Ch 1 Neck Anatomy

Question 1

List reasons why people would get a neck u/s?

Answer 1

-Thyroid evaluation (post thyroidectomy, radiation, ablation)
-Parathyroid evaluation
-Lymph node evaluation
-Salivary gland evaluation
-Post surgical
-Lumps/bumps
-Neck vasculature
-Biopsies/fine needle aspiration

Question 2

Which probe should we start with?

Answer 2

The highest frequency linear probe available
(ML 6-15)

Question 3

What is the set-up for a neck + thyroid exam?

Answer 3

-Have machine in line with the head of the bed to avoid reaching
-May remove pillow or place pillow lower under shoulders to extend neck
-May use reverse trendelenburg
-Tuck towels into shirt to have access to neck

Question 4

What is known as the adams apple?

Answer 4

Laryngeal prominence

Question 5

What are the 4 strap/infrahyoid muscles?

Answer 5

-Sternohyoid
-Sternothyroid
-Thyrohyoid
-Omohyoid

Question 6

Where are the strap muscles located in regards to the thyroid?

Answer 6

Anterior to the thyroid

Question 7

Where is the longus colli muscle located in regards to the thyroid?

Answer 7

Posterior to thyroid

Question 8

Where is the sternocleidomastoid muscle located in regards to the thyroid?

Answer 8

Lateral to strap muscles + thyroid

Question 9

Where is the anterior scalene muscle located in regards to the thyroid?

Answer 9

Posterior + lateral to thyroid

(lateral to longus colli muscle)

Question 10

List 4 important landmarks of the neck?

Answer 10

-Trachea (windpipe - connects throat to lungs)
-Esophagus (connects throat to stomach)
-Common carotid artery
-Internal jugular vein

Question 11

Is the esophagus more prominent on the left or right side?

Answer 11

Left

Question 12

Does the esophagus often look like a nodule?

Answer 12

Yes! Can turn into SAG + get the pt to swallow to ensure it is the esophagus

Question 13

Where is the trachea + esophagus located in regards to the thyroid?

Answer 13

In the center of the thyroid, although the esophagus m/c appears on the left

Question 14

How many salivary glands are there + what are they?

Answer 14

3 glands:

-Parotids (in front of ears)
-Submandibular/SMG (below jaw)
-Sublinguals (under tongue)

Question 15

List the glands of the neck?

Answer 15

-Salivary glands
-Thyroid gland
-Parathyroid glands

Question 16

How many parathyroid glands are there + what are they?

Answer 16

Typically 4:

-2 superior + posterior to mid/upper thyroid
-2 inferior + posterior to lower thyroid

(this varies)

Question 17

Do we normally see the parathyroid glands?

Answer 17

No! Only see them when they are abnormal

Question 18

Why do we use neck regions?

Answer 18

To describe the location of lymph nodes + other pathology

(used routinely for neck screening post thyroid cancer + thyroidectomy)

Question 19

Explain neck region level 1?

Answer 19

Submental/submandibular

1A - submental (b/w anterior bellies of the digastric muscles)

1B - submandibular (contains the SMG - bold)

Question 20

Explain neck region level 2?

Answer 20

Upper internal jugular chain

2A - contains the jugulodigastic nodes (bold) + internal jugular vein (IJV)

2B - posterior to IJV

Question 21

Explain neck region level 3?

Answer 21

Middle internal jugular plane

Superiorly: contains hyoid bone
Inferiorly: contains inf border of cricoid cartilage
Also: contains portion of the SCM

Question 22

Explain neck region level 4?

Answer 22

Lower internal jugular plane

-Starts at the inferior border of cricoid cartilage
-Contains medial supraclavicular nodes (bold)

Question 23

Explain neck region level 5?

Answer 23

Posterior triangle

5A - superior part
5B - inferior part that includes lateral supraclavicular nodes (bold)

Question 24

Explain neck region level 6?

Answer 24

Anterior compartment

Superiorly: inferior border of hyoid
Inferiorly: superior border of SSN
Also: thyroid bed (bold)

Question 25

Explain neck region level 7?

Answer 25

Suprasternal notch (SSN)

Question 26

Which level of the neck contains the SMG?

Answer 26

1B

Question 27

Which level of the neck contains the jugulodigastric nodes?

Answer 27

2A

Question 28

Which level of the neck contains the medial supraclavicular nodes?

Answer 28

4

Question 29

Which level of the neck contains the lateral supraclavicular nodes?

Answer 29

5B