Head & Neck physiology - Tracheal conditions and Graves disease Flashcards
what is graves disease?
autoimmune disease where you produce autoantibodies against thyroid stimulating hormone (TSH)
results in hyperthyroidism
what are the complications of graves disease?
thyroid eye disease
acropachy/clubbing
pre- tibial myxoedema
what is the treatment for graves disease?
Anti-thyroids
Radio-iodine
Surgery - Thyroidectomy
in what sex is graves disease most common?
females
what is the term for clinical sign of airway obstruction?
stridor
where is the obstruction likely to be if the stridor is…
- inspiratory?
- expiratory?
- biphasic?
1 = laryngeal (above the glottis) 2 = tracheobronchial (below the glottis) 3 = Glottis/subglottis
what is the treatment for stridor?
02
nebuliser adrenaline
IV dexamethasone
airway management
what is a brachial cyst ?
remnant of fusion failure of the brachial arches or lymph node cyst degeneration
where is a brachial cyst found?
extends anterior to the SCM at the junction between the upper and middle thirds
how are brachial cysts treated?
excision to prevent further infection
what is a pharyngeal pouch?
herniation of the pharyngeal mucosa between the thyropharygeus and cricopharyngeus muscles of the inferior constrictor of the oesophagus
what does a patient with a pharyngeal much present?
voice hoarsness dysphagia aspiration pneumonia regurgitation weight loss neoplasia
how is a pharyngeal pouch investigated?
barium swallow
what is the treatment for a pharyngeal pouch?
dilate
excision
what are the different types of thyroid cancers?
papillary - lymphatic metastasis
follicular - haematogenous metastasis
anapaestic - aggressive, local spread, poor prognosis, old age
medullary - 10% familial i.e. MEN
which type of thyroid cancer has haematogenous spread?
follicular thyroid cancer
what type of thyroid cancer arises from parafollicular C cells?
medullary thyroid cancer
which type of thyroid cancer is aggressive and occurs in old age?
anaplastic
a patient presents with a thyroid tumour which has spread via lymph nodes. what is the most likely type of cancer?
papillary thyroid cancer
a patient is found to have lost the high pitch tone in her voice. what nerve is most likely to have been affected?
superior laryngeal nerve
damage of what nerve causes hoarseness and why?
recurrent laryngeal nerve as it innervates the intrinsic muscles of the larynx which are responsible for movement of the vocal cords required for production sound.
where does a pharyngeal pouch develop?
between the cricopharyngeus and the thyropharyngeus muscles
what are the indications of a tracheostomy?
air way protection
if there is airway obstruction
to reduce dead space for ventilation
what clinical finding on examination may indicate graves disease?
thyroid bruit on auscultation
