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.

What makes smoking so addictive? How addictive is smoking?

What makes smoking so addictive? Is it a physical or psychological addiction? 

Smoking attracts and holds its devotees by three methods, and it is up to each individual smoker to determine how much each component of addiction affects him or her. Examining this mechanism of addiction not only will help the smoker understand why he or she smokes but will be of assistance once the decision is made to quit.

Nicotine is the physically addictive part of cigarette smoke. The potent effects of nicotine go far beyond those of most other legal substances. Nicotine reaches the brain just seconds after it is inhaled and releases chemicals that bring on the sensation of pleasure and a feeling of alertness. Smokers must have a steady supply of nicotine circulating in their blood and going to the brain. Without enough nicotine these sensations begin to diminish, and smokers quickly begin to feel the unpleasant effects of withdrawal, such as headaches, nausea, muscle pain, and insomnia. This is the point at which smokers begin to “crave” a smoke. The degree of nicotine addiction varies from person to person. You can test yours by observing how long you can comfortably go without a cigarette. Those who must smoke as soon as they get up in the morning probably have a high level of nicotine dependency.
Nicotine’s addictiveness is far beyond that of other substances that may have pleasing psychological or physiological effects. Caffeine, for instance, may become a habit, but many people find it less difficult than nicotine to cut back on, and in most cases it does no harm in moderation.

A cup of coffee or tea in the morning gets us used to caffeine the physical addiction and it is also a ritual that we find mentally gratifying the psychological addiction. Likewise, we become accustomed to associating certain activities, such as drinking coffee or alcohol, finishing a meal, or the proverbial postcoital interlude, with tobacco use. By repetition they become permanently linked as habits. Take note of the activities and environments that cause you to automatically light up, and you will get a glimpse of your psychological addiction.

A social addiction to smoking is what motivates many smokers to begin in the first place the need to fit in with a specific group of people or create a certain kind of image. This is actually a subcategory of psychological addiction, used to distinguish the need to belong from the associative habit described above. Peer pressure leads most smokers to start while still in their teens. Ninety percent of smokers start smoking before they are twenty one years old.


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