Anatomy

Question 1

What is the diencephalon?

Answer 1

• made up of the thalamus and the hypothalamus

- is at the centre of the cerebrum

Question 2

What is the anatomy of the diencephalon?

Answer 2

• the thalamus with the hypothalamus below
• the infundibulum connects the hypothalamus to there pituitary
• the pituitary is divided into anterior and posterior

Question 3

What hormones are made by the posterior pituitary?

Answer 3

• oxytocin

- vasopressin (ADH)

Question 4

What hormones are made by the anterior pituitary?

Answer 4

releasing hormones or release-inhibitory hormones

• GH
• prolactin
• TSH
• ACTH
• LH
• FSH

Question 5

What vessels transport the hypothalamic hormones?

Answer 5

hypophyseal portal veins

Question 6

What is the anatomy of the hypophyseal portal system?

Answer 6

venous
2nd capillary bed
portal vein
1st capillary bed
arterial

Question 7

What is the anatomical location of the pituitary gland?

Answer 7

• sits in the pituitary fossa of the sphenoid bone
• this fossa is within the sella turcica
• it is just under the optic chiasm

Question 8

What lobe do the optic tracts radiate out to?

Answer 8

the occipital lobe

Question 9

What can a pituitary mass do to the vision?

Answer 9

• midline compression of optic chiasm
• nasal retinae are affected
• bitemporal hemianopia from bilateral loss of peripheral vision

Question 10

What are the possibilities for surgical access to the pituitary?

Answer 10

• transcranial = under the frontal lobe

- transsphenoidal = via the nasal cavities and sphenoid sinus

Question 11

What is the vomer?

Answer 11

the inferior part of the nasal septum

Question 12

What are the paranasal sinuses?

Answer 12

• frontal
• maxillary
• sphenoid
• ethmoid air cells x3

Question 13

What can be used to gain better surgical access to the pituitary?

Answer 13

a LeFort 1 ‘down-fracture’ which is under nose across the maxilla

Question 14

What are the relevant sheets of dura mater called?

Answer 14

• diaphragm sellae

- tentorium cerebelli

Question 15

What are the dural venous sinuses?

Answer 15

channels within dura mater that drain blood into internal jugular veins

Question 16

What is the basic anatomy of the thyroid?

Answer 16

two lateral lobes connected by an isthmus (anterior to the 2nd and 3rd cartilages of the trachea)

Question 17

What is a goitre caused by?

Answer 17

an enlarged thyroid

Question 18

What is the basic anatomy of the parathyroid glands?

Answer 18

4 on the posterior surface of the lateral lobes

• 2 superior
• 2 inferior

Question 19

What can there sometimes be anatomically in the thyroid?

Answer 19

a pyramidal lobe extending superiorly from the left lateral lobe

Question 20

What is the muscle in the neck which pulls down the corners of the mouth and what is it innervated by?

Answer 20

platysma which is innervated by CN7 facial

Question 21

What are the main fascial compartments?

Answer 21

• prevertebral
• investing
• 2x carotid sheaths
• pretracheal

Question 22

What does prevertebral fascia enclose?

Answer 22

vertebrae and muscles controlling them

Question 23

What does investing fascia enclose?

Answer 23

all other compartments, trapezius and sternocleidomastoid

Question 24

What are the features of the carotid sheaths?

Answer 24

• close to thyroid

- alar fascia connects anteriorly to pretracheal fascia which descends up to head and down to mediastinum

Question 25

What do the carotid sheaths contain?

Answer 25

- vagus nerve - common and internal carotid arteries - internal jugular vein - lymph nodes

Question 26

What does the pretracheal fascia contain?

Answer 26

- oesophagus - trachea - thyroid - strap muscles - recurrent laryngeal nerves

Question 27

Where does the superior thyroid artery branch off?

Answer 27

the common carotid artery

Question 28

Where does the inferior thyroid artery branch off?

Answer 28

the right subclavian artery

Question 29

What is sometimes present in the midline of the thyroid?

Answer 29

the thyroid IMA artery

Question 30

What is the venous drainage of the thyroid?

Answer 30

- middle and the superior thyroid drain tot he internal jugular - the internal jugular and the inferior thyroid drain to the brachiocephalic

Question 31

What are the main lymph nodes that are relevant?

Answer 31

- deep cervical (superior and inferior) - pretracheal - paratracheal

Question 32

What is the passage of the recurrent laryngeal nerves?

Answer 32

- right= curves under R subclavian and travels up to posterior to thyroid - left= curves under arch of the aorta

Question 33

What are the strap muscles?

Answer 33

aka infrahyoid - sternohyoid - sternothyroid - thyrohyoid - omohyoid with superior and inferior belly (scapular attachment)

Question 34

How can the thyroid be reached surgically?

Answer 34

- above-clavicle incision - endoscopic - through armpit - through breast

Question 35

What attaches the thyroid gland to the trachea?

Answer 35

the ligament of Berry

Question 36

What would recurrent laryngeal nerve injury result in?

Answer 36

paralysis of the vocal cords - hoarseness (unilateral) - aphonia (bilateral) - weak cough