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Penny abdomen > Ch. 12 The Face and Neck > Flashcards

Ch. 12 The Face and Neck Flashcards

1
Q

Fluid produced by the salivary glands which aids in digestion

A

saliva

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2
Q

Salivary glands are exocrine glands whose primary function is to produce _____ that is ultimately released into the oral cavity through ducts

A

Saliva

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3
Q

Saliva, which aids in digestion, is mostly composed of what?

A

Water

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4
Q

Besides water, what is in saliva?

A

Enzymes like amylase and electrolytes

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5
Q

What are the three paired groups of salivary glands?

A

parotid, submandibular, sublingual

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6
Q

What transducer is most often used when imaging the salivary glands?

A

High frequency linear transducer

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7
Q

What does the salivary glands typically look like in ultrasound?

A

Typically hyperechoic compared to the adjacent musculature

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8
Q

The largest of the salivary glands

A

parotid gland

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9
Q

The parotid gland can be separated into 3 lobes, the main duct referred to as

A

stensen duct

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10
Q

The submandibular gland is drained by?

A

Wharton’s duct

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11
Q

Located bilaterally just under the tongue & anterior to the submandibular gland

A

sublinguial glands

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12
Q

Located bilaterally anterior to the ears extends inferiorly where its bounded anteriorly by the rami of the mandibles & posteriorly by the mastoid processes of the temporal bones

A

Parotid glands

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13
Q

Located beneath the floor of the mouth & are bordered laterally by the body of the mandible and superiorly by musculature

A

submandibular glands

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14
Q

Parotid glands appear ___ in sagittal and ___ in transverse.

A

elliptical, round

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15
Q

Sublingual glands are ___ in shape

A

round

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16
Q

Submandibular glands are more ___ in shape

A

triangular

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17
Q

Mucus retention cyst in the floor of the mouth arising from an obstructed sublingual or minor salivary duct

Sono: Well-defined, homogeneous, hypoechoic, or anechoic mass. Infected cyst will appear complex

A

ranula

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18
Q

An autoimmune disease that affects all glands that produce moisture, leads to dysfunction of salivary glands and severe dryness of the eyes, nose, skin, and mouth

Sono:Heterogeneous, hyperemic, visibly enlarged, and may contain diffuse hypoechoic regions

A

Sjogren syndrome

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19
Q

Inflammation of the salivary glands

Sono:Heterogeneous, hyperemic, visibly enlarged, and may contain diffuse hypoechoic regions

A

sialadenitis

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20
Q

Salivary duct stones, most commonly located within the submandibular glands

Sono:Dilated duct containing a shadowing, echogenic focus or foci

A

sialolithiasis

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21
Q

Benign, painless enlargement of the salivary glands, usually affects both parotid glands

Sono:Enlarged gland without hypervascularity

A

sialadenosis

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22
Q

Benign and most frequent tumor of the salivary glands; most commonly seen in the parotid gland

Sono:Hypoechoic mass; biopsy is often warranted

A

Pleomorphic adenoma

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23
Q

Most common malignancy of the salivary glands; typically starts in the parotid gland

Sono: Hypoechoic or heterogeneous mass with moderate to marked internal vascularity; biopsy is often warranted

A

Mucoepidermoid carcinoma

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24
Q

The word part “sial(o)” means

A

saliva

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25
Q

Especially when malignancy is suspected, an evaluation of the cervical _____ should be performed

A

lymphatic chain

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26
Q

Crucial endocrine gland that develops within 3rd week of gestation

A

Crucial endocrine gland that develops within 3rd week of gestation

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27
Q

The Thyroid is fully functional by the end of the _____ trimester.

A

first

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28
Q

the embryonic duct that is located from the base of the tongue to the midportion of the anterior neck

A

thyroglossal duct

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29
Q

Where is the thyroid gland located anatomically?

A

It descends down the thyroglossal duct to ultimately rest anterior to the trachea

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30
Q

Normal variant of the thyroid gland in which there is a superior extension of the isthmus

A

pyramidal lobe

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31
Q

Bridge on thyroid gland

A

isthmus

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32
Q

The thyroid uses ____ to produce its hormones

A

iodine

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33
Q

The hypothalaums produces thyroid releasing hormone which controls the release of ___ by the anterior pituitary gland.

