Anatomy And Physiology Flashcards
Superior neck boundary
Mandible
Inferior neck boundary
Clavicle
Anterior neck boundary
Anterior midline
Posterior neck boundary
Trapezius
Anterior neck triangle boundary
Anterior=midline of neck
Posterior=anterior border of sternocleidomastoid
Nerves in anterior neck triangle
Vagus 10
Glossopharyngeal 9
Accessory 11
Laryngeal
Vessels in anterior neck triangle
CCA ECA ICA IJV Facial vein
Nodes in anterior neck neck triangle
Submandibular
Submental
At which level does the CCA bifurcate?
C4
8 branches of ECA in neck
Superior thyroid Ascending pharyngeal Lingual Occipital Facial Posterior auricular Maxillary Superficial temporal
Indications for a central venous line?
Central venous pressure
Drug admin
Cardiac pacing
Blood sampling
Tx for central lines
Fluid resuscitations
Haemodialysis
IV nutrition
Complications of a central line
Pneumothorax Haematoma Cardiac tamponade Air embolism Chylothorax False passage Thrombosis Sepsis Line blockage
Where does the lymph in the neck drain to?
Cisterna chyli
Where does the parotid gland drain to?
Scalp
Face parotid gland
Where do the occipital glands drain to?
Scalp
Where do the superficial cervical nodes drain?
Breast and solid viscera
What’s a thyroglossal cyst?
Dilation of thyroglossal duct reminant
What must happen before a thryoglossal cyst is removed?
An US to make sure there’s functioning thyroid tissue else where
what is a thyroid mass?
A solitary nodule
Multi-nodular goitre
Cyst vs adenoma
Cyst=localised to due haemorrhage
Adenoma=Benigno follicular tissue
RFs for solitary thyroid nodule
F>M
30-40 years
10% malignancy in middle age
50% malignancy in young
Ix for a solitary thyroid nodule
us
Fine needle aspiration cytology
Thyroid lobectomy
What can fine needle aspiration cytology not distinguish between?
Between follicular adenoma and follicular carcinoma
The 4 types of thyroid cancer
Papillary lymphatic metastases
Follicular haematogenous metastases
Medullary
Anaplastic
From which cells does medullary thyroid cancer arise from?
Parafollicular C cells
What can lead to colloid goitre?
Gland hyperplasia Iodine deficiency Puberty Pregnancy Lactation
What is grave’s disease?
Auto-antibodies against thyroid stimulating hormone receptor
S+S of grave’s disease
Thyroid eye disease
-inflammation in the muscles, fatty tissue, eyelids and tear ducts
Acropachy
-soft tissue swelling of the hands/clubbing
Pre-tibial myxoedema
-lumpy lower legs/shins
Tx for grave’s disease
Anti-thyroids
Beta-blockers
Radio-iodine
Surgery
Complications of a thyroidectomy
Bleeding Voice hoarseness Thyroid storm -underactive or untreated hyperthyroidism Scar
S+S of multi-nodular goitre
No eye signs
Atrial fibrillation
How many parathyroid glands are there?
4
What do the parathyroid glands do?
Regulate calcium and phosphate levels
Where are the parathyroid glands located?
Posterior to the poles of the thyroid
S+S of parathyroid disease
Painful stones Aching bones Abdominal groans Renal failure Pancreatitis Weight loss Anxiety and depression
Ix for parathyroid disease
U+E Creatine -kindness functions Ca Phosphate -thyroid -parathyroid Vit D US CT/MRI Isotope scanning -shows cancer cells
4 fascia layers of the neck
Pre-tracheal
Pre-vertebral
Deep cervical
Carotid sheath
What’s a tracheostomy?
Incision into trachea to help breathing
Indications for tracheostomy
Airway obstruction
Airway protection
Poor ventilation to reduce dead space
Ongoing Tx for tracheostomy
Need suctioning
Need humidification
Need long term care
What’s stridor
Clinical sign of airway obstruction
What anatomical part causes an inspiratory stridor?
Laryngeal
What anatomical part causes an expiration stridor?
Tracheo-bronchial
What anatomical part causes a bi-phasic stridor?
Glottic/sub glottic
What’s a branchial cyst
Remnant of fusion failure of branchial arches or lymph node cystic degeneration
Can light pass through a branchial cyst
Yes
It transilluminates
Where is a branchial cyst located?
Anterior to SCM, at the junction of the upper and middle thirds
What’s a pharyngeal pouch?
Herniation of pharyngeal mucosa between thyropharyngeus and circopharyngeus of the inferior constrictor of the pharynx
S+S of a pharyngeal pouch?
Voice hoarseness Regurg Dysphagia Aspiration pneumonia Weight loss Neoplasia
Ix for pharyngeal pouch
Barium swallow
What is the oral vestibule?
Space between lips and teeth
Boundaries of the oral cavity
Lips to palatoglossal arch
The 4 muscles of mastication
Lateral pterygoid
Medial pterygoid
Temporalis
Masseter
3 phases of swallowing
Oral phase
Pharyngeal
Oesophageal
How is the anterior 2/3rds of the tongue made?
1st branchial arch
Sensation supply to anterior 2/3rds of tongue
Lingual nerve
Branch of V3
Taste sensation of anterior 2/3rds of tongue
Chorda tympani of the facial
How is the posterior 1/3rds of the tongue developed?
3rd branchial arch
What supplies the posterior 1/3rd of the tongue?
IX
What do the intrinsic muscles of the tongue do?
Change the shape of the tongue
What do the extrinsic muscles of the tongue do?
Alter the position
What set of muscles are on the top of the tongue?
Extrinsic
Epithelium in the oropharyx?
Stratified, non-keratinised
Nerve supply to the oropharynx
Pharyngeal plexus
IX-X
Nerve supply to the hypopharynx
IX-X
What’re the three paired cartilages in the trachea
Corniculate
Cuneiforme
Arytenoid
Nerve supply to the larynx
X
What’s the motor nerve supply to the intrinsic muscles of the larynx?
Recurrent laryngeal nerve
Which intrinsic muscle isn’t supplied (motor) by the recurrent laryngeal and what is it supplied by?
Cricothyroid
External laryngeal
Sensory innervation to the supraglottic area
Internal laryngeal
Sensory innervation to the glottic and subglottic area?
Recurrent laryngeal
