Module 4 : Parathyroid Glands

Question 1

how many thyroid glands are located in the neck

Answer 1

2 pairs

Question 2

what is the relationship of the parathyroid glands to the thyroid gland

Answer 2

• 2 superior located posteriori to the mid section of thyroid
• 2 inferior located posterior or inferior to the inferior pole of thyroid

Question 3

what is the typical dimension and shape of a parathyroid gland

Answer 3

• flat
• oval shape
• 1 x 3 x 5mm

Question 4

what is the echogenicity of a normal parathyroid gland compared to the thyroid gland

Answer 4

• isoechoic to thyroid

Question 5

what is the main physiologic function of the parathyroid glands

Answer 5

• prime source of parathyroid hormone which is the most important regulator of phosphorous and calcium in the extracellular fluid

Question 6

how is the patients neck position to examine parathyroid

Answer 6

• neck extended

Question 7

what is meant by a false positive parathyroid exam

Answer 7

• when a normal structure is identified incorrectly as a possible disease/pathology

Question 8

what 3 structures could create a false positive during a parathyroid assessment

Answer 8

• minor bundles
• esophagus
• longus colli muscles

Question 9

what is the most common cause of primary hyperparathyroidism

Answer 9

• single parathyroid adenoma

Question 10

in primary hyperthyroidism is calcium and PTH increased or decreased

Answer 10

• both are increased

Question 11

what is the most definitive treatment for hyperparathyroidism

Answer 11

• surgery

Question 12

what inherited disorder is strongly linked to parathyroid hyperplasia

Answer 12

• MEN syndrome (Types 1 and 2A)

Question 13

where is the most common location for ectopic superior ad inferior adenomas

Answer 13

• low neck
• mediastinum
• retrotracheal/retroesophageal
• endescended/carotid sheath
• intrathyroidal

Question 14

what are the two causes of secondary hyperthyroidism

Answer 14

• chronic renal insufficiency

- vitamin D deficiency

Question 15

what its eh typical sonographic appearance of a parathyroid adenoma

Answer 15

• hypoechoic
• homogenous
• solid

Question 16

what doppler patterns might assist you in differentiating a parathyroid adenoma from a lymph node

Answer 16

• adenomas will be hyper vascular with prominent diastolic flow or a peripheral vascular flow vs central pillar flow in LN
• adenoma may also have an enlarged extrthyroidal feeding artery from the inferior thyroidal artery

Question 17

what is the typical size and sonographic appearance of parathyroid carcinoma

Answer 17

• > 2cm
• lobulated
• heterogeneous
• internal cystic components