A

TSH- thyroid stimulating hormone

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34
Q

As a result of TSH released by the pituitary gland the thyroid releases the hormones contained within its cells

A

thyroxine (T4), triiodothyronine (T3), calcitonin

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35
Q

Thyroid hormone that aids in metabolism of fats, proteins and carbohydrates

A

thyroxine (T4), thriiodothyronin (T3)

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36
Q

Thyroid hormone that’s responsible for removing calcium from the blood for storage in the bones

A

calcitonin

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37
Q

Most abundant hormone produced by the thyroid

A

Thyroxine (T4)

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38
Q

Normal thyroid tissue is homogeneous and consists of medium to high level echogenicities similar to

A

the testes

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39
Q

Each adult pear shaped thyroid lobes meausres

A

4-6 cm in length, 2-3 cm width, 1-2cm thickness (rt lobe usually largest)

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40
Q

The isthmus normally measures between

A

2-6mm in AP

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41
Q

The neck muscles appear more __________ than the normal thyroid tissue.

A

hypoechoic

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42
Q

Surrounding structure to thyroid most often seen on the left side posterior to trachea and thyroid

A

esophagus (have pt swallow to differentiate from mass can see saliva passing in real time)

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43
Q

increased vascularity or hyperemia may be evident of

A

Graves disease and Hashimotos

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44
Q

The fluid produced by the thyroid gland that contains thyroid hormones is referred to as

A

colloid

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45
Q

The thyroid consists of what?

A

Multiple follicles that contain a fluid called colloid

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46
Q

What are the two prominent vascular structures that can be seen lateral to the thyroid gland?

A

CCA and internal jugular vein

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47
Q

When examining the thyroid, what should the sonographer do before the actual exam?

A

The sonographer should determine whether there are any palpable nodules by standing behind the patient and palpating the thyroid gland

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48
Q

The ______ is the first branch of the external carotid artery. The inferior thyroid artery is a branch of the thyrocervical trunk of the subclavian artery.

A

superior thyroid artery

49
Q

Strap muscles (sternohyoid, sternothyroid, thyrohyoid, and omohyoid) is _____to each lobe. The much larger sternocleidomastoid muscles pass _____ to the thyroid lobes. The longus colli muscles are seen ______ to each lobe.

A

anterior, lateral, posterior

50
Q

________is a highly efficient way to determine the characteristics of clinically palpable and sonographically identifiable thyroid nodules. The use of sonographic guidance for FNA is especially beneficial. During this minimally invasive procedure, the tissue is identified with sonography, and a small needle is inserted into the nodule. An FNA is considered a low-risk procedure.

A

Fine-needle aspiration (FNA)

51
Q

The most common cause of hyperthyroidism that produces bulging eyes, heat intolerance, nervousness, weight loss, and hair loss

A

Graves disease

52
Q

The most common cause of hypothyroidism in the United States

A

Hashimoto thyroiditis

53
Q

An enlarged, hyperplastic thyroid glands (causes include iodine deficiency, Graves, thyrioditis), isthmus may measure greater than 1cm

A

goiter

54
Q

Enlarged thyroid gland that contains multiple nodules with cystic and solid components

A

multinodular goiter or adenomatous goiter

55
Q

Most common mass identified within the thyroid gland (up to 68%)

A

benign thyroid nodules

56
Q

Clinical findings of a ______:
1. Palpable (and possibly visually) enlarged thyroid gland
2. Dyspnea
3. Dysphagia
4. Feeling of tightening in the throat
5. Coughing
6. Hoarseness

A

Goiter

57
Q

Sonographic findings of a ______:
1. Enlarged thyroid gland (isthmus that exceeds 1 cm in the anteroposterior plane)
2. Diffusely heterogeneous echotexture
3. Multiple nodules with cystic and solid components

A

Goiter

58
Q

________ is the general term for thyroid enlargement that can result from inadequate iodine intake. However, there can be other underlying causes.

A

goiter

59
Q

A condition that results from the overproduction of thyroid hormones

A

hyperthyroidism

60
Q

Most common cause of thyroid nodules

A

nodular hyperplasia

61
Q

most often small, round, and can have varying sonographic appearances, including completely anechoic, isoechoic, or hyperechoic. They may also have a surrounding halo

A

Follicular adenomas

62
Q

difficulty swallowing

A

dysphagia

63
Q

difficulty breathing

A

dyspnea

64
Q

______is the most common cause of thyroid nodules. Hyperplastic nodules, also referred to as adenomatous nodules, are almost always multiple and also have varying sonographic appearances.

A

Nodular hyperplasia

65
Q

With elastography ___ nodules in the thyroid compared to the tissue around them have an increased risk for malignancy.

