Chapter 12: The Neck

Question 1

benign congenital neck cysts found most often near the angle of the mandible

Answer 1

branchial cleft cysts

Question 2

the hypofunctioning thyroid nodules seen on a nuclear medicine study that have malignant potential

Answer 2

cold nodules

Question 3

the fluid produced by the thyroid that contains thyroid hormones

Answer 3

colloid

Question 4

an enlarged, hyperplastic thyroid gland

Answer 4

goiter

Question 5

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

Answer 5

Graves disease

Question 6

the most common cause of hypothyroidism in the United States

Answer 6

Hashimoto thyroiditis

Question 7

the hyperfunctioning thyroid nodules seen on a nuclear medicine study that are almost always benign

Answer 7

hot nodules

Question 8

the most common form of thyroid cancer

Answer 8

papillary carcinoma

Question 9

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

Answer 9

pyramidal lobe

Question 10

benign congenital cysts located within the midline of the neck superior to the thyroid gland near the hyoid bone

Answer 10

thyroglossal duct cysts

Question 11

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

Answer 11

thyroglossal duct

Question 12

the thyroid is an __________ gland

Answer 12

endocrine

Question 13

what produces thyroid-releasing hormone?

Answer 13

hypothalamus

Question 14

what does thyroid-releasing hormone do?

Answer 14

controls the release of thyroid-stimulating hormone by the anterior pituitary gland

Question 15

3 hormones released by the thyroid

Answer 15

thyroxine (T4)
triiodothyronine (T3)
calcitonin

Question 16

what do the 3 and 4 in T3 and T4 mean?

Answer 16

the number of iodine atoms contained within each hormone

Question 17

the most abundant hormone produced by the thyroid

Answer 17

thyroxine (T4)

Question 18

the most medial vessel to the thyroid

Answer 18

common carotid artery

Question 19

first branch of the external carotid artery

Answer 19

superior thyroid artery

Question 20

the inferior thyroid artery is a branch of what?

Answer 20

the thyrocervical trunk of the subclavian artery

Question 21

thyroid veins drain into what?

Answer 21

internal jugular vein

Question 22

normal measurements of the thyroid

Answer 22

lobes:
4-6 cm in length
2-3 cm in width
1-2 cm in thickness
(right lobe is usually largest)
isthmus:
2-6 mm front to back

Question 23

thyroid volume formula

Answer 23

length x width x thickness x 0.52

Question 24

neck muscles should appear __________ compared to thyroid tissue

Answer 24

hypoechoic

Question 25

3 strap muscles in the neck

Answer 25

sternohyoid sternothyroid omohyoid

Question 26

the esophagus lies __________ to the thyroid and is most often seen on the ________ side

Answer 26

posterior | left

Question 27

the most efficient way to determine the character of clinically identifiable thyroid nodules

Answer 27

fine needle aspiration (FNA)

Question 28

3 common causes of goiter

Answer 28

iodine deficiency Graves disease thyroiditis

Question 29

an isthmus that measures greater than ____ is indicative of thyroid enlargement

Answer 29

10 mm

Question 30

an enlarged thyroid gland that contains multiple nodules with cystic and solid components

Answer 30

multinodular or adenomatous goiter

Question 31

Sonographic findings: heterogeneous echotexture (neck) may contain multiple nodules with cystic and solid components

Answer 31

goiter

Question 32

Graves disease is also called what?

Answer 32

diffuse toxic goiter

Question 33

``` Clinical findings: bulging eyes heat intolerance nervousness weight loss hair loss ```

Answer 33

Graves disease (hyperthyroidism)

Question 34

Sonographic findings: enlarged gland heterogeneous or diffusely hypoechoic echotexture thyroid inferno

Answer 34

Graves disease (hyperthyroidism)

Question 35

Hashimoto disease may also be called what?

Answer 35

chronic lymphocytic thyroiditis

Question 36

``` Clinical findings: depression increased cold sensitivity elevated blood cholesterol levels slight weight gain may occur constipation ```

Answer 36

Hashimoto thyroiditis (hypothyroidism)

Question 37

Sonographic findings: mild enlargement of the thyroid gland heterogeneous echotexture hypervascular gland

Answer 37

Hashimoto thyroiditis (hypothyroidism)

Question 38

most common masses identified within the thyroid gland

Answer 38

benign thyroid nodules

Question 39

most common benign thyroid neoplasm

Answer 39

follicular adenomas

Question 40

the presence of what within a thyroid seems to increase the likelihood of a malignancy

Answer 40

microcalcifications

Question 41

5 characteristics of benign thyroid nodules

Answer 41

``` extensive cystic components cysts nodule (nuclear medicine finding) ```

Question 42

5 characteristics of malignant thyroid nodules

Answer 42

``` hypoechoic mass mass with internal microcalcifications solitary mass enlargement of the cervical lymph nodes (metastasis) "cold" nodule (nuclear medicine finding) ```

Question 43

how many pairs of parathyroid glands are there?

