Late manifestation of SVC obstruction syndrome and tracheal compression in our patient can be attributed to
cephalad extension of mediastinal tumour.6 For such cervico-thoracic masses, the surgical excision approach is median sternotomy along with neck exploration.9 Tumour adherent to pericardium or pleura should be dealt with meticulously, however literature supports subtotal resection of benign teratomas in order to preserve nearby viscera has shown excellent outcomes.6
Degeneration of the central cells of this vaginal plate, which occur in a
cephalad direction, enables creation of the lower vagina.
In elective (labor −) CS, hysterotomy is made more
cephalad and it incises 'thick' uterine portion, whereas in emergent (labor +) CS, hysterotomy is made more caudal and it incises 'thin' portion: '
cephalad and thick' versus 'caudal and thin' characterizes the hysterotomy in elective versus emergent CS.
With the needle at the same point of insertion, it was withdrawn upto the level of subcutaneous tissue and redirected 450 in the
cephalad direction and 100 medially towards point A, until patellar movements were observed.
A tumor thrombus was present within the most
cephalad right renal vein extending to 1.6cm from the insertion to the IVC.
The cervix is grasped with the tenaculum, which applies a constant midline
cephalad countertraction (VIDEO 3).
Intubation is performed with
cephalad traction on the tube and with the bevel directed laterally so that its leading edge is pointed away from the turbinates.
Normally, the branchial arches grow medially in a
cephalad to caudal direction with the first arch closing initially, followed by the others subsequently.
A single injection of 15 mL of 0.5% bupivacaine with 1: 200,000 epinephrine and 25 mcg of dexmedetomidine was administered, evaluating for a U-shaped spread, defined as local anesthetic distribution in a
cephalad, posterior, and caudad position to the axillary artery, as described by Dingemans et al.
Although this technique has similarities to the posterior transversus abdominis plane (TAP) block, the extent of its effects has been suggested to be greater because the target injection point is more dorsal and the potential
cephalad spread of local anaesthetics could reach the thoracic paravertebral space [3, 4].
Caption: Figure 1: Right shoulder and chest XR showing prominence of the
cephalad portion of the lateral end of the clavicle suggesting the presence of an old clavicular injury in this location.