What is a radical neck dissection? when is it done?

What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

Diabetes Question: What should I do if I'm always too tired to exercise?

To some extent, that depends on what you did to get tired. If you're weary from your job as steeplejack or longshoreman, or if you're a housewife who's cleaned the whole house or galloped after a four-year-old all day, you've already had a great deal of exercise. Getting more is not that critical for you. On the other hand, if you're tired from a long day of sedentary office tensions or sitting in the car, then you need exercise for more reasons than diabetic ones, and you should clamp your jaw and force yourself, at least initially. Just as the appetite comes with the eating, the energy and enthusiasm for exercise come with the exercising. Often the fatigue you feel at the end of a day comes from a lack of physical activity rather than from too much of it.

If you find yourself too tired to exercise and it's not a true physical tiredness, you may go to bed and find yourself too keyed up and tense to sleep. The next day you've got a lack-ofsleep tiredness going. Vicious cycle. But if you get out there and move those bones around, blessed sleep will descend upon you as soon as you hit the pillow. You'll sleep the sleep of the physically tired and virtuous. And you can hardly sleep better sleep than that.


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