The human body is a sophisticated instrument assembled by nature, and any surgery on any part of the body should not be taken lightly.
The blood vessels and nerves within the superficial fascia can be divided into anterior, lateral and posterior groups according to their location.
The anterior group includes the trochlear artery and vein and the trochlear nerve 2 cm from the midline, and the supraorbital artery and vein and the supraorbital nerve 2.5 cm from the midline. The supratrochlear artery and the supraorbital artery are branches of the ophthalmic artery. If they are connected back, they will have to be connected to the ophthalmic artery, which is located in the forehead.
The lateral group includes two groups, the anterior and posterior auricular groups. The anterior auricular group includes the superficial temporal artery and vein and the auriculotemporal nerve, and the posterior auricular group includes the posterior auricular artery and vein and the posterior auricular branch of the facial nerve, the posterior branch of the greater auricular nerve of the cervical plexus, and the lesser occipital nerve.
The above contents were what Geng, a serious student, saw when he took out the neurosurgery notebook he had simply written down in his pocket and opened it to review it on the spot. For this reason, he looked at Pan, who was assigned as the first assistant, with concern.
You know, Song Mao had been targeting them, especially classmate Pan, and was ready to torture him at any time.
The scalp has so many 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 greater occipital nerve. The greater occipital nerve is the posterior branch of the second cervical nerve. It passes through the deep nuchal muscles and arrives at the plane of the superior nuchal line. It passes through the trapezius aponeurosis two centimeters away from the midline and goes to the skull top area. It is accompanied by the occipital artery and vein.
The arteries and veins of the skull are like a wide net with many anastomosis points, ensuring that the scalp will not easily necrotize when a large piece is broken. The nerves of the skull are also overlapping and dense, so when doing local anesthesia of a relatively large area of scalp, one medicine is often not enough, and multiple needles are needed to be inserted widely.
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"Check it first." Song Xuelin said to his assistant.
As expected, Geng looked at Pan anxiously.
After receiving the instructions, Pan concentrated on finding the anatomical position.
There was a large group of teachers watching me, not just from the neurosurgery department, which was a huge pressure.
I don’t know if Xie was intentionally helping him relieve stress by discussing the patient’s ECG line on the monitor with someone outside the heart.
"I think it's more like second-degree type II atrioventricular block," Xie Wanying said. "The PR interval is long, and there are signs of QRS wave drops in the middle."
Second-degree atrioventricular block occurs when part of the conduction from the atrium to the ventricle is interrupted due to certain causes, resulting in the inability of the atrium to conduct to the ventricle. The QRS wave representing the ventricular electrical activity is delayed or dropped, while the P wave appears relatively normal on the electrocardiogram curve.
Due to this situation, although the patient was on the verge of shock, his heart rate was slow rather than fast, which attracted the attention of doctors in local hospitals. They specifically notified the cardiologist from the National Association for the Treatment of Disability to participate in the emergency treatment.
Clinically, second-degree atrioventricular block is divided into type I and type II. The former is more common. Both types can be seen in patients with myocardial infarction. Considering that the female patient is not young, in her forties, she is inevitably tired after working for a long time. It is not ruled out that sudden syncope caused by cardiac factors led to the accidental tragedy. After the neurosurgery is completed, the next step is to carefully examine the patient's heart.
"Hmm..." Fu Xinheng listened to her diagnosis and analysis without much disagreement, and then asked her about the next treatment plan, "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 and see the results." Xie Wanying replied.
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