Face & Neck Flashcards
A patient with hypercalcemia presents to the sonography department for a neck sonogram. What abnormality in the neck should be suspected?
parathyroid adenoma
parotid gland enlargement
thyroid papillary carcinoma
Hashimoto thyroiditis
parathyroid adenoma
Benign congenital cysts located superior to the thyroid gland near the hyoid bone are referred to as:
branchial cleft cyst
follicular adenomas
thyroglossal duct cysts
parathyroid adenomas
thyroglossal duct cysts
Normally, how many parathyroid glands are found within the adult neck?
3
4
6
8
4
A cystic mass noted at the mandibular angle is most likely a:
branchial cleft cyst
follicular adenoma
thyroglossal duct cyst
parathyroid adenoma
branchial cleft cyst
Which of the following would more likely be a malignant thyroid nodule?
cold nodule
hot nodule
cold nodule
Parathyroid glands control the release and absorption of which nutrient?
thyroxine (T4)
triiodothyronine (T3)
calcitonin
calcium
calcium
A normal lymph node will not measure greater than:
8 mm
5 mm
12 mm
10 mm
10 mm
With which of the following is elevated serum calcium associated?
Graves’ disease
thyroglossal duct cyst
parathyroid adenoma
thyroid adenoma
parathyroid adenoma
Which of the following best describes the normal appearance of a cervical lymph node?
hypoechoic, oblong structure with a distinct echogenic rim
rounded, echogenic structure with small calcifications
solid, hypoechoic mass that measures greater than 1 cm
solid, echogenic mass that measures less than 1 cm
hypoechoic, oblong structure with a distinct echogenic rim
Which abnormality is associated with the sonographic findings of a thyroid inferno?
Hashimoto thyroiditis
Graves’ disease
hyperparathyroidism
cervical lymphadenopathy
Graves’ disease
All of the following are sonographic findings of malignant thyroid nodules EXCEPT:
internal calcifications
hyperechoic mass
cervical node involvement
solitary mass
hyperechoic mass
All of the following are diagnostic findings of a likely benign thyroid nodule EXCEPT:
anechoic nodule
eggshell calcification
hyperechoic nodule
cold nodule
cold nodule
Which of the following is the most common form of thyroid cancer?
follicular
anaplastic
lymphoma
papillary
papillary
What is the most common cause of hypothyroidism?
Graves’ disease
Hashimoto thyroiditis
papillary carcinoma
parathyroid adenoma
Hashimoto thyroiditis
All of the following are sonographic findings of an abnormal lymph node EXCEPT:
rounded shape
echogenic hilum
calcifications
enlargement
echogenic hilum
What is the most common cause of hyperthyroidism?
Graves’ disease
Hashimoto thyroiditis
papillary carcinoma
parathyroid adenoma
Graves’ disease
Which gland is located immediately anterior to the ear?
submandibular gland
sublingual gland
thyroid gland
parotid gland
parotid gland
Which muscle does fibromatosis colli mostly affect?
omohyoid
longus colli
sternocleidomastoid
infrahyoid
sternocleidomastoid
A 30 year old patient presents to the sonography department for a thyroid sonogram with a history of weight loss, hair loss, and hyperparathyroidism. You note that the patient has bulging eyes. What is the most likely diagnosis?
Hashimoto thyroiditis
Graves’ disease
hyperparathyroidism
cervical lymphadenopathy
Graves’ disease
The fluid produced by the thyroid gland that contains thyroid hormones is referred to as:
thyroxine
calcitonin
colloid
triiodothyronine
colloid
In the presence of Hashimoto thyroiditis, the thyroid produces:
too many thyroid hormones
too much calcium
too few thyroid hormones
too much iodine
too few thyroid hormones
A 45 year old female patient presents to the sonography department with a palpable neck mass 6 months following a thyroidectomy for papillary carcinoma. Which of the following would be the most likely etiology of the palpable mass?
torticollis
lymphadenopathy
sialadenitis
Graves’ disease
sialadenitis
Which of the following is the duct that drains the submandibular gland?
