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General Surgery
Neck Thyroid Gland, Salivary Glands
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
13 sections · 196 slides
Overview
- Scope of this topic
Thyroid gland: development and congenital anomalies
- Median thyroid anlage
- Thyroglossal duct
- Descent of the median anlage
- Embryonic path of descent of the thyroid gland
- Normal vestiges of thyroid gland development
- Lateral anlages and C cells
- Lingual thyroid
- Thyroglossal duct cyst
- Sistrunk procedure
- Sites of accessory ectopic thyroid tissue
- Lateral aberrant thyroid
- A Classification of Congenital Anomalies of the Thyroid Gland a
- A Classification of Congenital Anomalies of the Thyroid Gland a (continued)
- A Classification of Congenital Anomalies of the Thyroid Gland a (continued)
- Reported Cases of Thyroglossal Duct-Associated Carcinoma a
Surgical anatomy of the thyroid gland
- General topography of the thyroid gland
- True and false capsules
- Structures related to the capsules
- Arterial supply of the thyroid gland
- Arterial supply to the thyroid gland
- Superior thyroid artery
- Branches of the superior thyroid artery
- Branches of the superior thyroid artery
- Inferior thyroid artery
- Recurrent nerve and the inferior thyroid artery
- Recurrent laryngeal nerve crossing the inferior thyroid artery
- Thyroid ima artery
- Venous drainage of the thyroid gland
- Venous drainage of the thyroid gland
- Middle thyroid vein
- Lymphatic drainage: concepts and patterns
- Three concepts of thyroid lymphatic drainage
- Lymph nodes receiving drainage from the thyroid gland
- Lymph node regions for management of thyroid carcinoma
- Node groups at highest risk in differentiated thyroid carcinoma
- Metastatic spread of thyroid carcinoma
- Incidence of Metastasis in Thyroid Carcinoma
- Localization of Node Involvement
- Node Involvement According to Localization of the Tumor in the Thyroid Lobe
Laryngeal nerves in thyroid surgery
- Recurrent laryngeal nerves: normal anatomy
- Embryonic aortic arches and recurrence of the laryngeal nerve
- Non-recurrent inferior laryngeal nerve
- Extralaryngeal branching of the recurrent nerve
- Course of the recurrent laryngeal nerve at the thyroid: lateral view
- Course of the recurrent laryngeal nerve: cross-sectional view
- Vulnerability along the course
- Relationship of Recurrent Laryngeal Nerve and Inferior Thyroid Artery
- Exposure of the recurrent laryngeal nerve
- Landmarks for finding the nerve
- Grading of the tuberculum of Zuckerkandl
- Tubercle of Zuckerkandl and the distal recurrent nerve
- Superior laryngeal nerve
- Branching of the superior laryngeal nerve and the carotid arteries
- Internal laryngeal nerve
- External laryngeal nerve
- Superior laryngeal nerve trunks in the sternothyroid-laryngeal triangle
- Types of the superior laryngeal nerve loop
- Superior laryngeal nerve branches and the upper pole
- Cernea classification of the external branch
- Fascial plane between vessels and nerve
- Nerves and arteries of the larynx, lateral view
Thyroid histology, physiology and surgery
- Histology of the thyroid gland
- Functions of the follicular cell
- Synthesis and secretion of thyroxine and triiodothyronine
- Regulation of thyroid hormone secretion and the tests that measure it
- Choice of thyroid operation
- Management pathway for a solitary thyroid nodule
- Thyroid carcinoma: histology and behaviour
- Nodal surgery in papillary carcinoma
- Medullary and anaplastic carcinoma
Anatomic complications of thyroidectomy
- Securing the superior thyroid vessels at the upper pole
- Arterial injury at thyroidectomy
- Venous injury at thyroidectomy
- Organ injury: pleura and airway
- Retrosternal thyroid gland and its relation to the pleura
- Injury to the parathyroid glands
- Vagus nerve: blood supply and injury
- Vagal artery on the right side of the neck
- Vagal vein draining to the superior thyroid vein
- Vagal vein draining to the inferior thyroid vein
- Vagal artery on the left side of the neck and thorax
- Recurrent laryngeal nerve injury
- Recurrent Laryngeal Nerve Vulnerability
- Vocal cord paralysis: assessment
- Superior laryngeal nerve injury
- Cervical sympathetic chain injury
- Plan of the right hypoglossal nerve and ansa cervicalis
- Ansa cervicalis, its roots and its branches to the infrahyoid muscles
- Dividing the strap muscles
Parathyroid glands
- Branchial apparatus and its derivatives
- Origin of the two parathyroid pairs
- Migration of the parathyroid glands
