By Vijay K. Maker, Edgar Guzman-Arrieta
This article is prepared via organ method and the illustrations spotlight surgical pearls borne of expertise and polished via the learn of pertinent references. Hand-drawn and illustrated figures exhibit certain anatomical relationships as we see them in-vivo. A question/answer structure augments the photographs to permit the reader to actively examine the subject and to appraise his/her wisdom in that sector. The dialogue sections attempt to provide an explanation for not just what the proper resolution is, but additionally why the distractors are fallacious, so as to encourage dialogue and self-reflection.
Cognitive Pearls usually surgical procedure information the specific notion strategies and institutions that underlie the certainty of the subjects handy, with the rationale of bettering the joys and delight that basically an educated and well-grounded perform of surgical procedure supplies.
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Extra info for Cognitive Pearls in General Surgery
E) An inadequate curvature in the tracheostomy tube may lead to erosion into the tracheal wall and into other structures. Comments The incisions performed during an emergent cricothyroidotomy are thought out to minimize bleeding. A vertical skin incision in the midline offers the fastest exposure and allows extension if necessary. The cricothyroid membrane is best incised horizontally in its lower aspect to minimize the likelihood of injury to the cricothyroid artery, which runs horizontally along its superior aspect.
This is especially true if the inferior thyroid artery (and to the lesser extent the superior thyroid artery) is ligated away from the gland, before they have given off the branches for the parathyroid. To avoid this complication, the thyroid blood vessels should be ligated on the surface of the gland. Even though the inferior thyroid artery is the predominant supply to both parathyroid glands in over 80 % of cases, communicating vessels exists between the superior and inferior thyroid artery. There is no middle thyroid artery accompanying the middle thyroid vein.
Comments Ribs are classified into three categories. True ribs are joined to the sternum by the costal cartilages. False ribs are joined to superior ribs by cartilages that in conjunction form the costal arch. Floating ribs do not articulate anteriorly, but are stabilized by the intercostal muscles. In adults, the ribs are placed in a fashion similar to bucket handles, where upon contraction of the intercostals muscles, they are pulled superiorly and anteriorly increasing the diameter of the thoracic cavity and contributing to the negative intrathoracic pressure resulting in inspiration.
Cognitive Pearls in General Surgery by Vijay K. Maker, Edgar Guzman-Arrieta