Related Articles StatPearls Book. 2020 01 Authors: Abstract Brachytherapy (BT) is a radiotherapy technique where radioactive devices are inserted near tumors to safely deliver high doses of radiation to eliminate and shrink tumors. Brachy- means short distance in Greek. It was first used in 1901 by Alexandre Danlos and Paul Bloch, who received a radioactive sample from Marie Sklodowska Curie and her husband, Pierre. Danlos and Bloch were attempting to treat lupus....
Thu Sep 24, 2020 16:44
Related Articles StatPearls Book. 2020 01 Authors: Abstract The cribriform plate is a portion of the ethmoid bone located at the base of the skull. The base of the skull is the term used to describe the most inferior portion of the skull. It is comprised of portions of the frontal bone, ethmoid bone, sphenoid bone, temporal bone, and occipital bone. The base of the skull is divided into three sections, the anterior fossa, the middle fossa, and the posterior fossa....
Thu Sep 24, 2020 16:24
Related Articles StatPearls Book. 2020 01 Authors: Abstract Polycythemia, derived from poly (many) and cythemia (cells in the blood), is a condition defined as an abnormal increase in the red blood cell (RBC) mass. For a normal healthy adult, the RBC mass is 23 to 29 mL/kg in females and 26 to 32 mL/kg in males.[1][2] Patients with hematocrit values greater than 51% and 48% and hemoglobin values greater than 185g/L and 165 g/L in males and females respectively...
Thu Sep 24, 2020 14:55
Related Articles StatPearls Book. 2020 01 Authors: Abstract Obesity is a chronic disease with increasing prevalence worldwide, not only in adults but also in adolescents and children, and is now considered to be a global epidemic.[1] Epidemiologic studies have defined obesity by the body mass index (BMI), which is calculated by dividing a person’s weight in kilograms by the square of their height in meters. That helps to stratify obesity-related health risks at...
Thu Sep 24, 2020 14:55
Related Articles StatPearls Book. 2020 01 Authors: Abstract Vagus nerve is the longest mixed cranial nerve associated structurally with the post olivary sulcus of the medulla oblongata. The literal translation of the vagus is 'wanderer,' which aptly represents its widespread interfacing of cortex, brainstem, hypothalamus, and the body. Its afferent and efferent pathways comprise about 80% and 20%, respectively. With a premise that venous hyperemia caused seizures,...
Thu Sep 24, 2020 14:54
Related Articles StatPearls Book. 2020 01 Authors: Abstract Epilepsy surgery is indicated in 30% to 40% of patients with refractory seizure disorders despite being on one year of therapy with an adequate dosage of two antiepileptic therapy.[1] Though the anterior temporal lobectomy has been the prototype epilepsy surgery, there has been a paradigm shift in the surgical principle of ensuring maximum disconnection of the epileptic neural pathways, in sharp contrast...
Thu Sep 24, 2020 14:54
Related Articles StatPearls Book. 2020 01 Authors: Abstract Laryngeal papillomatosis (LP), also known as recurrent respiratory papillomatosis (RRP), is the most common benign mesenchymal neoplasm of the larynx in children. RRP is characterized by an over-proliferation of benign squamous papillomas in the aerodigestive tract. The condition has a childhood-onset type and an adult-onset type. It is one of the most difficult benign histologic conditions to treat due...
Thu Sep 24, 2020 13:29
Related Articles StatPearls Book. 2020 01 Authors: Abstract The larynx is a well-protected structure surrounded by mandible, sternum, and cervical spine. Its elasticity and mobility add to its protection.[1][2] Laryngeal cartilages do not ossify before 20 years of age, but thereafter, the larynx can vary among individuals regardless of age.[3] The larynx has an important function in respiration, swallowing, and phonation. Minor trauma to larynx can disrupt these...
Thu Sep 24, 2020 13:29
Related Articles StatPearls Book. 2020 01 Authors: Abstract Oral cavity malignancy, excluding non-melanoma skin cancer, is the most common carcinoma of the head and neck. 90% of these neoplasms are squamous cell carcinoma (SCCA), with minor salivary gland malignancies and other rare tumors comprising the rest.[1][2] The tongue, along with the lip and the floor of the mouth, represents one of the most commonly involved subsites within the oral cavity.[1][2] Importantly,...
Thu Sep 24, 2020 13:22
Related Articles StatPearls Book. 2020 01 Authors: Abstract The facelift, or rhytidectomy, is among the most common cosmetic surgical procedures performed in the United States. Patients seek facelifts to counterfeit the effects of aging on the face. Aging causes skin and soft tissue descent as well as lipoatrophy leading to tear trough deformity, obvious palpebromalar groove, loss of malar volume, jowls, increased nasolabial folds, and marionette lines. The facelift...
Thu Sep 24, 2020 13:22
Related Articles StatPearls Book. 2020 01 Authors: Abstract The carotid body is a 2 to 6 mm, round bilateral sensory organ in the peripheral nervous system located in the adventitia of the bifurcation of the common carotid artery. These peripheral chemosensory cells play a vital, physiologic role in the human body as they maintain physiologic homeostasis and regulation of sustaining life. These sensory chemoreceptors act to detect chemical changes in the body...
Thu Sep 24, 2020 13:22
Related Articles StatPearls Book. 2020 01 Authors: Abstract Sebaceous carcinoma (SC) is a rare and aggressive malignancy that develops from the sebaceous glands. Sebaceous carcinoma is most common in the periocular area, head, and neck, but can occur anywhere in the body where sebaceous glands are present.[1] Sebaceous carcinomas may behave as primary neoplasms or may occur in association with Muir-Torre syndrome (a form of Lynch syndrome characterized by sebaceous...
