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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

A

6

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

A

Endocrine

24
Q

Describe the structure of the thyroid gland

A

2 lobes joined by isthmus

25
Q

What does the thyroid gland produce and what are there functions

A

Thyroid and calcitonin
Calcitonin- lower calcium
Raise phosphate

26
Q

What is a Thyroglossal Cyst

A

Dilatation of thyroglossal duct remnant

Moves on tongue protrusion

27
Q

What type of thyroid masses can there be

A

Solitary Nodule
Diffuse Enlargement
Multi-nodular goitre

28
Q

Give examples of solitary nodules

A

o Cyst due to localised haemorrhage
o Adenoma- benign follicular tissue
o Carcinoma
o Lymphoma

29
Q

Give examples of diffuse enlargement

A

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
Q

Give an example of a multi-nodular goitre

A

Due to graves disease or toxic goitre

31
Q

What are the indications for a Thyroidectomy

A
  • Airway obstruction
  • Malignancy or suspected malignancy
  • Thyrotoxicosis
  • Cosmesis
  • Retrosternal extension
32
Q

What are the complications of a thyroidectomy

A
  • Bleeding primary or secondary
  • Voice hoarseness
  • Thyroid storm
  • Infection
  • Hypoparathyroidism
  • Scar (keloid/hypertrophic)
33
Q

Describe the parathyroid gland and its function

A

Usually 4 glandsRegulates calcium &phosphate levels

Located posterior to poles of thyroid

34
Q

Name symptoms of parathyroid disease

A 
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
Q

How do you diagnose parathyroid disease

A
  • 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
Q

What are the 2 causes of Hyperparathyroidism

A

Adenoma
Hyperplasia
Malignancy

37
Q

Name the 4 fascia layers of the neck

A
  • Pre-tracheal
  • Pre-vertebral
  • Deep cervical (investing)
  • Carotid Sheath
38
Q

Indications of Tracheostomy

A
  • Airway obstruction
  • Airway protection
  • Poor ventilation to reduce dead space
  • Need suctioning
  • Need humidification
  • Need long-term care
39
Q

How do you treat stridor

A

• Treat with O2, nebulised adrenaline, IV dexamethasone, (Heliox), (definitive) airway management

40
Q

What is a Branchial Cyst

A

• Remnant of fusion failure of branchial arches or lymph node cystic degeneration

41
Q

What is a Pharyngeal Pouch

A

• Herniation of pharyngeal mucosa between thryopharyngeus and cricopharyngeus muscles of the inferior constrictor of the pharynx

42
Q

Symptoms and Signs of Pharyngeal Pouch

A

• Voice hoarseness, dysphagia, aspiration pneumonia, regurgitation, weight loss, neoplasia (1%)

43
Q

Investigation of Pharyngeal Pouch

A

barium swallow, excision (endoscopic/open), dilate

Head and Neck (16 decks)

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