Stepson duct
Wharton duct
Siegel duct
Partridge duct
Wharton duct
Which of the following does the thyroid gland utilize to produce its hormones?
colloid
iodine
iron
calcium
iodine
Which muscles are located posterior to each thyroid lobe?
sternocleidomastoid
longus colli
sternohyoid
omohyoid
longus colli
Which muscles are located lateral to each thyroid lobe?
sternocleidomastoid
longus colli
sternohyoid
omohyoid
sternocleidomastoid
Which of the following is associated with congenital muscular torticollis?
fibromatosis colli
branchial cleft cyst
pleomorphic adenoma
sialadenosis
fibromatosis colli
What structure may be confused for a thyroid or parathyroid mass because of its relationship to the trachea and the posterior aspect of the left thyroid gland?
esophagus
common carotid artery
internal jugular vein
sternothyroid
esophagus
Which vascular structure is located closest to the thyroid lobes?
external carotid vein
external carotid artery
internal jugular vein
common carotid artery
common carotid artery
A thyroid isthmus that measures greater than ____ is indicative of thyroid enlargement
8 mm
5 mm
12 mm
10 mm
10 mm
Which of the following is the term for stones within the salivary duct?
sjögren syndrome
torticollis
cervical lymphadenopathy
sialolithiasis
sialolithiasis
Which muscles are located anterior to the thyroid gland?
sternocleidomastoid
longus colli
thyrocervical trunk
strap
strap
What is the first branch of the external carotid artery?
internal carotid artery
optic artery
superior thyroid artery
inferior thyroid artery
superior thyroid artery
Psammoma bodies are
A. hypoechoic structures
B. comet-tail artifacts emanating from inside a colloid mass
C. punctuate calcific deposits
D. mural or wall nodules within a solid mass
punctuate calcific deposits
All of the following are hormones produced by the thyroid EXCEPT:
thyroxine
iodine
triiodothyronine
calcitonin
iodine
Which of the following is the hormone that is the most abundantly produced by the thyroid?
thyroxine
iodine
triiodothyronine
calcitonin
thyroxine
Which of the following is an autoimmune disease that affects the glands that produce moisture, leading to dysfunction of the salivary glands, and dryness of the eyes, nose, skin, and mouth?
Wharton syndrome
sjögren syndrome
Stenson syndrome
sialadenosis syndrome
sjögren syndrome
What type of gland is the thyroid gland?
endocrine
exocrine
both
neither
endocrine
the superior extension of the thyroid isthmus is referred to as the:
thyroglossal duct
branchial cleft
yodeler’s love
pyramidal lobe
pyramidal lobe
Which of the following is the most common form of salivary gland cancer?
mucoepidermoid carcinoma
papillary carcinoma
ancillary carcinoma
medullary carcinoma
mucoepidermoid carcinoma
You have been requested to perform a thyroid ultrasound on a patient with a palpable nodule in the left neck. Which of the following transducers would provide the most optimal scan?
2.25 MHz curved linear array
3.5 MHz curved linear array
5.0 MHz curved linear array
7.5 MHz curved linear array
10.0 MHz linear array
10.0 MHz linear array
Identify the structure labeled A:
strap muscle
longus coli muscle
sternocleidomastoid muscle
esophagus
isthmus
sternocleidomastoid muscle
Identify the structure labeled B:
strap muscle
longus coli muscle
sternocleidomastoid muscle
esophagus
isthmus
isthmus
identify the structure labeled C:
esophagus
trachea
sternohyoid
cervical spine
jugular vein
trachea
identify the structure labeled D:
esophagus
parathyroid
longus coli muscle
cervical spine
common carotid artery
esophagus
identify the structure labeled E:
common carotid artery
internal jugular vein
external jugular vein
longus coli muscle
subclavian vein
internal jugular vein
What muscle is seen as thin, hypoechoic bands immediately anterior to each thyroid lobe?
A. sternocleidomastoid
B. longus coli
C. sternohyoid
D. sternothyroid
E. both C and D
both C and D
What muscle is located posterior to each lobe of the thyroid?
A. sternocleidomastoid
B. longus coli
C. sternohyoid
D. sternothyroid
E. both C and D
longus coli
What is the role of color and spectral Doppler in evaluating thyroid nodules?
A. increased color Doppler flow within a nodule indicates malignancy
B. identification of a vascular halo around a nodule indicated a benign condition
C. hyperemic of a heterogeneous thyroid by color Doppler indicates malignancy
D. A, B, and C
E. neither color nor spectral Doppler has been shown to be sensitive in determining if a thyroid nodule is benign or malignant
E. neither color nor spectral Doppler has been shown to be sensitive in determining if a thyroid nodule is benign or malignant
You are performing a thyroid ultrasound on a patient with a history of Hashimoto’s thyroiditis. What is the sonographic appearance of this condition?
multiple large, hypoechoic nodules throughout both lobes
many small, echogenic nodules throughout both lobes
enlarged thyroid with heterogenous echotexture
diffuse enlargement of the thyroid with heterogenous echotexture
enlarged thyroid with homogeneous, low-level echotexture
diffuse enlargement of the thyroid with heterogenous echotexture
You are performing a thyroid study on a patient with an enlarged gland. Color Doppler shows markedly increased vascularity of both lobes. Which of the following is most likely?
