Head & Neck- Anatomy / Physiology

Question 1

What arteries lie within the anterior triangle of the neck?

Answer 1

common carotid
external carotid
internal carotid
facial

Question 2

what veins lie within the anterior triangle of the neck?

Answer 2

internal jugular

facial

Question 3

what nerves lie within the anterior triangle of the neck?

Answer 3

hypoglossal neve
glossopharyngeal nerve 
accessory nerve (XI)
vagus nerve 
laryngeal nerve

Question 4

infection within the anterior triangle of the neck could travel through which lymphatics?

Answer 4

the submandibular nodes

the submental nodes

Question 5

what arteries lie within the posterior triangle of the neck?

Answer 5

occipital artery

Question 6

what veins lie within the posterior triangle of the neck?

Answer 6

external jugular vein

Question 7

what nerves lie within the posterior triangle of the neck?

Answer 7

cervical nerve plexus
accessory nerve (XI)

Question 8

where does the cervical plexus emerge between?

Answer 8

the middle scalene and levator scapulae

Question 9

what are the branches of the external carotid artery?

Answer 9

superior thyroid 
ascending pharyngeal 
lingual 
occipital 
posterior auricular 
facial 
maxillary 
superficial temporal

Question 10

where does the EJV give off the maxillary vein?

Answer 10

within the parotid gland

Question 11

what are the main branches of the external jugular vein?

Answer 11

anterior JV 
posterior JV 
posterior auricular vein
retromandibular 
maxillary
superficial temporal vein

Question 12

what are the main branches of the internal JV?

Answer 12

superior thyroid vein
facial
supratrochlear
supraorbital

Question 13

why would someone need a central line?

Answer 13

central venous pressure 
IV nutrition 
drug administration 
cardiac pacing 
blood sampling 
haemodialysis

Question 14

what are the complications associated with central lines?

Answer 14

air embolism 
pneumothorax 
haematoma 
cardiac tamponade 
chylothorax 
false passage 
sepsis 
thrombosis 
line blockage

Question 15

what is chylothorax and why might it occur as a complication of a central line?

Answer 15

chylothorax is lymph (chyle) accumulation within the pleural cavity due to disruption or damaging of the thoracic duct

Question 16

where do lymph nodes within the head and neck drain to?

Answer 16

cisterna chyli then the thoracic duct

Question 17

what are the causes of lymphadenopathy?

Answer 17

infection
inflammation
malignancy

Question 18

what are the 2 thyroid lobes joined by?

Answer 18

fibrous tissue = isthmus

Question 19

what does the thyroid hormone produce?

Answer 19

thyroxine and calcitonin (help to lower Ca and raise phosphate levels)

Question 20

what is a thyroglossal cyst?

Answer 20

the thyroglossal duct remnant fills with fluid causing dilatation
may become infection
occurs in the midline

Question 21

how can you assess a patient to see if a lump in their midline is a thyroglossal cyst?

Answer 21

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)

Question 22

lymph from what areas/organs drain into the supraclavicular lymph nodes?

Answer 22

breast, oesophagus and solid viscera

Question 23

lymph from what areas/organs drain into the cervical lymph nodes?

Answer 23

breast and solid viscera drain into superficial

thoracic duct drain into deep

Question 24

lymph from what areas/organs drain into the submandibular lymph nodes?

Answer 24

tongue
nose
paransal sinuses
oral cavity 
submandibular gland

Question 25

the submental lymph nodes drain what?

Answer 25

lips | floor of mouth

Question 26

parotid salivary duct drains what?

Answer 26

parotid gland scalp face

Question 27

lymph from the scalp drains into what lymph groups?

Answer 27

occipital | parotid

Question 28

what are the different types of thyroid masses?

Answer 28

solitary nodule diffuse enlargement multi - nodular goitre

Question 29

what are the most common causes of multi nodule goitre of the thyroid gland?

Answer 29

graves disease | toxic goitre

Question 30

what are the most common causes of diffuse enlargement of the thyroid gland?

Answer 30

``` Colloid goitre (adenomatous nodules); - gland hyperplasia - puberty - pregnancy - lactation - iodine deficiency Graves disease Thyroiditis ```

Question 31

what are the indications for a thyroidectomy?

Answer 31

thyrotoxicosis airway obstruction malignancy/suspicion retrosternal extension (goitre with portion of its mass 50% within the mediastinum)

Question 32

what are the complications from a thyroidectomy?

Answer 32

``` hypothyoroidism hypoparathyroidism thyroid storm voice paralysis / dysphonia bleeding infection scar ```

Question 33

what is the functions of the parathyroid glands?

Answer 33

the regulate Ca and phosphate levels

Question 34

what are the most common parathyroid diseases?

Answer 34

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

Question 35

what investigations are used to detect parathyroid disease?

Answer 35

``` urea and electrolytes creatinine calcium phosphate parathyroid hormone bicarbonate vitamin D ``` USS CR/MRI - detect ectopic glands Isotope scanning - detect diseased glands

Question 36

what can secondary hyperplasia of the parathyroid be caused by?

Answer 36

renal failure which causes low calcium resulting in hyperplasia of parathyroid gland

Question 37

describe the anatomy of the parathyroid glands.

Answer 37

4 glands | located posterior to the poles of the thyroid gland

Question 38

what investigations are carried out when assessing a thyroid mass?

Answer 38

fine needle aspiration cytology ultra sound scan CXR thyroid function tests

Question 39

whats the difference between a branchial cyst and a thyroglossal cyst?

Answer 39

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.