Answer 43

2 | 4 total glands, sometimes 5

Question 44

purpose of the parathyroid glands

Answer 44

calcium regulators | control the release and absorption of calcium by producing parathyroid hormone (PTH

Question 45

most common cause of enlargement of a parathyroid gland

Answer 45

parathyroid adenoma

Question 46

Clinical findings: elevated serum calcium elevated parathyroid hormone (PTH)

Answer 46

parathyroid adenoma

Question 47

Sonographic findings: | hypoechoic mass adjacent to the thyroid

Answer 47

parathyroid adenoma

Question 48

``` Sonographic findings: enlargement of the node >1 cm rounded shape loss of the echogenic hilum calcifications ```

Answer 48

abnormal lymph nodes

Question 49

Clinical findings: | palpable mass within the midline of the neck superior to the thyroid gland

Answer 49

thyroglossal duct cyst

Question 50

Sonographic findings: | anechoic, well-defined, and unilocular cyst with posterior enhancement

Answer 50

thyroglossal duct cyst

Question 51

Clinical findings: | palpable neck mass located near the angle of the mandible

Answer 51

branchial cleft cyst

Question 52

Sonographic findings: | anechoic mass near the angle of the mandible

Answer 52

branchial cleft cyst

Question 53

``` Benign congenital cysts located superior to the thyroid gland near the hyoid bone are referred to as: A. branchial cleft cysts B. follicular adenomas C. thyroglossal duct cysts D. parathyroid adenomas ```

Answer 53

thyroglossal duct cysts

Question 54

``` A cystic mass noted at the mandibular angle is most likely a: A. branchial cleft cyst B. follicular adenoma C. thyroglossal duct cyst D. parathyroid adenoma ```

Answer 54

branchial cleft cyst

Question 55

``` Parathyroid glands control the release and absorption of which nutrient? A. thyroxine (T4) B. triiodothyronine (T3) C. calcitonin D. calcium ```

Answer 55

calcium

Question 56

Which of the following best describes the normal appearance of a cervical lymph node? A. a hypoechoic, oblong structure with a distinct echogenic hilum B. a rounded, echogenic structure with small calcifications C. a solid, hypoechoic mass that measures less than 1 cm D. a solid, echogenic mass that measures less than 1 cm

Answer 56

a hypoechoic, oblong structure with a distinct echogenic hilum

Question 57

``` All of the following are sonographic findings of malignant thyroid nodules except: A. internal calcifications B. echogenic mass C. cervical node involvment D. solitary mass ```

Answer 57

echogenic mass

Question 58

``` All of the following are diagnostic findings of benign thyroid nodules except: A. anechoic mass B. eggshell calcification C. hyperechoic mass D. cold nodule ```

Answer 58

cold nodule

Question 59

``` Which of the following is the most common form of thyroid cancer? A. follicular B. anaplastic C. lymphoma D. papillary ```

Answer 59

papillary

Question 60

``` All of the following are sonographic findings of an abnormal lymph node except: A. rounded shape B. echogenic hilum C. calcifications D. enlargement ```

Answer 60

echogenic hilum

Question 61

``` Which muscles are located posterior to each thyroid lobe? A. sternocleidomastoid B. longus colli C. sternohyoid D. omohyoid ```

Answer 61

longus colli

Question 62

``` Which muscles are located lateral to each thyroid lobe? A. sternocleidomastoid B. longus colli C. sternohyoid D. omohyoid ```

Answer 62

sternocleidomastoid

Question 63

``` Which vascular structure is located closest to the thyroid lobes? A. external carotid vein B. external carotid artery C. internal jugular vein D. internal carotid artery ```

Answer 63

internal carotid artery

Question 64

``` Which muscles are located anterior to the thyroid gland? A. sternocleidomastoid B. longus colli C. thyrocervical trunk D. strap ```

Answer 64

strap muscles