Thu Sep 24, 2020 13:03
Related Articles StatPearls Book. 2020 01 Authors: Abstract The female reproductive system development can be traced to the paramesonephric duct. Bilateral paramesonephric ducts form the fallopian tubes and then fuse to form the uterus and the upper portion of the vaginal canal. The uterus is held by several ligaments that are responsible for its anteverted and anteflexed position in the pelvis. The embryo embeds and develops into a fetus in the uterus. The placenta...
Thu Sep 24, 2020 13:03
StatPearls Book. 2020 01 Authors: Abstract Glomus jugulare is a rare, slow-growing neuroendocrine paraganglioma of the head and neck that arises within the jugular foramen and is localized to the jugular fossa in the temporal bone of the skull base.[1][2] Paragangliomas are benign and originate from neural crest derivatives, known as the paraganglia. Paragangliomas are also known as chemodectomas, and their estimated incidence has been reported up to 1 to 3 per...
Wed Aug 19, 2020 16:54
StatPearls Book. 2020 01 Authors: Abstract Endotracheal intubation is an essential skill performed by multiple medical specialists to secure a patient’s airway as well as provide oxygenation and ventilation. There are multiple techniques available, including the visualization of the vocal cords with a laryngoscope or video laryngoscope, direct placement of the endotracheal tube into the trachea via cricothyrotomy, and fiberoptic visualization of the vocal cords...
Wed Aug 19, 2020 16:09
StatPearls Book. 2020 01 Authors: Abstract The intracranial cavity consists of three components: cerebrospinal fluid (CSF), blood, and brain tissue. CSF is contained within the subarachnoid space between the arachnoid and pia layers of the meninges. CSF is produced by a specialized vascular structure called choroid plexus within each ventricle of the brain. A blood-CSF barrier is formed by ependymal cells that line the ventricles and choroid epithelial cells...
Wed Aug 19, 2020 16:05
StatPearls Book. 2020 01 Authors: Abstract The recurrent laryngeal nerve (RLN) branches off the vagus nerve (cranial nerve X) and has an indirect course through the neck. It supplies innervation to all of the intrinsic muscles of the larynx, except for the cricothyroid muscles, as well as sensation to the larynx below the level of the vocal cords. The right RLN branches from CN X around the level of T1-T2 loops under the right subclavian artery traveling posteriorly,...
Wed Aug 19, 2020 16:01
StatPearls Book. 2020 01 Authors: Abstract A papilloma is a benign (non-cancerous) tumor arising from an epithelial surface and usually known to grow in an outward direction. Commonly, a papilloma refers to squamous cell papillomas which appear as frond-like tumors that can develop almost anywhere on the body with squamous epithelium: Skin: as warts and cutaneous papillomas. Lip. Oral cavity. Eyelid. Tongue. Pharynx. Larynx. Esophagus. Cervix. Genital tract:...
Wed Aug 19, 2020 16:01
StatPearls Book. 2020 01 Authors: Abstract Aspiration is a common problem that can occur in healthy or sick patients wherein pharyngeal secretions, food material, or gastric secretions enter the larynx and trachea and can descend into the lungs, causing an acute or chronic inflammatory reaction. The term chronic aspiration refers to a common condition that occurs in the elderly population, pediatric patients with certain neurological conditions, and chronically...
Wed Aug 19, 2020 16:01
StatPearls Book. 2020 01 Authors: Abstract Angioneurotic edema is a relatively common presentation in the emergency department (ED). It presents as unpredictable frequent edematous episodes of cutaneous and mucosal tissues such as lips, eyes, oral cavity, larynx, and gastrointestinal system (GIS). Urticaria (hives) and angioedema are part of a spectrum of allergic symptoms and occasionally have a non-allergic etiology. Laryngeal edema causing airway obstruction...
Wed Aug 19, 2020 16:01
StatPearls Book. 2020 01 Authors: Abstract Glossectomy is a term used to describe a family of surgical procedures resulting in resection of the tongue. While there are many classifications, glossectomy is commonly classified by the laterality (left, right, or midline) and the proportion of tongue removed. These include partial glossectomy (less than one-half), hemiglossectomy (half of the tongue), subtotal glossectomy (more than half, but less than a total glossectomy),...
Wed Aug 19, 2020 15:29
StatPearls Book. 2020 01 Authors: Abstract For prehospital providers, there are several causes for the patient with altered mental status or being unconscious to include the mnemonic AEIOU TIPS for Alcohol and acidosis, Endocrine, Epilepsy, Electrolytes, Encephalopathy, Infection, Opiates, Overdose, Uremia, Underdose, Trauma (head injury and blood loss), Insulin, Poisoning, Psychosis, Stroke, Seizure, and Syncope. Hypoglycemia, or low blood glucose level, is...
Wed Aug 19, 2020 15:24
StatPearls Book. 2020 01 Authors: Abstract Mediastinal carcinoid tumors are represented by thymic carcinoid neoplasms. Primary carcinoid tumors of the thymus were first described in 1972.[1] The term carcinoid is an old term that refers to a carcinoma-like appearance of the tumors and is often used interchangeably with neuroendocrine tumors (NETs). Thymic carcinoid tumors are rare neoplasms arising from the thymus deriving from the foregut, being the least common...
Wed Aug 19, 2020 13:49
StatPearls Book. 2020 01 Authors: Abstract Oral hemangiomas (OHs) are benign tumors that develop due to endothelial cell proliferation and occur in and around the oral cavity. While 60 to 70 percent of hemangiomas occur in the head and neck region, OHs are relatively rare and most frequently involve the lips, tongue, buccal mucosa, and palate. OHs have also been noted in the mandible and maxilla (central hemangiomas) and within the masseter and other muscles...
