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H and N > Anatomy & Physiology of Neck > Flashcards

Anatomy & Physiology of Neck Flashcards

1
Q

Boundaries of anterior triangle of neck (2)

A

Anterior - midline of neck

Posterior - anterior border of SCM

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2
Q

Contents of anterior triangle of neck

  • salivary gland (1)
  • arteries (3)
  • veins (2)
  • nerves (3)
  • lymph nodes (3)
A

Salivary gland - submandibular (FILLS MOST OF ANTERIOR TRIANGLE)

Arteries - CCA, ECA, facial

Veins - IJV, facial

Nerves - CN X - XII

Lymph nodes - deep cervical, submental, submandibular

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3
Q

Boundaries of posterior triangle of neck (2)

A

Anterior - posterior border of SCM

Posterior - anterior border of trapezius

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4
Q

Contents of posterior triangle of neck

  • arteries (3)
  • veins (3)
  • nerves (2)
  • lymph nodes (1)
A

Arteries - occipital, subclavian, suprascapular

Veins - EJV, subclavian, suprascapular

Nerves - accessory, cervical plexus

Lymph nodes - supraclavicular

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5
Q

Terminal branches of ECA

A

Maxillary and superficial temporal arteries

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6
Q

2 fascia layers of the neck

A

Superficial cervical fascia - between skin and deep cervical fascia

Deep cervical fascia

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7
Q

4 component layers of deep cervical fascia + what they each compartmentalise

A

Investing layer of fascia - most superficial

Pre-tracheal fascia (cover visceral compartment)

Pre-vertebral fascia (covers vertebral column and muscles around it)

Carotid sheath (covers neurovascular compartment)

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8
Q

Thyroid gland structure

A

2 lobes joined by isthmus

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9
Q

Function of calcitonin produced by thyroid gland

A

Lowers serum calcium and raises phosphate

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10
Q

Blood supply of thyroid gland

A

Superior and inferior thyroid artery

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11
Q

What veins in the neck area are used for central lines

A

IJV

Subclavian

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12
Q

Where do lymph nodes in the head and neck ultimately drain into

A

Cisterna chyli (L1) –> drains into thoracic duct

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13
Q

How many groups of lymph nodes are there in the neck + name them (think clinical examination)

A 
10:
Supraclavicular
Superficial cervical - anterior/posterior cervical chain
Parotid
Submandibular
Submental
Pre-auricular
Post-auricular/ mastoid
Occipital
Facial

Deep cervical

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14
Q

How many levels are lymph nodes are divided into

*in surgery, referred to as lymph node levels; not their group

A

Level I

Level II - IV

Level V

Level VI

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15
Q

What group of lymph nodes in the neck receives all the lymph in the head and neck

A

Deep cervical lymph nodes - either lymph directly drains into them or lymph from superficial lymph nodes drain into them

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16
Q

Where does lymph from deep cervical lymph nodes ultimately drain into

A

Thoracic duct

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17
Q

What 3 things could lymphadenopathy be due to

A

Infection
Inflammation
Malignancy

18
Q

What is a thyroglossal cyst

A

Dilation of thyroglossal duct remnant in the midline of the neck

19
Q

What was the purpose of the thyroglossal duct

A

Thyroid gland arised from it embryologically

20
Q

Physical diagnosis of thyroglossal cyst

A

Cyst moves up when you stick tongue out because thyroglossal duct opens up in posterior tongue

21
Q

Treatment of thyroglossal cyst

A

Surgical excision of cyst + thyroglossal duct

22
Q

Investigations for a thyroid mass (3)

A

FNAC
USS
Thyroid lobectomy

23
Q

4 types of thyroid cancer

A

Papillary - spreads lymphatic ally
Follicular - blood spread
Medullary
Anaplastic

24
Q

What can’t FNAC distinguish in a thyroid mass

A

If it’s a follicular adenoma or carcinoma

25
Q

What is colloid goitre due to

A

Thyroid gland hyperplasia

26
Q

What is grave’s disease + who does it affect more

A

Autoimmune disease of thyroid gland

Females

27
Q

Pathophysiology of grave’s disease

A

Autoantibodies act against thyroid stimulating hormone receptor, causing it to become OVER-ACTIVE –> HYPERTHYROIDISM

28
Q

Grave’s disease is the NO.1 cause of what

A

Hyperthyroidism

29
Q

Complications of Graves’ disease (2)

A

Thyroid eye disease

Pre-tibial myxoedema (graves’ dermopathy) - red swollen skin on shins and feet

30
Q

Treatment of Graves’ disease (4)

A

Anti-thyroids
Beta blockers
Radio-iodine

Surgery - thyroidectomy

31
Q

Indications for thyroidectomy (3)

A

Airway obstruction
Malignancy
Thyrotoxicosis

32
Q

A thyroid mass can be classified into what 3 groups

A

Solitary nodule
Diffuse enlargement
Multi-nodular goitre

33
Q

What is a multi-nodular goitre

A

Lump containing many thyroid nodules

34
Q

What is a toxic goitre

A

multi-nodular thyroid gland swelling that contains thyroid nodules which function independent of thyroid stimulating hormone, i.e. produces thyroid hormone whenever it wants without having to be stimulated by TSH –> hyperthyroidism

35
Q

Do you get bulging eyes in people with a toxic goitre

36
Q

Investigations for toxic goitre (3)

A

Thyroid function tests - TSH, T3/4
FNAC
CXR

37
Q

What lymph nodes make up the level I neck lymph nodes (2)

A

submental, submandibular

38
Q

What lymph nodes make up the level II-IV neck lymph nodes

A

Deep cervical chain (deep to SCM)

39
Q

What lymph nodes make up the level V neck lymph nodes

A

Lymph nodes in posterior triangle of neck, e.g. supraclavicular

40
Q

What lymph nodes make up the level VI neck lymph nodes

A

Lymph nodes in anterior midline of neck, e.g. pre-tracheal

H and N (14 decks)

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