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Head and Neck > Lecture 1 Neck > Flashcards

Lecture 1 Neck Flashcards

1
Q

Name the anatomical contents of the neck

A
  • Arteries
  • Veins
  • Nerves
  • Lymph Nodes
  • Lymphatic Channels
  • Thyroid Gland
  • Parathyroid Glands
  • Muscles
  • Trachea
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2
Q

Name the boundaries of the neck

A
  • Superior- Mandible
  • Inferior- Clavicle
  • Anterior- Anterior midline
  • Posterior- Trapezius
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3
Q

Name the boundaries of the anterior triangle

A
  • Anterior: midline of the neck
  • Posterior: anterior border of sternocleidomastoid
  • Superior: Mandible
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4
Q

Name the boundaries of the posterior triangle

A
  • Anterior: posterior border of sternocleidomastoid
  • Posterior: anterior border of trapezius
  • Inferior: Clavicle
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5
Q

Anterior triangle contents

A
  • CCA
  • ECA
  • Facial artery
  • Hypoglossal nerves
  • Vagus nerves
  • Glossopharyngeal nerves
  • Submandibular nodes
  • Submental nodes
  • ICA
  • IJV
  • Facial vein
  • Accessory nerves
  • Laryngeal nerves
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6
Q

Posterior Triangle contents

A
  • Accessory nerve
  • Occipital artery
  • Lymph nodes
  • Cervical nerve plexus
  • External jugular vein
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7
Q

Where do the common carotid arteries divide into the internal and external arteries

A

C4

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8
Q

External carotid artery branches in the neck

A 
o	Superior thyroid
o	Ascending pharyngeal
o	Lingual
o	Occipital
o	Facial
o	Posterior auricular
o	Maxillary
o	Superficial temporal
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9
Q

Main veins

A
  • Posterior auricular
  • Retromandibular
  • External Jugular vein
  • Oblique jugular vein
  • Posterior external jugular vein
  • Superficial temporal vein
  • Supra orbital vein
  • Supratrochlear vein
  • Facial vein
  • Maxillary vein
  • Communicating vein
  • Anterior jugular vein
  • Jugular arch
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10
Q

Why would someone need a central line inserted

A
  • Central venous pressure
  • Drug administration
  • Cardiac pacing
  • Blood sampling
  • Fluid resuscitation
  • Haemodialysis
  • Intravenous nutrition
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11
Q

What are the complications of central line insertion

A
  • Pneumothorax
  • Haematoma
  • Cardiac tamponade
  • Air embolism
  • Chylothorax
  • False passage
  • Thrombosis
  • Sepsis
  • Line blockage
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12
Q

How many lymph nodes are in the head and neck

A

~600

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13
Q

Where do the lymph nodes from the head and new drain

A

Cisterna chyli

Thoracic duct on left

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14
Q

What nodes drain the scalp, face and parotid gland

A

Parotid nodes

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15
Q

What nodes drain the scalp only

A

Occipital nodes

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16
Q

What nodes drain breast and solid viscera

A

Superficial cervical nodes

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17
Q

What is the final drainage pathway to thoracic duct

A

Deep cervical nodes

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18
Q

What nodes drains tongue, nose, paranasal sinuses, submandibular gland, oral cavity

A

Submandibular nodes

19
Q

What nodes drain the lips and floor of mouth

A

Submental nodes

20
Q

What noes drain the breast, oesophagus and soli viscera

A

Supraclavicular nodes

21
Q

How many lymph node levels are there

22
Q

What is lymphadenopathy

A

Disease of the lymph node where they are abnormal size or consistency

23
Q

What type of gland is the thyroid gland

24
Q

Describe the structure of the thyroid gland

A

2 lobes joined by isthmus

25
What does the thyroid gland produce and what are there functions
Thyroid and calcitonin Calcitonin- lower calcium Raise phosphate
26
What is a Thyroglossal Cyst
Dilatation of thyroglossal duct remnant | Moves on tongue protrusion
27
What type of thyroid masses can there be
Solitary Nodule Diffuse Enlargement Multi-nodular goitre
28
Give examples of solitary nodules
o Cyst due to localised haemorrhage o Adenoma- benign follicular tissue o Carcinoma o Lymphoma
29
Give examples of diffuse enlargement
o Colloid goitre: due to gland hyperplasia, iodine deficiency, puberty, pregnancy and lactation o Grave’s disease: more common in female. Autoantibodies against thyroid-stimulating hormone receptor resulting in HYPERTHYROIDISM
30
Give an example of a multi-nodular goitre
Due to graves disease or toxic goitre
31
What are the indications for a Thyroidectomy
* Airway obstruction * Malignancy or suspected malignancy * Thyrotoxicosis * Cosmesis * Retrosternal extension
32
What are the complications of a thyroidectomy
* Bleeding primary or secondary * Voice hoarseness * Thyroid storm * Infection * Hypoparathyroidism * Scar (keloid/hypertrophic)
33
Describe the parathyroid gland and its function
Usually 4 glandsRegulates calcium &phosphate levels | Located posterior to poles of thyroid
34
Name symptoms of parathyroid disease
``` Name any of these: • Painful stones • Aching bones • Psychic moans • Abdominal groans • Renal calculi • Polyuria • Renal failure • Pathological fractures • Osteoporosis • Bone pain • Abdominal pain • Constipation • Peptic ulceration • Pancreatitis • Weight loss • Anxiety & Depression • Confusion • Paranoia ```
35
How do you diagnose parathyroid disease
* U&E * Creatinine * Calcium * Phosphate * Parathyroid hormone * Bicarbonate * Vitamin D * US Scan * CT/MRI: identify ectopic glands (any thyroid tissue not located in its usual position) * Isotope scanning: detect diseased glands
36
What are the 2 causes of Hyperparathyroidism
Adenoma Hyperplasia Malignancy
37
Name the 4 fascia layers of the neck
* Pre-tracheal * Pre-vertebral * Deep cervical (investing) * Carotid Sheath
38
Indications of Tracheostomy
* Airway obstruction * Airway protection * Poor ventilation to reduce dead space * Need suctioning * Need humidification * Need long-term care
39
How do you treat stridor
• Treat with O2, nebulised adrenaline, IV dexamethasone, (Heliox), (definitive) airway management
40
What is a Branchial Cyst
• Remnant of fusion failure of branchial arches or lymph node cystic degeneration
41
What is a Pharyngeal Pouch
• Herniation of pharyngeal mucosa between thryopharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx
42
Symptoms and Signs of Pharyngeal Pouch
• Voice hoarseness, dysphagia, aspiration pneumonia, regurgitation, weight loss, neoplasia (1%)
43
Investigation of Pharyngeal Pouch
barium swallow, excision (endoscopic/open), dilate

Head and Neck (16 decks)

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