Wed Aug 19, 2020 13:49
StatPearls Book. 2020 01 Authors: Abstract The parotid gland is salivary gland others include submandibular and sublingual glands. It is enclosed within a fascial capsule and comprises a superficial lobe and a deep lobe separated by the facial nerve. It is an exocrine gland that secretes saliva into the oral cavity after parasympathetic stimulation. The Stensen canal is the primary excretory duct for the parotid gland, passing through the masseter muscles, penetrating...
Wed Aug 19, 2020 13:49
StatPearls Book. 2020 01 Authors: Abstract Cardiac rhabdomyoma is a rare and benign mesenchymal tumor of striated muscle origin. It most commonly involves the head and neck.[1] It classifies under cardiac and extracardiac types. Extracardiac further classifies into adult, fetal, and germ cell tumors. Cardiac rhabdomyoma (CR) is the most common pediatric heart tumor, mostly occurring before the age of 1 year. Anatomically, they are considered as hamartomas....
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The cerebral venous system is a network most commonly described as two essential systems working in conjunction with one another: the superficial system and the deep system. The superficial cerebral system, which is typically more relevant in clinical scenarios, is made up of the sagittal sinuses and cortical veins, which drains the superficial surfaces of the cerebral hemispheres. The deep cerebral system is comprised...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract Melanotic neuroectodermal tumor of infancy (MNTI) is a rapidly growing benign tumor that arises from the neural crest. It typically occurs in infants in the head and neck region. It was described for the first time in 1918 by Krompecher, and since the origin was unknown, it was described as congenital melanocarcinoma. Until 1966, this tumor was characterized by variable names (e.g., retinal anlage tumor, pigmented...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The thoracic duct is the largest lymphatic duct in the body,[1] with a typical length of 45 cm and a diameter of 2 to 5 mm. It drains lymph from the whole body except the right hemithorax, the right side of the head and neck, and the right upper limb. Chylothorax is the term used for thoracic duct leak and collection into the pleural space. The thoracic duct typically starts at the second lumbar vertebra at the cisterna...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The buccal nerve is the only sensory branch of the anterior mandibular division of the trigeminal nerve. It innervates the major part of the buccal mucosa, the inferior buccal gingiva in the molar area, and the skin above the anterior part of the buccinator muscle. The buccal nerve divides into superficial and deep branches. The superficial branches end in the skin of the cheek, and the deep branches have their distribution...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The prevertebral muscles of the head and neck include the rectus capitis anterior, rectus capitis lateralis, longus capitis, and longus colli muscles. The prevertebral muscles are located posterior to the prevertebral fascia, the posterior border of the retropharyngeal space, and anterior to the cervical vertebral column.[1] The prevertebral muscles constitute a part of the prevertebral or deep layer of the deep...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract A dermoid cyst is a benign cutaneous developmental anomaly that arises from the entrapment of ectodermal elements along the lines of embryonic closure.[1][2] These benign tumors are lined by stratified squamous epithelium with mature skin appendages found on their wall and their lumens filled with keratin and hair.[3] Dermoid cysts are considered to be congenital, but not all of them are diagnosed at birth.[3][4][5]...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The gingiva, also known as the gums, is the pink-colored keratinized mucosa that surrounds and protects the teeth. It is perfused by multiple small arteries that originate from branches coming off of the carotid artery. It receives innervation by nerves derived from the mandibular and maxillary divisions of the trigeminal nerve. The gingiva is part of the periodontium, which includes the investing and supporting...
Wed Aug 19, 2020 13:07
StatPearls Book. 2020 01 Authors: Abstract The thyroid gland is a major endocrine organ that produces triiodothyronine (T3), tetraiodothyronine (T4), and calcitonin. These hormones are essential for bodily function and metabolism. This endocrine gland has a highly vascular blood supply due to its physiologic significance. The superior thyroid artery (STA) arising from the external carotid artery (ECA), and the inferior thyroid artery (ITA) branching from...
Wed Aug 19, 2020 13:07
Related Articles StatPearls Book. 2020 01 Authors: Abstract Approved by the food and drug administration (FDA) in December of 2019, clinicians can use lemborexant to treat insomnia in adults. Additionally, lemborexant has demonstrated to be safe for use in patients with mild obstructive sleep apnea (OSA).[1] There are no other currently approved indications that Lemborxant may be used for, although its use for treating irregular sleep-wake rhythm in patients with...
Fri Jul 10, 2020 15:03
Related Articles StatPearls Book. 2020 01 Authors: Abstract Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of optic nerve swelling and optic neuropathy in adults over 50 years of age.[1]. Risk factors that have been strongly associated with NAION include hypertension, hypercholesterolemia, diabetes mellitus, cardio- and cerebrovascular disease, and obstructive sleep apnea.[2]. While the exact pathogenesis of a NAION has not been...
Fri Jul 10, 2020 15:03
Related Articles StatPearls Book. 2020 01 Authors: Abstract Methylxanthines are a purine-derived group of pharmacologic agents that have clinical use because of their bronchodilatory and stimulatory effects. This class includes several drugs, including the world’s most widely used caffeine. The FDA has approved the use of several methylxanthine derivatives for the treatment of reversible airway obstruction diseases such as chronic bronchitis, emphysema, and asthma....
