contains the postauricular artery and vein, the posterior branch of the facial nerve, the posterior auricular branch of the cervical plexus, the posterior branch of the greater auricular nerve, and the lesser occipital nerve.
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The above contents were what Geng, who was studying seriously, saw when he took out the simple neurosurgery notes in his pocket, opened them, and reviewed them on the spot. For this reason, he looked worriedly at Classmate Pan, who was assigned as the first assistant.
You know, Song Mao has been targeting a few of them, especially Classmate Pan, and is ready to torture them at any time.
The scalp is so rich in nerves and blood vessels that it is not easy to remember them all.
Let’s look at the posterior group of nerves and blood vessels. The posterior group includes the occipital artery, vein and the greater occipital nerve. The greater occipital nerve is the posterior branch of the second cervical nerve. It passes through the deep nuchal muscles and then reaches the greater superior nuchal line plane, which is at the distance from the midline
Two centimeters later, it passes through the trapezius aponeurosis and reaches the cranial region. It is accompanied by the occipital artery and vein.
The arteries and veins on the top of the skull have as many anastomosis points as a wide net, ensuring that the scalp will not easily become necrotic when a large piece of the scalp is broken. The nerves on the top of the skull are also densely packed, so when performing local anesthesia on a relatively large area of the scalp, one pill is often used.
If it is not enough, multiple needles need to be applied widely.
"Check it first." Song Xuelin said to his assistant.
Sure enough. Classmate Geng looked at Classmate Pan anxiously.
After receiving the instructions, classmate Pan concentrated on finding the anatomical position.
There were a large group of teachers watching around me, not just the neurosurgery department, which was a huge pressure invisibly.
I don’t know if classmate Xie was deliberately helping him reduce stress, and was discussing the patient’s electrocardiogram lines with the cardiothoracic person in front of the monitor.
"I think it's more like second-degree type II atrioventricular block." Xie Wanying analyzed, "The PR interval is long, and there are signs of qrs wave drop in the middle."
Second-degree atrioventricular block means that part of the conduction from the atrium to the ventricle is interrupted due to some reasons, resulting in the atrium being unable to conduct to the ventricle. The qrs wave representing the ventricular electrical activity is delayed or dropped, and the p wave appears in the electrocardiogram.
The relative performance on the curve is normal.
Due to this situation, although the patient was on the verge of shock, his heart rate was not fast but slow, which attracted the attention of doctors at the local hospital. They specifically informed the National Association that it was correct for the cardiologist here to participate in the emergency treatment.
Clinically, second-degree atrioventricular block is divided into type I and type II. The former is more common, and both can be seen in patients with myocardial infarction. Considering that this female patient is not young, she is in her forties and works long hours.
Fatigue is unavoidable, and it cannot be ruled out that sudden syncope due to cardiac factors may lead to unexpected tragedies. After the neurosurgery is completed, the next step is to carefully examine the patient's heart.
"Well -" Fu Xinheng didn't have any major objections after hearing her diagnosis and analysis, and then asked her about the next step in diagnosis and treatment, "What do you think needs to be done now?"
"I think we can take a preventive blood test to check blood potassium and myocardial infarction to see the results." Xie Wanying replied.
