Chapter 2988 [2988]

The human body is a precision instrument assembled by nature, and surgery on any part should not be taken lightly.

The blood vessels and nerves in the superficial fascia can be divided into anterolateral and posterior groups according to their location.

The anterior group includes the trochlear arteriovenous and trochlear nerve 2 cm from the midline, and the supraorbital arteriovenous and supraorbital nerve 2.5 cm from the midline. The superior trochlear artery and the supraorbital artery are branches of the ophthalmic artery. If they are connected back, they will be connected to the ophthalmic artery, and the location is the forehead.

The outer group includes two groups in front of the ear and behind the ear. The preauricular group has the superficial temporal artery and vein and the auricular temporal nerve, and the retroauricular group has the posterior branch of the posterior auricular artery and vein, the posterior branch of the facial nerve, the posterior branch of the cervical plexus, and the lesser occipital nerve.

The above content is what Geng, who studied hard, took out the simple neurosurgery notes in his pocket to check and review on the spot. For this reason, he looked worriedly at Pan, who was assigned as the first assistant.

You know, Song Mao has been targeting them, especially Pan, who is ready to abuse at any time.

The nerves and blood vessels of this scalp are so rich that it is not easy to remember them all.

Look at the back group of neurovascular. The posterior group has 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 to the plane of the greater superior nuchal line, and passes through the trapezius aponeurosis at two centimeters from the midline to the parietal region of the skull. Accompanied by the occipital artery and vein.

The arteries and veins on the top of the skull are like a wide net with many anastomotic points to ensure that the scalp is not easily necrotic when a large piece is broken. The nerves on the top of the skull are also densely overlapped with each other, so when doing local anesthesia of a relatively large area of ​​the scalp, it is often not enough to use one medicine, and multiple needles need to be given widely.

"Look at each other first." Song Xuelin said to the assistant.

Sure enough. Geng looked at Pan anxiously.

Pan, who received the instruction, focused on finding the anatomy position.

Surrounded by a large group of teachers, there is not only neurosurgery, but there is a lot of pressure invisibly.

I don't know if classmate Xie is deliberately helping him to decompress, and discussing the patient's ECG line with someone outside his heart in front of the monitor.

"I think it is more like a 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 cause, causing the atrial conduction to fail to go down to the ventricle, and the QRS wave representing the electrical activity of the ventricle is delayed or dropped, while the p wave in the electrocardiogram Relatively normal performance on the curve.

Because of this situation, although the patient was on the verge of a shock period, his heart rate was slow instead of fast, which attracted the attention of the doctors in the local hospital, and it was right to specifically inform the cardiologist of the National Association of China 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 the female patient is not young, she is in her forties, and she will inevitably be tired after working for a long time. It cannot be ruled out that the sudden syncope caused by the heart caused the accidental tragedy. After the neurosurgery operation is completed, the next step is to carefully examine the heart of the patient.

"Well——" Fu Xinheng listened to her diagnosis and analysis without any major disagreement, and then asked her the next diagnosis and treatment plan, "What do you think should be done now?"

"I think it is possible to take a blood test for blood potassium and myocardial infarction as a preventive measure to see the results." Xie Wanying replied.