Fri Jul 10, 2020 15:03
Related Articles StatPearls Book. 2020 01 Authors: Abstract The intracranial pressure is controlled by the production, flow, and absorption of the cerebrospinal fluid. If there is an alteration in these processes leading to an alteration in the CSF pressure, there is a manifestation of neurologic symptoms that is most commonly a headache. Spontaneous intracranial hypotension (SIH) presents with postural headache and low cerebrospinal fluid (CSF). The underlying...
Fri Jul 10, 2020 14:51
Related Articles StatPearls Book. 2020 01 Authors: Abstract Laryngeal cancers are one of the most common head and neck malignancies and thought to make up 1% of all cancers worldwide. Glottic cancer is defined as a malignancy arising from the true vocal cords and the anterior and posterior commissure of the larynx. Like other laryngeal cancers, smoking and alcohol abuse typically causes glottic cancer; however, tumors from this subsite have a better prognosis...
Fri Jul 10, 2020 14:29
Related Articles StatPearls Book. 2020 01 Authors: Abstract Valproic acid is a branched, and short-chain fatty acid is a derivative of naturally occurring valeric acid. Valproic acid's primary use is as an anti-seizure medication, as well as in migraine, bipolar, mood, and anxiety disorders. Recent work has also demonstrated its efficacy as adjuvant therapy in HIV, cancer, and neurodegenerative diseases as its histone deacetylase (HDAC) inhibition property. Valproic...
Fri Jul 10, 2020 17:38
Related Articles StatPearls Book. 2020 01 Authors: Abstract Epilepsy is a condition where there are at least two seizures (unprovoked) that occur in more than 24 hours apart. The term epilepsy syndrome is to describe a condition that incorporates clinical features, EEG/seizure type, and imaging as a prognosticate treatment response and clinical course. Features that are important in epilepsy syndromes are age, seizure triggers, comorbidities such as psychiatric...
Fri Jul 10, 2020 17:38
Related Articles StatPearls Book. 2020 01 Authors: Abstract I-131 scan is a non-invasive radionucleotide scan used for imaging of functional thyroid tissue and thyroid cancer remnant/metastasis. Theranostics in nuclear medicine described as combining diagnostic imaging and treatment for a specific disorder by using the same molecule either radiolabeled in a different form or same radiolabeled agent in different doses.[1] The visualization of the target allows...
Fri Jul 10, 2020 17:44
Related Articles StatPearls Book. 2020 01 Authors: Abstract The radioactive iodine uptake (RAIU) test is used to quantitate the overall metabolism and kinetics of iodine in the thyroid gland by measuring how much orally ingested iodide is concentrated in the thyroid gland. Iodine-123 (I-123) is the most commonly used isotope for RAIU. Iodine is essential for metabolism as it is required for the intrathyroidal synthesis of triiodothyronine (T3) and thyroxine (T4)....
Fri Jul 10, 2020 17:44
Related Articles StatPearls Book. 2020 01 Authors: Abstract The most common type of cancer arising in the kidney is renal cell carcinoma (aka hypernephroma or Grawitz tumor), making up more than 9 out of 10 renal cancers in adults. Other types include transitional cell carcinomas of the renal pelvis, which behave like bladder cancers. Renal sarcoma is another rare tumor of the kidney. This review will focus mainly on renal cell carcinoma (RCC), which accounts...
Fri Jul 10, 2020 14:45
Related Articles StatPearls Book. 2020 01 Authors: Abstract Germ cell tumors (GCT), derived from primordial germ cells, are a diverse group of neoplasms that arise in the gonads (testicles and ovaries) primarily and may also arise in the anterior mediastinum, pineal gland, and brain. They are clinically classified into two major categories, with significant clinical and prognostic implications: Seminomas and non-seminomas. Seminomas generally have a good prognosis,...
Fri Jul 10, 2020 14:45
Related Articles StatPearls Book. 2020 01 Authors: Abstract Testicular cancer is an uncommon malignancy of the males. It is divided into germ-cell tumors and sex cord-stromal tumors. Germ cell tumors are the commonest type, accounting for about 95% of testicular malignancies. Germ cell tumors are further divided into seminomatous and non-seminomatous. The rare sex cord-stromal tumors account for about 5% of testicular cancers. A Leydig tumor is the commonest variant. Testicular...
Fri Jul 10, 2020 14:45
Related Articles StatPearls Book. 2020 01 Authors: Abstract Primary vaginal cancer is rare, making up 1% to 2% of all female reproductive tract cancers.[1] The vagina is a unique organ with distinct tissue types and planes. It is a 7 to 10 cm long fibromuscular tube extending from the cervix to the vulva. It sits posterior to the urethra and bladder and anterior to the rectum. The organ is divided into three parts, which are important for classifying tumor location...
Fri Jul 10, 2020 14:45
Related Articles StatPearls Book. 2020 01 Authors: Abstract Rhombic flaps are geometric local transposition flaps and offer significant versatility within reconstructive surgery. This flap is most commonly used to fill skin cancer defects of the head and neck region. While successful outcomes have been reported in a range of anatomical locations and pathological defects such as in spina bifida, burn contractures, chronic pilonidal sinuses, hand, and breast reconstruction.[1][2][3] This...
Fri Jul 10, 2020 14:43
Related Articles StatPearls Book. 2020 01 Authors: Abstract Rotational vertebral artery syndrome, or colloquially "bow hunter syndrome," is a rare cause of vertebrobasilar insufficiency. In patients with Bow Hunter Syndrome, rotation of the head and neck can lead to compression of the vertebral artery at the atlantoaxial or subaxial levels in the spine. The name "bow hunter syndrome" is derived from a patient who developed Wallenberg syndrome (a lateral medullary...