Graves’ disease
adenomatous goiter
Hashimoto’s thyroiditis
follicular adenoma
colloid nodule
Graves’ disease
A patient has been referred for a thyroid ultrasound to locate a parathyroid adenoma. How many parathyroid glands are present in most people?
1
2
3
4
6
4
You are performing a thyroid ultrasound on a patient with increased serum calcium levels. What pathology are you searching for?
Hashimoto’s thyroiditis
Graves’ disease
adenomatous thyroid nodule
parathyroid adenoma
colloid cyst
parathyroid adenoma
During sonographic imaging of the thyroid, you detect several cervical lymph nodes. Which of the following is NOT true regarding these lymph nodes?
ultrasound cannot detect normal lymph nodes
visualization of inflammatory lymph nodes in the neck is common
most normal cervical lymph nodes have an oblong or oval shape
the greatest dimension in normal cervical lymph nodes is the longitudinal axis
most inflammatory lymph nodes exhibit an echogenic hilum
ultrasound cannot detect normal lymph nodes - this is NOT a true statement
Which of the following is NOT true regarding thyroid nodules?
the overwhelming majority of thyroid nodules are benign
thyroid nodules are very common
a solitary thyroid nodule is usually malignant
nodules with a significant cystic component are usually benign
nodules may be hyperechoic or hypoechoic to the thyroid
a solitary thyroid nodule is usually NOT malignant
You have been asked to identify a parathyroid adenoma. What is the typical sonographic appearance of this structure?
hyperechoic, round, solid nodule
heterogeneous, oval, solid nodule
round, solid nodule, isoechoic to the thyroid gland
homogenous, hypoechoic, solid oval-shaped nodule
hypoechoic nodule with highly echogenic hilum
homogenous, hypoechoic, solid oval-shaped nodule
You are performing an ultrasound exam to rule out the presence of parathyroid adenoma. Hyperparathyroidism is usually caused by enlargement of how many parathyroid glands?
1
2
3
4
5
1
You are performing an ultrasound exam on a patient with parathyroid hyperplasia. How many glands are usually involved in this condition?
1
2
3
4
5
4
While performing a thyroid ultrasound, you detect a lymph node suspicious for malignancy. Which of the following sonographic features is consistent with nodal malignancy in the neck?
rounded lymph node
heterogenous echotexture
intranodal calcification
absence of an echogenic hilum
all of the above
all of the above
During transverse imaging of the thyroid, you detect a hypoechoic, round nodule posterior and medial to the thyroid. How can you determine if this is the esophagus or a nodule?
image the patient in both inspiration and expiration
have the patient perform a Valsalva maneuver
have the patient swallow while scanning the area
scan the patient in an upright position
all of the above
have the patient swallow while scanning the area
What vessel is seen to course through the transverse foramina of the cervical spine?
common carotid
superior thyroid
inferior thyroid
thyrocervical
vertebral
vertebral
The superior thyroid artery is a branch of what artery?
common carotid
internal carotid
external carotid
thyrocervical
inferior thyroid
external carotid
What is the most common form of thyroid cancer?
papillary carcinoma
follicular carcinoma
medullary carcinoma
lymphoma
metastatic disease
papillary carcinoma
During transverse insonation of the thyroid gland, you detect two large vessels just lateral to the thyroid. What is the most medial vessel?
common carotid artery
internal jugular vein
vertebral artery
subclavian artery
external jugular vein
common carotid artery
During transverse insonation of the thyroid gland, you detect two large vessels just lateral to the thyroid. What is the most lateral vessel?
common carotid artery
internal jugular vein
vertebral artery
subclavian artery
external jugular vein
internal jugular vein
The thyrocervical trunk arises from what artery?
common carotid artery
internal carotid artery
external carotid artery
subclavian artery
vertebral artery
subclavian artery
You are performing a thyroid ultrasound on a young woman with hypothyroidism. You detect a moderately enlarged, hypoechoic thyroid with a coarsened parenchymal echotexture. Which of the following conditions is most likely present, considering this history and findings?
Graves’ disease
multinodular adenomatous goiter
Hashimoto’s thyroiditis
papillary carcinoma
normal thyroid
Hashimoto’s thyroiditis
Which of the following describes the correct patient positioning for sonographic evaluation of the thyroid?
supine in a reversed trendelenburg position
right thyroid lobe is examined with the patient in left lateral decubitus position and the left thyroid lobe is examined with the patient in right lateral decubitus position
probe with neck extended
supine with neck hyperextended by a pad underneath the scapulae
upright position with the chin on the chest
supine with neck hyperextended by a pad underneath the scapulae
On the left side of the neck, the common carotid arises from what artery?
innominate
subclavian
right common carotid
internal jugular
aortic arch
aortic arch
