Anatomy & Physiology - Neck Flashcards
Generally speaking, what are the boundaries of the neck?
Superior - Mandible
Inferior - Clavicle
Anterior - Anterior midline
Posterior - Trapezius
What are the boundaries of the triangles of the neck?
Anterior triangle - anterior: midline of the neck, posterior: anterior border of the sternocleidomastoid
Posterior triangle - anterior: posterior border of the sternocleidomastoid, posterior: anterior border of the trapezius
What are the major components of the anterior triangle?
CCA, ECA, ICA, IJV, Facial vein, Facial artery, Vagus nerves, hypoglossal nerves, submandibular nodes, submental nodes
What are the major components of the posterior triangle?
EJV, Cervical plexus, Accessory nerve, Occipital artery
At what vertebral level does the CCA divide?
C4
What are some indications for a central line?
Central venous pressure, fluid resus, drug administration, haemodialysis
What are some complications of a central line?
Pneumothorax, air embolism, thrombosis, haematoma, sepsis
How many lymph nodes are in the head and neck of the average human?
~600
Where do the head and neck lymph nodes drain to?
The cisterna chyli and then to the thoracic duct
What do the parotid nodes drain?
The face, parotid gland
What do the deep cervical nodes drain?
They are the final drainage pathway to the thoracic duct
What do the submandibular nodes drain?
Tongue, nose, paranasal sinuses, submandibular gland, oral cavity
What do the submittal nodes drain?
Lips, floor of mouth
What are the three general causes of lymphadenopathy?
Infection, inflammation, malignancy
What is produced by the thyroid gland?
Thyroid hormone, calcitonin
What type of gland is the thyroid gland?
Endocrine gland
What is the join of the two lobes of the thyroid called?
The isthmus
What is a thyroglossal cyst?
A dilation of a thyroglossal duct remnant. May become infected, grows with age. Moves on tongue protrusion.
Ix for thyroglossal cyst?
US - ensures functioning thyroid tissue elsewhere
Mx for thyroglossal cyst?
Excision but chance of recurrence
What are the three types of a thyroid mass?
Solitary nodule, diffuse enlargement, multi-nodular goitre
What are the causes of a solitary thyroid nodule?
Cyst - due to localised haemorrhage Adenoma - benign follicular tissue Carcinoma Lymphoma Prominent nodule in multi-nodular goitre
F>M, 30-40years
Ix for solitary thyroid nodule?
FNAC! - cannot differentiate between follicular adenoma and follicular carcinoma
Ultrasound
Tissue required for histological diagnosis
Mx for solitary thyroid nodule?
Thyroid Lobectomy
What are the types of thyroid cancer?
Papillary - lymphatic metastasis
Follicular - haematogenous metastasis
Medullary - familial association 10%, arise from parafollicular C cells
Anapalastic - agressive, local spread, poor prognosis
What are the causes of diffuse thyroid enlargement?
Colloid goitre: due to gland hyperplasia, iodine deficiency, puberty, pregnancy, lactation
Grave’s disease
Thyroiditis
What is Grave’s disease?
F>M
Auto-antibodies produced against thyroid-stimulating hormone receptors
Results in hyperthyroidism
Mx for Grave’s disease?
Anti-thyroids, beta-blockade, radio-iodine & surgery
What are the indications for thyroidectomy?
Airway obstruction, malignancy or suspected malignancy, thyrotoxicosis, cosmoses, retrosternal extension
What are the complications of thyroidectomy?
Bleeding - primary or secondary, voice hoarseness, thyroid storm, infection