Fri Jul 10, 2020 14:43
Related Articles StatPearls Book. 2020 01 Authors: Abstract Radial neck fractures commonly occur in children and tend to be more prevalent at ages 9 to 10 years; they represent up to 10% of all pediatric elbow fractures. The mechanism of injury is usually a fall on an outstretched hand with a valgus compressive force across the elbow joint. The initial assessment should include an examination of the elbow joint, followed by plain radiographs of the elbow. Obtaining...
Fri Jul 10, 2020 14:43
Related Articles StatPearls Book. 2020 01 Authors: Abstract Cutaneous melanoacanthoma is a benign skin tumor. It was originally described by Bloch in 1927 as a non-nevoid type I melano-epithelioma; subsequently, in 1960, Mishima and Pinkus coined the term melanoacanthoma. The lesion morphology mimics that of melanoma. It typically presents as a solitary black nodule that has been present for nearly 6 years and has increased to a diameter of 2 or more centimeters....
Fri Jul 10, 2020 14:43
Related Articles StatPearls Book. 2020 01 Authors: Abstract Simulation has become a mainstay in the education of not only healthcare professionals but many different professions the world over. As our global medical knowledge continues to expand, and our societal, technological advancements continue to broaden, the idea of learning on a live patient is becoming a less preferred method of teaching medical professionals.[1] Patient safety is a commonly cited reason...
Sat Jun 20, 2020 09:36
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The nasopharynx represents the most superior portion of the pharynx, bounded superiorly by the skull base and inferiorly by the soft palate. The nasopharynx connects the nasal cavity to the oropharynx and contains the Eustachian tube openings and adenoids. Notable clinical situations include nasopharyngeal carcinoma and adenoidal hypertrophy. This review will discuss the anatomy of the nasopharynx, including the...
Thu Jun 04, 2020 16:20
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Skull fractures are common injuries observed in the setting of both blunt and penetrating trauma. The frontal sinuses are located within the frontal bone, superior and medial to the orbits. The frontal sinuses begin developing around 5 to 6 years old and become fully developed between the ages of 12 to 20. They are innervated by both the supraorbital and supratrochlear nerves, which are supplied by the ophthalmic...
Thu Jun 04, 2020 16:20
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The innervation of the larynx is intricate, detailed, and represents some of the more complex relationships in the anatomy of the head and neck. The vagus nerve is the large nerve that supplies the many branches of nerves that innervate the larynx. The superior laryngeal nerve, its external and internal branches, and the recurrent laryngeal nerve all have very distinct roles in motor and sensory innervation of...
Thu Jun 04, 2020 16:08
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract A seizure is a transient occurrence of abnormal excessive or synchronous neuronal activity in the brain. Seizures manifest in different ways based on the anatomic regions of hyperactive neuronal activity. For example, patients may develop focal symptoms due to abnormal activity in the temporal lobe, whereas global signs represent widespread aberrant neuronal activity. Seizures may initially manifest as focal symptoms...
Thu Jun 04, 2020 17:29
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Radioactive iodine (iodine-131) therapy is indicated for the management of hyperfunctioning thyroid disease and thyroid cancer.[1][2] It is classified as radioactive nuclear medicine and was first synthesized in 1941, and the FDA approved it in 1971 for its therapeutic use. Its action causes permanent destruction to the thyroid tissue by emitting radiation of two sorts, gamma and beta rays.[3][4] Gamma radiation...
Thu Jun 04, 2020 17:26
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract A somatic mutation describes any alteration at the cellular level in somatic tissues occurring after fertilization. These mutations do not involve the germline and consequently do not pass on to offspring. Somatic mutations are a normal part of aging and occur throughout an organism’s life cycle either spontaneously as a result of errors in DNA repair mechanisms or a direct response to stress. Mutations occurring...
Thu Jun 04, 2020 15:27
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The teeth are multifunctional appendages that essential in basic human functions, like eating and speech. Teeth are composed of multiple unique tissues with varying density and hardness that allows them to tolerate the significant forces and wear of mastication. They are attached to the maxilla (upper jaw) and the mandible (lower jaw) of the mouth. Humans have four different types of teeth that each have a specific...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Microcystic adnexal carcinoma (MAC) is a rare malignant sweat gland tumor that commonly occurs on the head and neck.MAC has a predilection for the central face, but may be found although it may be found on the trunk, axilla, extremities, and genitals. MAC is characterized by its slow growth but local aggressiveness.[1] There are approximately 200 cases worldwide; however, it was Goldstein and others that first...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract An anatomical structure resembling a pully is known as a trochlea; "trochlea" is a Greek word, the English meaning of the trochlea is pully. In the human body, many pulley-like structures are known as a trochlea; for example, the medial part of an articular area at the lower end of the humerus is called the trochlea. A ligamentous structure attached to the hyoid bone acts as pully for the digastric muscle.[1] The...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The frontalis muscle plays a significant role in our day-to-day social interactions. As the only muscle that raises the eyebrows, its function goes beyond simply keeping the brows out of oneâs visual field; it is also necessary for conveying emotions and nonverbal communication. The antagonist muscles to the frontalis muscle are the procerus muscle, the corrugator supercilii muscle, and the orbicularis oculi muscle. (Fig...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The neck refers to the collection of structures that connect the head to the torso. It is a complex structure composed of many bones, muscles, nerves, blood vessels, lymphatics, and other connective tissues. The cervical spine is the bony part of the neck. Its primary function is to provide support for the skull, while still allowing for movement. It is the most flexible part of the spine. This flexibility allows...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The brachiocephalic artery, brachiocephalic trunk, or more commonly referred to clinically as the innominate artery, is one of the three great vessels of the aortic arch that supplies blood to the head, neck and upper extremities. Specifically, the artery goes on to form the right subclavian artery, which provides blood to the right upper extremity, and the right common carotid artery, which is one of the main...