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Head and Neck > Anatomy/Physiology of Neck > Flashcards

Anatomy/Physiology of Neck Flashcards

1
Q

Anatomical contents of the neck?

A 
Arteries 
Veins 
Nerves 
Lymph Nodes 
Lymphatic channels 
Thyroid gland 
Parathyroid gland
Muscles 
Trachea
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2
Q

Main artery in neck? What level does it bifurcate?

A

Common carotid artery

Bifurcates at C4 in ECA & ICA

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3
Q

Branches of the External Carotid Artery in the neck?

A 
Superior thyroid 
Ascending pharyngeal 
Lingual
Occipital
Facial
Posterior auricular 
Maxillary 
Superficial temporal
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4
Q

About how many lymph nodes are in the head and neck? How are they classified?

A

600

Described in groups and levels

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5
Q

Describe the structure of the thyroid gland? What hormones does in produce?

A

2 lobes and an isthmus - just inferior to the larynx

Produces thyroid hormone and calcitonin

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6
Q

What is a thyroglossal cyst?

Easy way to diagnose?

A

A dilatation of the remnant of the thyroglossal duct

The cyst moves with protrusion of tongue - get patient to stick tongue out

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7
Q

Possible causes of a solitary thyroid nodule?

A 
Cyst - localized haemorrhage 
Adenoma 
Carcinoma 
Lymphoma 
Prominent nodule in multi-nodular goitre
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8
Q

How should thyroid nodules be investigated?

A

Fine needle aspiration cytology

USS

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9
Q

What is a cyst?

A

A sac-like pocket of membranous tissue containing fluid. May become infected

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10
Q

Types of thyroid cancer?

A
  • Papillary
  • Follicular
  • Medullary
  • Anaplastic
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11
Q

Types of cells in the thyroid gland and their functions?

A

Follicular cells - produces thyroid hormone

Parafollicular C cells - produce calcitonin

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12
Q

Where do papillary tumours arise? How do they spread?

A

Arise in the follicular cells of the thyroid

Commonly spread via lymphatics

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13
Q

Where do follicular tumours arise? How do they spread?

A

Arise in the follicular cells of the thyroid

Commonly spread hematogenously

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14
Q

Where do Medullary tumours arise?

A

Develop in the C cells - 10% familial association (MEN2)

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15
Q

What is anaplastic thyroid cancer? What’s the prognosis like?

A

Poorly differentiated cancer - may arise from other more differentiated cancers

Very aggressive, poor prognosis

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16
Q

Causes of diffuse thyroid enlargement?

A

Colloid Goitre Grave’s disease

Thyroiditis

17
Q

What is a colloid goitre?

Causes?

A

Non-malignant enlargement of the thyroid gland

Gland hyperplasia
Iodine deficiency
Puberty, pregnancy, lactation

18
Q

What is Grave’s disease?

Treatment?

A

Autoimmune disease against thyroid stimulating hormone, causes hyperthyroidism

Treatment:
Anti-thyroids, beta-blockade, radio-iodine
Surgery

19
Q

What are the indications for a thyroidectomy?

A 
Airway obstruction
Malignancy 
Thyrotoxicosis 
Cosmesis 
Retrosternal extension
20
Q

Causes of multi-nodular goitre?

A

Grave’s disease

Toxic Goitre (multiple autonomously functioning nodules)

21
Q

What is Grave’s disease?

A

Autoimmune disorder which results in hyperthyroidism

22
Q

How many parathyroid glands are there? What is their function?

A

4 (usually - located on posterior thyroid)

Regulate calcium and phosphate levels

23
Q

Signs of parathyroid disease?

A

Painful stones
Aching bones
Psychic moans
Abdominal groans

Renal failure, osteoporosis, peptic ulceration, renal calculi, polyuria

24
Q

Investigations for suspected parathyroid disease?

A 
Urea & electrolytes 
Bloods (creatinine, calcium, phosphate, parathyroid hormone)
Vitamin D levels 
USS 
CT/MRI (identify ectopic gland)
25
Q

What can parathyroid disease progress on to?

A

Adenoma (80%)

Hyperplasia (12%)

Malignancy

26
Q

Management of parathyroid disease?

A

Surgical removal of adenomas/hyperplastic glands

If malignancy remove the carcinoma, thyroid gland and associated lymph nodes

27
Q

4 Fascial layers of the neck?

A

Pre-tracheal
Pre-vertebral
Deep cervical
Carotid sheath

28
Q

What is a tracheostomy?

A

Surgical incision in someones neck to allow passage of a tube into their windpipe

WHERE IS THE INCISION MADE??

29
Q

Indications for tracheostomy?

A

Airway obstruction
Airway protection
Poor ventilation in dead space

30
Q

What is a branchial cyst? How does it present?

A

Remnant of embryological structure

Presents as enlarged lump anterior to the SCM (usually only presents when infected)

31
Q

What is a pharyngeal pouch (Zenker’s diverticulum)?

A

Herniation of the pharyngeal mucosa

  • causes dysphagia, voice hoarseness

Head and Neck (15 decks)

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