Head & Neck- Anatomy / Physiology Flashcards
What arteries lie within the anterior triangle of the neck?
common carotid
external carotid
internal carotid
facial
what veins lie within the anterior triangle of the neck?
internal jugular
facial
what nerves lie within the anterior triangle of the neck?
hypoglossal neve glossopharyngeal nerve accessory nerve (XI) vagus nerve laryngeal nerve
infection within the anterior triangle of the neck could travel through which lymphatics?
the submandibular nodes
the submental nodes
what arteries lie within the posterior triangle of the neck?
occipital artery
what veins lie within the posterior triangle of the neck?
external jugular vein
what nerves lie within the posterior triangle of the neck?
cervical nerve plexus accessory nerve (XI)
where does the cervical plexus emerge between?
the middle scalene and levator scapulae
what are the branches of the external carotid artery?
superior thyroid ascending pharyngeal lingual occipital posterior auricular facial maxillary superficial temporal
where does the EJV give off the maxillary vein?
within the parotid gland
what are the main branches of the external jugular vein?
anterior JV posterior JV posterior auricular vein retromandibular maxillary superficial temporal vein
what are the main branches of the internal JV?
superior thyroid vein
facial
supratrochlear
supraorbital
why would someone need a central line?
central venous pressure IV nutrition drug administration cardiac pacing blood sampling haemodialysis
what are the complications associated with central lines?
air embolism pneumothorax haematoma cardiac tamponade chylothorax false passage sepsis thrombosis line blockage
what is chylothorax and why might it occur as a complication of a central line?
chylothorax is lymph (chyle) accumulation within the pleural cavity due to disruption or damaging of the thoracic duct
where do lymph nodes within the head and neck drain to?
cisterna chyli then the thoracic duct
what are the causes of lymphadenopathy?
infection
inflammation
malignancy
what are the 2 thyroid lobes joined by?
fibrous tissue = isthmus
what does the thyroid hormone produce?
thyroxine and calcitonin (help to lower Ca and raise phosphate levels)
what is a thyroglossal cyst?
the thyroglossal duct remnant fills with fluid causing dilatation
may become infection
occurs in the midline
how can you assess a patient to see if a lump in their midline is a thyroglossal cyst?
ask them to swallow - it will move up and down with swallowing
ask them to stick their tongue out - the cyst will move up as they do this
(this is because the thyroglossal duct is a remnant of the thyroid gland as it forms from the tongue embryologically)
lymph from what areas/organs drain into the supraclavicular lymph nodes?
breast, oesophagus and solid viscera
lymph from what areas/organs drain into the cervical lymph nodes?
breast and solid viscera drain into superficial
thoracic duct drain into deep
lymph from what areas/organs drain into the submandibular lymph nodes?
tongue nose paransal sinuses oral cavity submandibular gland
the submental lymph nodes drain what?
lips
floor of mouth
parotid salivary duct drains what?
parotid gland
scalp
face
lymph from the scalp drains into what lymph groups?
occipital
parotid
what are the different types of thyroid masses?
solitary nodule
diffuse enlargement
multi - nodular goitre
what are the most common causes of multi nodule goitre of the thyroid gland?
graves disease
toxic goitre
what are the most common causes of diffuse enlargement of the thyroid gland?
Colloid goitre (adenomatous nodules); - gland hyperplasia - puberty - pregnancy - lactation - iodine deficiency Graves disease Thyroiditis
what are the indications for a thyroidectomy?
thyrotoxicosis
airway obstruction
malignancy/suspicion
retrosternal extension (goitre with portion of its mass 50% within the mediastinum)
what are the complications from a thyroidectomy?
hypothyoroidism hypoparathyroidism thyroid storm voice paralysis / dysphonia bleeding infection scar
what is the functions of the parathyroid glands?
the regulate Ca and phosphate levels
what are the most common parathyroid diseases?
painful stones - renal calculi, polyuria, renal failure
aching bones - osteoporosis, bone pain
physic moans - anxiety, depression, confusion, paranoia
abdominal groans- abdominal pain, constipation, peptic ulceration, pancreatitis, weight loss
what investigations are used to detect parathyroid disease?
urea and electrolytes creatinine calcium phosphate parathyroid hormone bicarbonate vitamin D
USS
CR/MRI - detect ectopic glands
Isotope scanning - detect diseased glands
what can secondary hyperplasia of the parathyroid be caused by?
renal failure which causes low calcium resulting in hyperplasia of parathyroid gland
describe the anatomy of the parathyroid glands.
4 glands
located posterior to the poles of the thyroid gland
what investigations are carried out when assessing a thyroid mass?
fine needle aspiration cytology
ultra sound scan
CXR
thyroid function tests
whats the difference between a branchial cyst and a thyroglossal cyst?
branchial cyst lies in the upper and middle 3rd of the SCM
thyroglossal cyst lies in the midline
branchial cyst is remnant of fusion failure of branchial arches or lymph node cystic degeneration
thyroglossal cyst is a remnant of connection between tongue and thyroid gland.