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The orbital cavity drains via a system of venous blood vessels referred to collectively as the ophthalmic veins. The primary ophthalmic veins are the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV). Accessory veins include the medial ophthalmic vein and middle ophthalmic vein, which occur in approximately 40% and 1% to 20% of the population, respectively.[1][2][3][4] The ophthalmic veins anastomose...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Adenoid cystic carcinoma (ACC) is a rare malignancy arising from the secretory glands, most commonly seen involving the salivary glands. It accounts for approximately 1% of all malignancies of the head and neck region. However, it is the most common tumor of the minor salivary glands and the second most common tumor of the major salivary glands. Overall, it accounts for 10% of all salivary gland tumors.[1]Â The...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The human vertebral column or spine has five distinct anatomical regions named cervical, thoracic, lumbar, and sacral spine. However, the cervical spine is a potential area of importance due to its proximity to the head, containment of the upper spinal cord, and vertebral arteries that contribute to the posterior circulation of the brain. Seven cervical vertebrae, combined with cartilages, various ligaments, and...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Head and neck anatomy can be complicated as a result of the vast number of minute anatomical structures in the spatially limited anatomic region. Clinically, there are a vast number of structures that require special attention, and failure to do so can result in fatal consequences. The neck is divided into several regions, triangles, and zones to organize the complex anatomy of this area. The two primary neck...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Proper palate formation in the developing fetus is essential for functional phonation and feeding after birth. The palate forms the roof of the mouth and separates the oral cavity from the nasal cavity. The palate undergoes complex morphological changes during embryogenesis to achieve its final form and divides into an anterior immobile hard bony segment and a posterior mobile soft palate that does not contain...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Three layers called the meninges encase the brain and spinal cord. From superficial to deep, these layers are the dura mater, arachnoid mater, and pia mater. The dura mater is a dense connective tissue layer that is adherent to the inner surface of the skull. Next is the arachnoid mater that is a thin impermeable layer, and the innermost is the pia mater, which is a vascular layer that closely invests over the...
Thu Jun 04, 2020 14:46
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Inducible laryngeal obstruction (ILO) describes a narrowing or inappropriate obstruction of the true vocal fold and/or the supraglottic structures in response to a trigger or stimulus. When this phenomenon occurs during exercise, it is referred to as exercise-induced laryngeal obstruction (EILO). The ILO terminology has been recently adopted. Since 2013, the term inducible laryngeal obstruction (ILO) has been used...
Tue Apr 21, 2020 15:01
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Proper circulation of oxygenated blood is such an incredibly important function of the human body that it is included in the “ABCDE’s” (airway, breathing, circulation, disability, and exposure) of the primary survey conducted in the emergent clinical setting.[1] Adequate circulation throughout the body is crucial for supplying oxygenated blood to vital organs. Some of the most important conduits of blood flow are...
Tue Apr 21, 2020 14:28
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract For decades, the central skull base has been a challenge to surgeons, given its inaccessible location. Pituitary surgery or hypophysectomy has evolved over the last century from open surgery, requiring craniotomy, to a fully endoscopic endonasal procedure through the sphenoid sinuses. The transsphenoidal approach was described and popularised in 1910, by Harvey Cushing and Oskar Hirsch, utilizing sublabial and...
Tue Apr 21, 2020 14:28
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Malignant otitis externa, although it is not a malignancy, it behaves and spreads like one, hence the name.[1] The first case of MOE was reported in 1938, and the term ‘malignant otitis externa’ was described later by Chandler in 1968, due to its high fatality rate in that time.[2] Malignant otitis externa is a life-threatening infection that mainly affects the external auditory canal and skull base, and the infection...
Tue Apr 21, 2020 14:28
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The temporoparietal fascia flap (TPFF) is a versatile flap well recognized in the reconstruction of craniofacial defects.[1] Most commonly, the TPFF is utilized in a pedicled fashion for the reconstruction of the scalp, auricle, facial soft tissue, orbital, oral cavity, nasopharyngeal, and skull base defects.[2] Moreover, the flap may be harvested with the overlying scalp, making it particularly useful for defects...
Tue Apr 21, 2020 14:28
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract In the simplest terms, therapeutic exercise involves movement prescribed to correct impairments, restore muscular and skeletal function and/or maintain a state of well-being. The many benefits of exercise are too numerous to count in any one article, though therapeutic exercise involves a cavalcade of benefits for the restoration of function, quality of life, and overall health. Many people exist at a bare minimum...
Tue Apr 21, 2020 14:21
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Radioactive iodine ablation (RAI), which entails the administration of radioactive iodine-131, is used for the treatment of hyperthyroidism and in the adjuvant setting for differentiated thyroid carcinoma (DTC).[1][2]PMID: 32310605
Tue Apr 21, 2020 15:25
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The thyroid uptake and scan is a radiologic diagnostic tool to determine thyroid function and pathologies. This diagnostic procedure works on the principle of the unstable nuclide of the atom, which tries to attain stability by releasing an alpha, beta, and gamma rays. Clinicians use these rays for diagnostic and treatment purposes. The test uses a radioactive tracer, which is a protein or a molecule attached...
Tue Apr 21, 2020 15:25
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract bel Methotrexate is an FDA-approved folic acid antagonist indicated for the treatment of rheumatoid arthritis because of its high potency and efficacy in such patients; it can also be useful in patients with juvenile idiopathic arthritis.[1] Gubner first suggested methotrexate use in rheumatoid arthritis after he performed a double blinded-placebo controlled clinical trial of methotrexate in patients having...