A

stiffer

66
Q

Graves disease, which may also be referred to as a _______, is the most common cause of hyperthyroidism

A

diffuse toxic goiter

67
Q

bulging eyes

A

exophthalmos

68
Q

clinical finding associated with Graves disease in which there is thickening of the skin and edema on the anterior legs

A

pretibial myxedema

69
Q

infrequent or light menstrual periods

A

oligomenorrhea

70
Q

Clinical findings of _______:
Bulging eyes (exophthalmos)
Heat intolerance
Nervousness
Weight loss (with increased appetite)
Hair loss
Tachycardia, palpitations, high-output heart failure
Muscle wasting
Fine tremors
Oligomenorrhea
Pretibial myxedema

A

Graves Disease

71
Q

Sonographic findings of ______:
1. Enlarged gland
2. Heterogeneous or diffusely hypoechoic echotexture
3. Thyroid inferno

A

Graves Disease

72
Q

What is the other term for Hashimoto thyroiditis?

A

Chronic autoimmune lymphocytic thyroiditis

73
Q

With this condition, the thyroid becomes inflamed, and as a result, the thyroid produces smaller amounts of thyroid hormones.

A

Hashimoto thyroiditis

74
Q

_______is an autoimmune disease and is the most common cause of hypothyroidism in the United States.

A

Hashimoto thyroiditis

75
Q

Clinical findings of______:
(in early stage pts are asymptomatic)
Depression
Increased cold sensitivity
Elevated blood cholesterol levels
Slight weight gain may occur
Puffy face and puffiness under the eyes
Menorrhagia
Pallor

A

Hashimoto Thyroiditis

76
Q

Sonographic findings of _______
1. Mild enlargement of the thyroid gland (initially)
2. Heterogenous echotexture
3. Multiple, ill-defined hypoechoic regions separated by fibrous hyperechoic tissue
4. Hypervascular gland

A

Hashimotos Thyroiditis

77
Q

Most common form of thyroid cancer. Other forms of thyroid malignancies include follicular carcinoma, medullary carcinoma, anaplastic carcinoma, lymphoma, and metastases of the thyroid

A

Papillary carcinoma

78
Q

______characteristics of thyroid nodules

Extensive cystic components

Cysts <5 mm

Hyperechoic mass

“Eggshell” calcifications

Spongiform composition

Wider-than-tall shape

“Hot” nodule (nuclear medicine finding)

A

Benign

79
Q

______characteristics of thyroid nodules

Hypoechoic mass

Taller-than-wide shape

Mass with internal microcalcifications (psammoma bodies)

Solitary mass

Marked vascularity within the central part of the nodule

Interrupted peripheral calcification

Extracapsular invasion

Lobulated margins

Enlargement of the cervical lymph nodes (metastasis)

“Cold” nodule (nuclear medicine finding)

A

Malignant

80
Q

Microcalcifications within a thyroid mass can increased the likelyhood of _______ in the thyroid

A

Malignancy

81
Q

Round, calcified deposits that appear punctate (marked w dots) hypoerechoic foci w/o shadowing

A

psammoma bodies

82
Q

What is the standardized reporting and description system of sosnographically identified thyroid nodules called?

A

TI-RADS (5 levels based on 5 features: composition, echogenicity, shape, margin, punctate echogenic foci)

83
Q

The highest category of TI-RAD is

A

TR5, highly suspicious (more point = high risk of malignancy)

84
Q

Nuclear medicine utilizes this study to classify thyroid nodules as either hyperfunctioning or hypofunctioning.

A

Scintigraphy

85
Q

Hyperfunctioning or “hot nodules” yield dark areas on a thyroid scan (nuc med schintigraphy) almost always

A

benign

86
Q

Hypofunctioning or “cold nodules” yield light or blank areas on a thyroid scan “nuc med schinitgraphy)

A

malignant potential

87
Q

This examination includes the injection of a radiopharmaceutical that is high in iodine

A

Scintigraphy

88
Q

Their are typically ___ parathyroid glands, some people have 5

A

4 (2 pairs)

89
Q

Normal parathyroid gland measurement (sono appearance is similar to thyroid tissue)

A

5mm x 3mm x 1mm

90
Q

Parathyroid gland is commonly located near (their locations are variable)

A

the posterior aspect of the midportion of each lobe, one often inferior to each lobe

91
Q

Serves as calcium regulators of the body, controls the release & absorption of calcium by producing PTH

A

parathyroid gland

92
Q

Most common cause of enlargement of a parathyroid gland (elevated serum calcium levels and PTH)

A

parathyroid adenoma (appears as hypoechoic mass adjacent to thyroid)

93
Q

Enlargement of the cervical lymph nodes

A

cervical lymphadenopathy

94
Q

If the patient has elevated serum calcium (hypercalcemia), what should the sonographer do?