- Migratory pathways of the parathyroid glands
- Anatomic locations of ectopic parathyroid glands
- Topography of the parathyroid glands
- Rules for locating the glands
- Number and ectopia of the glands
- Preoperative localisation
- Vascular supply of the parathyroid glands
- Positions of the parathyroid glands and their vascular supply
- Anatomic distribution of upper and lower parathyroid glands
- Calcium and parathyroid hormone feedback
- Strategy for finding a missing parathyroid gland
- Complications of parathyroidectomy
- Multiglandular disease
- Location of Parathyroids in 50 Cadavers
- Variations in Vascular Supply of 1405 Parathyroids Identified at 354 Autopsies a,b
- Successful Surgery for Primary Hyperparathyroidism
Trachea at the neck
- General structure of the cervical trachea
- Tracheal cartilages and the fibromuscular wall
- Cricothyroid membrane
- Cricothyroid artery crossing the cricothyroid membrane
- Dimensions of the cricothyroid membrane
- Tracheostomy: landmarks and relations
- Indications and technique of tracheostomy
- Complications of tracheostomy
- Tracheostomy tube curvature and position
- Cricothyroidostomy
Parotid gland
- Salivary glands and their ducts
- Development and anomalies of the parotid
- General relations of the parotid gland
- Anatomic relations of the buccal pad of fat
- Parotid fascia and the parotid space
- Structures in the bed of the parotid gland
- Parotid gland and the branches of the external carotid artery
- Venous drainage of the parotid gland
- Parotid gland and the tributaries of the jugular veins
- Parasympathetic supply of the parotid
- Parasympathetic innervation of the parotid gland
- Secretomotor nerve supply to the parotid gland
- Sympathetic supply to the parotid gland
- Auriculotemporal nerve
- Facial nerve and the parotid gland
- Relations of the parotid gland to the facial nerve
- Identifying the facial nerve at operation
- Superficial distribution of the facial nerve
- Great auricular nerve
- Nerve injury after parotidectomy
- Mandibular nerve deep to the ramus of the mandible
- Benign Salivary Gland Neoplasms in Children (229 from Literature, 18 from Johns Hopkins)
- Malignant Salivary Gland Neoplasms in Children (243 from Literature, 3 from Johns Hopkins)
- Malignant Salivary Gland Neoplasms in Children (243 from Literature, 3 from Johns Hopkins) (continued)
- Summary of Treatment and Outcome of 272 Cases in Childhood Salivary Gland Neoplasms
- Summary of Treatment and Outcome of 272 Cases in Childhood Salivary Gland Neoplasms (continued)
- Summary of Treatment and Outcome of 272 Cases in Childhood Salivary Gland Neoplasms (continued)
Submandibular and sublingual glands
- Form and relations of the submandibular gland
- Submandibular duct and the lingual nerve
- Marginal mandibular nerve
- Surgery of the submandibular gland
- Sublingual and minor salivary glands
- Superficial and deep structures of the sublingual region
- Lateral view of the sublingual region
- Surgery of the sublingual glands
Branchial remnants
- Branchial fistulas
- Course of the second cleft fistula
- Congenital cervicoaural fistula or cyst
- Track of a second pouch and cleft fistula
- Types of second branchial cleft and pouch cysts
- Surgery and complications of branchial remnants
- Derivatives of branchial arches and pouches: aortic arch, cranial nerve and remnants
- Derivatives of branchial arches and pouches: aortic arch, cranial nerve and remnants (continued)
- Derivatives of branchial arches and pouches: fleshy and skeletal structures
- Derivatives of branchial arches and pouches: fleshy and skeletal structures (continued)
Radical neck dissection
- Definition and boundaries
- The danger zone of the posterior triangle
- Nerves in the operative field
- Hypoglossal, vagus and phrenic nerves
- Spinal accessory nerve in the posterior triangle
- The completed radical dissection of the neck
- Vascular injury in radical neck dissection
- Air embolism, thoracic duct and carotid artery
- Nerve injury after radical neck dissection
- Facial nerve, brachial plexus and deformity
- Structures that may be sacrificed in radical neck dissection
- Structures whose sacrifice is controversial
- Structures that must be preserved unless directly invaded
Summary and references
- Recurring principles of the region
- Numbers worth carrying from this topic
- Sources cited in the text
- Sources cited in the text (continued)
- Sources cited in the text (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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