Tue Apr 21, 2020 14:33
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The glabella is a median elevation between two superciliary arches. Glabella is present just above the nasion- an intersection of internasal and frontonasal suture. The skin covering the glabella is known as glabellar skin, which is also the source of redundant thick skin commonly used for reconstruction of the upper nasal dorsum and medial canthal area.[1] Historically, the use of glabellar skin was first...
Tue Apr 21, 2020 14:33
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The costocervical trunk is a branch of the subclavian artery which supplies the upper extremities and contributes partly to the blood supply of the head and neck. The subclavian artery has a different origin on each side. On the right side, it originates from the brachiocephalic trunk while stemming directly from the arch of the aorta on the left side.[1][2] It is critical to know the course of the subclavian...
Tue Apr 21, 2020 14:33
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Tracheostomy is a procedure where an artificial airway is established surgically or percutaneously in the cervical trachea. The term “tracheostomy” has evolved to refer to both the procedure as well as the clinical condition of having a tracheostomy tube. The first documented tracheostomy (or tracheotomy) was performed in the 15th century. In 1976, Dr. Frost wrote an interesting historical account on the development...
Tue Apr 21, 2020 14:33
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract At the end of the nineteenth century, two pathologists, Julius Arnold (1835-1915) and Hans Chiari (1851-1916), described a complex clinical and pathological condition involving deformity of the cerebellum and brainstem, in children. Chiari malformations are now defined as a spectrum of hindbrain abnormalities involving the cerebellum, brainstem, skull base, and cervical cord. According to the type of herniation...
Tue Mar 03, 2020 14:30
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Topiramate (TPM) is a compound that belongs to the family of medications called antiepileptic drugs (AEDs). AEDs are generally used for neurologic and psychiatric purposes. The primary indication for this family of drugs is for seizure disorders; hence then name "antiepileptic drugs." In psychiatry, these are classically used as mood stabilizers, although their administrations have seen a broader application. Specifically,...
Tue Mar 03, 2020 14:25
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Laryngotracheal stenosis (LTS) is a narrowing of the upper airway between the larynx and the trachea with potentially devastating consequences, including respiratory failure, cardiopulmonary arrest, and death. The upper airway is comprised of the larynx, glottis, subglottic region, and trachea. The trachea is a cylindrical-shaped tube with an anterior cartilaginous wall formed by c-shaped rings and a posterior...
Tue Mar 03, 2020 15:51
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Esophageal reflux is considered the most common disease encountered by gastroenterologists and general practitioners. It contributes to a large proportion of cases treated by general practitioners (primary care physicians). In Western countries, the prevalence of the disease is approximately 10% to 20%, and severe disease is observed in 6% of the population; in Asian countries, the prevalence is approximately 5%....
Tue Mar 03, 2020 15:51
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The lingual artery, which supplies the tongue as well as the oral floor, is a major branch of the external carotid artery. It appears anteromedially from the external carotid artery, at the tip of the greater horn of the hyoid bone, between the superior thyroid artery and the facial artery.[1] The lingual artery moves medially to the hyoid bone while crossing the hypoglossal nerve (CN XII). It then courses deep...
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The anatomy of the head and neck is very complicated secondary to the numerous fine structures that have a variable course and depth as they traverse through the tissue. There are several very important neurovascular structures anatomically situated in the head and neck, which may suffer a potential injury during surgical dissection. The neck divides into subdivisions and compartments that aid in the organization...
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Deglutition or swallowing is an innate function. Swallowing sounds like a simple physiological human function, but it is a complex, multifaceted process involving a variety of muscles and nerves. It is the starting point for the peristaltic transport of food to the stomach. Deglutition in humans can be of three distinct phases: oral phase, pharyngeal phase, and esophageal phase, of which the first one is voluntary,...
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The facial nerve is the seventh cranial nerve. It contains the motor, sensory, and parasympathetic (secretomotor) nerve fibers, which provide innervation to many areas of the head and neck region. The facial nerve is comprised of three nuclei: The main motor nucleus. The parasympathetic nuclei. The sensory nucleus.PMID: 32119456
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The thyroglossal duct is a connection that serves as a pathway for the primordium thyroid gland in its embryogenesis. This pathway originates at the junction of the anterior two-thirds and the posterior third of the tongue at its base. This pathway commences at the foramen caecum, goes anteriorly, and ends at 2nd and 3rd cartilage of the trachea, where the thyroid ends its trajectory and matures. In its trajectory,...
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The carotid sinus, also known as the carotid bulb, is a neurovascular structure that appears as a dilation at the bifurcation of the common carotid artery, and the beginning of the internal carotid artery. It is localized near the arterial pulse, inferior to the angle of the mandible at the level of the thyroid cartilage. The carotid sinus contains baroreceptors (stretch receptors), which are sensitive to pressure...
Tue Mar 03, 2020 14:45
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The prevalence of obesity continues to rise with the United States of America (USA) currently ranking second in the world. According to CDC data, in 2015-2016, the prevalence of obesity (BMI greater than or equal to 30) was 39.8% affecting approximately 93.3 million adults in the United States. Almost 5% of the population was extremely obese (BMI greater than or equal to 40). Obesity predisposes to multiple comorbidities,...
Tue Jan 28, 2020 14:22
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the...
Tue Jan 28, 2020 14:14
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Opioid use disorder is the chronic use of opioids that causes clinically significant distress or impairment. Opioid use disorders affect over 16 million people worldwide, over 2.1 million in the United States, and there are over 120,000 deaths worldwide annually attributed to opioids.[1] There are as many patients using opioids regularly as there are patients diagnosed with obsessive-compulsive disorder, psoriatic...
