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Head and Neck > Anatomy/Physiology of the Neck > Flashcards

Anatomy/Physiology of the Neck Flashcards

1
Q

What are the boundaries of the neck?

A

Superior- mandible
Inferior- clavicle
Anterior- anterior midline
Posterior- Trapezius

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2
Q

What muscle separates the anterior and posterior triangles of the neck?

A

The sternocleidomastoid

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3
Q

What are the branches of the external carotid artery?

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

What are the complications of a central line?

A 
Pneumothorax
Haematoma
Cardiac tamponade
Air embolism
Chylothorax
False passage
Thrombosis
Sepsis
Line blockage
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5
Q

How do the lymph nodes of the head and neck drain?

A

They drain to the cisterna chyli, then into the thoracic duct on the left

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6
Q

What structures are drained by the parotid nodes?

A

Scalp, face and parotid gland

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7
Q

What structures are drained by the occipital nodes?

A

Scalp

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8
Q

What structures are drained by the superficial cervical nodes?

A

Breast and solid viscera

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9
Q

What structures are drained by the deep cervical nodes?

A

Final drainage pathway of other nodes to thoracic duct

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10
Q

What structures are drained by the submandibular nodes?

A

Tongue, nose, paranasal sinuses, submandibular gland and oral cavity

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11
Q

What structures are drained by the submental nodes?

A

Lips and floor of mouth

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12
Q

What structures are drained by the supraclavicular nodes?

A

Breast, oesophagus and solid viscera

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13
Q

What are the main causes of lymphadenopathy?

A

Infective
Inflammatory
Malignant

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14
Q

What hormones does the thyroid gland produce?

A

Thyroid hormone and calcitonin

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15
Q

What are the characteristics of a thyroglossal cyst?

A 
Dilatation of thryoglossal duct remnant
May become infected
Lies in midline and grows with age
Moves with tongue protrusion
Excised but chance of recurrence
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16
Q

What are the different kinds of thyroid masses?

A

Solitary nodule
Diffuse enlargement
Multi-nodular goitre

17
Q

What are the causes of a solitary thyroid nodule?

A 
Cyst due to localised haemorrhage
Adenoma
Carcinoma
Lymphoma
Prominent nodule in multi-nodule goitre
18
Q

How are solitary thyroid nodules investigated?

A

Fine needle aspiration and ultrasound scanning

Thyroid lobectomy if follicular adenoma or carcinoma is suspected to differentiate between the two

19
Q

What are the different kinds of diffuse thyroid enlargement?

A

Colloid goitre- due to gland hyperplasia, iodine deficiency, puberty, pregnancy or lactation
Grave’s disease
Thyroiditis

20
Q

What are the characteristics of Grave’s disease?

A 
F>M
Auto-antibodies against thyroid-stimulating hormone receptor stimulate receptor and causes hyperthyroidism
Thyroid eye disease
Acropachy/clubbing
Pre-tibial myxoedema
21
Q

How is Grave’s disease treated?

A

Anti-thyroids
Beta-blockade
Radio-iodine
Surgery

22
Q

What are the indications for a thyroidectomy?

A 
Airway obstruction
Malignancy/suspected malignancy
Thyrotoxicosis
Cosmesis
Retrosternal extension
23
Q

What are the complications of a thyroidectomy?

A 
Bleeding
Voice hoarseness
Thyroid storm
Infection 
Hypoparathyroidism
Hypothyroidism
Scar
24
Q

What are the causes of a multi-nodular goitre?

A

Grave’s disease

Toxic goitre

25
Q

What are the characteristics of a toxic goitre?

A

Older patients
No eye signs
Atrial fibrillation often co-morbidity

26
Q

How should multi-nodular goitres be investigated?

A

Thyroid function tests
Fine needle aspiration cytology
Chest X-ray

27
Q

What is the role of the parathyroid glands and where are they found?

A

Regulate calcium and phosphate levels

Located posterior to the poles of the thyroid

28
Q

What are the symptoms of parathyroid disease?

A

Renal calculi, polyuria, renal failure
Patholigcal fractures, osteoporosis, bone pain
Abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
Anxiety and depression, confusion, paranoia

29
Q

How can parathyroid disease be investigated?

A 
Urea and electrolytes, creatinine, calcium, phosphate
Parathyroid hormone, bicarbonate
Vitamin D
Ultrasound scan
CT/MRI
Isotope scanning
30
Q

What are the causes of hyperparathyroidism?

A

Adenoma
Hyperplasia
Malignancy

31
Q

How is parathyroid disease managed?

A

Medical treatment
Surgery easier if patient is fit
Remove adenomas or hyperplastic glands or carcinomas

32
Q

What are the indications for a tracheostomy?

A

Airway obstruction
Airway protection
Poor ventillation to reduce dead space

33
Q

What are the characteristics of a branchial cyst?

A

Remnant of fusion failure of branchial arches or lymph node cystic degeneration
Transilluminates
Anterior to sternocleidomastoid at junction between upper and middle thirds
Becomes infected, enlarging
Excised to prevent further infection

34
Q

What is the cause of a pharyngeal pouch?

A

Herniation of pharyngeal muscle mucosa between thyropharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx

35
Q

What are the symptoms of a pharyngeal pouch?

A 
Voice hoarseness
Dysphagia
Aspiration pneumonia
Regurgitation
Weight loss
Neoplasia (1%)
36
Q

How is a pharyngeal pouch managed?

A

Barium swallow

Excision or dilation

Head and Neck (14 decks)

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