A

Analyze the neck carefully for signs of parathyroid adenoma

95
Q

hyperparathyroidism can cause ____

A

hypercalcemia

96
Q

Clinical findings of a _______:
1. Elevated serum calcium
2. Elevated PTH

A

Parathyroid Adenoma

97
Q

Sonographic findings of a ________:
1. hypoechoic mass adjacent to thyroid

A

Parathyroid Adenoma

98
Q

What is the normal size of cervical lymph nodes?

A

Less than 1cm

99
Q

What does cervical lymph nodes look like in sonography?

A

Oblong shaped hypoechoic structures with a distinguishable echogenic hilum

100
Q

Abnormal lymph nodes can result from infections and malignancy. They may also be more ______ in shape, _____ their normal hilar feature, contain calcifications, or demonstrate abnormal vascular patterns

A

rounded, lose

101
Q

The postsurgical neck sonogram—especially in those who require imaging following a thyroidectomy (removal of thyroid) because of cancer—should include a thorough examination of the neck for ________(i.e., metastatic disease to the nodes).

A

lymphadenopathy

102
Q

Clinical findings of _______:
1. palpable neck mass (possibly)
2. enlarged nodes may be painful

A

Abnormal Lymph Nodes

103
Q

Sonographic findings of _______:
1. enlargement of the node >1cm
2. rounded shape
3. loss of echogenic hilum
4. calcifications
5. May be hyperemic or demonstrate abnormal vascular patterns with color Doppler

A

Abnormal Lymph Nodes

104
Q

Benign congenital cysts located within the midline of the neck superior to the thyroid gland and are typically located below the level the hyoid bone

A

Thyroglossal duct cysts

105
Q

rare pediatric fibrous tumor located within the sternocleidomastoid muscle

A

fibromatosis collic

106
Q

Clinical findings of a _______:
1. palpable mass within the midline of the neck superior to the thyroid gland
2. infected cysts may be painful

A

Thyroglossal Duct Cyst

107
Q

Sonographic findings of a ______:
1. anechoic, well defined, and unilocular cyst with posterior enhancement
2. may have internal components

A

Thyroglossal Duct Cyst

108
Q

As the tissues of the neck develop in utero from the branchial apparatus, branchial clefts, which normally involute, may be maintained. ________are congenital neck cysts that result from this maldevelopment.They are found most often near the angle of the mandible, but may occur in the lower, lateral neck.

A

Branchial cleft cysts

109
Q

A branchial cleft ______ can also occur in the same region.______ may allow fluid to leak to the skin surface.

A

fistulas

110
Q

Clinical findings of a _______:
1. Palpable neck mass located near the angle of the mandible
2. Infected cysts may be painful

A

Branchial Cleft Cyst

111
Q

Sonographic findings of a ________:
1. Anechoic mass near the angle of the mandible

A

Branchial Cleft Cyst

112
Q

Clinical findings of _______:
1. Pediatric palpapble neck mass
2. Torticollis

A

Fibromatosis Coli

113
Q

Sonographic findings of ______:
1. Fusiform-shaped mass within the sternocleidomastoid muscle that is hypoechoic, hyperechoic, or even isoechoic to the adjacent tissue
2. May also contain calcifications that shadow
3. May yield a hyperemic pattern with color Doppler

A

Fibromatosis Coli

114
Q

Because of the mass within the sternocleidomastoid muscle, the muscle shortens, resulting in the twisting of the infant’s chin toward the nonaffected side—termed congenital muscular _____.

A

torticollis (twisted neck)

115
Q

Clinical Findings of a ______:
Pediatric palpable neck mass
Asymptomatic or painful due to infection or hemorrhage

A

Lymphangioma

116
Q

Sonographic Findings of ______:
Thin-walled, hypoechoic or anechoic, septated mass

A

Lymphangioma

117
Q

A lymphangioma, also referred to as ______, is a neck mass that may require sonographic evaluation. These masses are typically found in the posterior neck in utero or in the neonatal period.

A

cystic hygroma

118
Q

They consist of a buildup of lymphatic fluid

A

Lymphangioma

Penny abdomen (11 decks)

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