Tue Jan 28, 2020 15:34
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The larynx is continuous with pharynx superiorly and the trachea inferiorly. It is comprised of an intricate skeleton of cartilages held together by fibro-elastic membranes. Intrinsic muscles of the larynx moving these cartilages allow it to perform vital functions. Its most fundamental role is as a protective sphincter of the airway, but it also allows effort closure and vocalization. Understanding of the structure...
Tue Jan 28, 2020 15:28
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Magnus reported the first case of pseudobulbar palsy in 1837 in a patient having multiple infarcts. Lepine, in 1877 introduced the term pseudobulbar palsy for differentiation purposes. Pseudobulbar palsy is due to an upper motor lesion caused by bilateral disturbance of the corticobulbar tracts. The corticobulbar tracts exert supranuclear control over brainstem motor nuclei and are involved in the muscular movement...
Tue Jan 28, 2020 14:20
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The smooth functioning of the human body depends on coordination between somatic and visceral parts of the nervous system. Visceral part of the nervous system is commonly known as the autonomic nervous system. It has two components parasympathetic and sympathetic. Visceral efferent has at least two sets of neurons, i.e. preganglionic and postganglionic neurons. Fibers of cranial parasympathetic ganglion originate...
Tue Jan 28, 2020 14:20
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The greater petrosal nerve or superficial petrosal nerve is a branch of the nervus intermedius (nerve of Wrisberg) that carries parasympathetic, taste, and sensory fibers of the facial cranial nerve (CN VII). The preganglionic parasympathetic fibers develop from the superior salivatory nucleus of the tractus solitarius in the pontine tegmentum and progress in the nervus intermedius before joining the facial nerve...
Fri Jan 24, 2020 14:27
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract The levator scapulae muscles are superficial extrinsic muscles of the back that primarily function to elevate the scapulae. Levator comes from the Latin levare, meaning "to raise." Scapulae refer to the scapulas, or shoulder blades, possibly originating from the Greek "skaptein," meaning "to dig." In conjunction with other posterior axial-appendicular muscles, the levator scapulae can inferiorly rotate the glenoid...
Fri Jan 24, 2020 14:27
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Gastroesophageal reflux disease (GERD) is a common disorder of the gastrointestinal tract that involves the movement of stomach contents into the esophagus or mouth, causing discomfort or complications.[1] Population-based studies have identified GERD as one of the most common upper gastrointestinal (GI) tract disorders, with a prevalence of about 20% in the United States.[2] Patients may present with typical symptoms,...
Fri Jan 24, 2020 16:09
Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Metastasis is a term used to describe the spread of tumor cells from primary sites to surrounding structures and distant sites. It is considered a significant cause of morbidity and mortality. Distant metastasis is an indicative marker of the aggressive nature of the primary tumor. Metastasis to the lung is a complex multistep process. Metastatic tumors cells go through stages of detachment from the primary tumor...
Fri Jan 24, 2020 14:32
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract Obesity refers to abnormal or excess body weight (mainly fat) concerning height. It is a growing health problem in the United States as well as around the globe with a significant economic burden. More than a third of individuals in the USA have a body mass index (BMI) of over 30kg/m^2, and the cost for obesity has risen to $147 billion annually. It is also associated with various comorbidities, which include...
Tue Dec 24, 2019 15:10
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract Soft-tissue sarcoma (STS) arises mainly from the embryonic mesoderm with some contribution from the neuroectoderm. STS is a rare malignancy that accounts for less than 1% of all adult cancers. It encompasses an extremely heterogeneous group of tumors with over 70 molecular subtypes. Leiomyosarcoma (LMS) is one of the more common subtypes of STS, comprising up to 25% of all sarcomas. Classically, LMS would either...
Tue Dec 24, 2019 14:15
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract The thyroid gland is a vital butterfly-shaped endocrine gland situated in the lower part of the neck. It is present in front and sides of the trachea, inferior to the larynx. It plays an essential role in the regulation of the basal metabolic rate (BMR), and stimulates somatic and psychic growth, besides having a vital role in calcium metabolism. It is a gland consisting of two lobes, the right and the left lobes...
Tue Dec 24, 2019 15:27
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract The pharynx is the digestive system posterior to the nasal cavity, oral cavity, and larynx and divides into the oropharynx, nasopharynx, and laryngopharynx. A group of muscles called the pharyngeal muscles, which consist of the outer circular layer and the inner longitudinal layer, forms the lumen of the pharynx. The outer circular layer consists of the superior, middle, and inferior pharyngeal constrictor muscles....
Tue Dec 24, 2019 15:27
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract The basilar artery (BA) is formed over the surface of pons by two vertebral arteries to supply the critical areas of the brain and brainstem. Anatomically, it can subdivide into three arbitrary segments: proximal form vertebral artery (VA) to anterior inferior cerebellar arteries (AICA), middle from AICA to the origin of superior cerebellar arteries (SCA) and finally distal segment from SCA to the terminal posterior...
Tue Dec 24, 2019 14:35
Related ArticlesStatPearls Book. 2019 01 Authors: Abstract As the largest of the cranial nerves, the trigeminal nerve is responsible for the primary sensory input from the head and neck as well as providing motor innervation to the muscles of mastication. The trigeminal nerve innervates key vascular structures such as the brainstem, the cavernous sinus, and peripheral divisions. With such an extensive distribution within the head and neck, various lesions may contribute...
Tue Dec 24, 2019 14:35
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