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MRCS Part A > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

Papillary thyroid carcinoma

A

> Young females
Papillary and colloid follicules
Histology - papillary projections / empty nuclei
Excellent prognosis
Multinodular
Lymphnode spread

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2
Q

Follicular adenoma

A

> Single nodule
Non malignant from histology

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3
Q

Follicular carcinoma

A

> Histology - encapsulated (differentiated from adenoma)
Vascular invasion
Lymphatic spread
Common bone metastasis

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4
Q

Medullary carcinoma

A

> From parafollicular C-cells, not thyroid tissue
Secrete calcitonin
Associated with MEN Type 2a
Lymphatic and haematogenous spread

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5
Q

Blood supply to thyroid

A

superior and inferior thyroid arteries.

> Left Subclavian artery > thyrocervical trunk > inferior thyroid arteries

> External carotid artery > superior thyroid arteries

> Thyroidea ima (in 10% of population -from brachiocephalic artery or aorta)

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6
Q

Venous supply from thyroid

A

> Superior and middle thyroid veins - into the IJV

> Inferior thyroid vein - into the brachiocephalic veins

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7
Q

Origins of parathyroid glands

A

Superior parathyroids > 4th pharyngeal pouch
Inferior parathyroids > 3rd pharyngeal pouch

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8
Q

Contents of carotid sheath

A

Vagus, common carotid, IJV
Outside - Ansa cervicalis

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9
Q

Ansa cericalis

A

Sternohyoid, omohyoid, sternothyroid

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10
Q

1st Pharyngeal Arch

A

Trigeminal Nerve V
Maxillary Artery
Malleus / Incus
Mastication muscles

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11
Q

1st Pharyngeal Pouch

A

Middle ear
Thyroid

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12
Q

2nd Pharyngeal Arch

A

Facial Nerve VII
Hyoid / Stapedius Artery
Stylo-Hyoid cartilage / Stapes
Facial Expression muscles

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13
Q

2nd Pharyngeal Pouch

A

Tonsillar fossa
Thyroid

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14
Q

3rd Pharyngeal Arch

A

Glossopharyngeal Nerve IX
Internal Carotid Artery
Hyoid cartilage
Posterior portion of tongue

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15
Q

3rd Pharyngeal Pouch

A

Thymus
Inferior parathyroids

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16
Q

4th Pharyngeal Arch

A

Vagus Nerve X
Right subclavian artery / Arch of Aorta
Pharyngeal and Laryngeal muscles

17
Q

4th Pharyngeal Pouch

A

Thymus
Superior parathyroids

18
Q

Cavernous Sinus Content

A

Internal Carotid Artery

Nerves
> Occulomotor CN 2
> Trochlear CN 4
> Abducens CN 6
> Trigeminal - Opthalmic CN 5A
> Trigeminal - Maxillary CN 5B

Bones - Sphenoid bone from Superior orbital fissure topetrous part of temporal bone

19
Q

CN1 exits skull

A

Cribiform plate

20
Q

CN2 exits skull

A

Optic canal

21
Q

CN3 exits skull

A

SOF

22
Q

CN4 exists skull

A

SOF

23
Q

CN5 exists skull

A

Ophthalmic = SOF
Maxilla - Foramen rotundum
Mandibular - Foramen vale

24
Q

CN6 exits skull

A

SOF

25
Q

CN7 exits skull

A

IAM

26
Q

CN8 exits skull

A

IAM

27
Q

CN9 exits skull

A

Jugular foramen

28
Q

CN10 exits skull

A

Jugular forâmen

29
Q

CN11 exist skull

A

Jugular forâmen

30
Q

CN12

A

Hypoglossal canal

31
Q

Lymphatics of auricle

A

> The lateral surface of the upper half drains to the superficial parotid lymph nodes
The cranial surface of the superior half drains to the mastoid nodes and deep cervical lymph nodes
The lower half and lobule drain into the superficial cervical lymph nodes.

32
Q

Lymphatics of tongue

A

> Tip of the tongue > Ipsilateral sub mental nodes and from there to the deep cervical nodes.
Mid portion of the tongue > submandibular nodes and then to the deep cervical nodes. Mid tongue tumours that are laterally located will usually drain to the ipsilateral deep cervical nodes, those from more central regions may have bilateral deep cervical nodal involvement.
Posterior third of the tongue > bilateral nodal metastases are more common in this area.

33
Q

Branches of external carotid

A

Anterior
> Superior Thyroid
> Lingual
> Facial

Posterior
> Posterior auricular
> Occipital

Deep
> Ascending Pharyngeal

Terminal
> Maxillary
> Superficial Temporal

34
Q

Level of hyoid bone

A

C3

35
Q

Level of bifurcation of carotids

A

C4

36
Q

Level of cricoid cartilage

A

C6

MRCS Part A (1 decks)

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