Neck Flashcards
What is a normal variant extending superior to the isthums
Pyramdial lobe
The ____ muscles (sternohyoid and sternothyroid) of the neck are seen as thin sonolucent bands along the anterior surface of the thyroid gland. While the larger____ muscles are located anteriolaterally
Strap, sternocleidomastoid
What 2 structures are located lateral to the thyroid lobes
1) Common cartoid artery
2) internal jugular vein
Posterior to the thyroid is the _____ _____ muscle, which is seen as a wedge- shaped sonolucent structure adjacent to the cervical vertebrae
Longus colli
The ______ ______ _______ is composed of the recurrent laryngeal nerve and inferior thyroid vessels. Seen as a vague hypoechoic area between the longus colli muscle and the thyroid gland
Minor neurovascular bundle
What is gland is located on the posterior aspect of the thyroid
Parathyroid gland
What structure is located in the midline and gives a characteristic curvinlinear reflecting surface with associated reverberation artifact
Trachea
What structure is located to the left and is seen as a target sign transversely
Esophagus
Where is the minor neurovascular bundle located in relationship to the thyroid
Posterior
The thyroid arterial supply comes from the
1) superior thyroid arteries
2) inferior thyroid arteries
The venous blood from the thyroid is drained into the internal jugular vein via the ____ and ____ _____ _____ and into the innominate veins via the _____ _____ ____
superior, middle thyroid veins, inferior thyroid veins
What is the most commonly encountered benign thyroid nodule
Colloid, adenomatous, or hyperplastic nodules
What is a true thyroid neoplasm that is characterized by a solitary well-defined mass
Benign follicular adenoma
What is the most common primary thyroid cancer
Papillary carcinoma
Follicular cancers tend to spread via the ____ ____ rather than the lymphatics
blood stream
What typically secretes the hormone calcitonin
Medullary carcinoma
what cancer is associated with multiple endocrine neoplasia syndrome
Medullary carcinoma
What typically occurs in the elderly and represents one of the most lethal human solid tumors
Anaplastic thyroid carcinoma
A patient comes to your department and you notice exopthalmia. What is the likely cause?
a) Addisons disease
b) graves disease
c) Hypertension
d) diabetes
B) graves disease
What is the landmark for the posterolateral border of the thyroid
a) trachea
b) esophagus
c) strap muscle
d) common carotid artery
e) superior thyroid artery
d) common cartoid artery
Hyperthyroidism associated with a diffuse goiter is associated with which of the following?
a) papillary carcinoma
b) Graves disease
c) Hasimotos thyroiditis
d) adenoma
b) Graves disease
What is the largest endocrine gland in the human and functions to control the basal metabolic rate
Thryoid gland
What is the most common congenital cyst found in the neck
Thyroglossal duct cyst
What is the most common location for ectopic functioning tissue
Lingual thryoid
What is the principal responsiblity of the thyroid gland
Maintenance of body metabolism
The thyroid gland secretes what 3 horomes
1) T3
2) T4
3) calcitonin
What type of artifact can be frequently be encountered in complex cystic thyroid nodules
Comet tail artifacts
What is a benign, neoplastic growth of thyroid glandular epithelium usually contained within a fibrous capsule
A thyroid adenoma
What describes a specific new tissue growth
Adenoma
A 35 year old woman presents with a tender neck, and on physical exam, an enlarged thyroid is found. An enlarged inhomogenous thyroid with irregular borders is seen on the songram. What is this most characteristic of?
a) a malignant lesion
b) Graves disease
c) cyst
d) adenomatous hyperplasia
e) hasimotos thyroiditis
e) hasimotos thyroiditis
What is the most common occurring thyroid function disorder
Hypothyroidism
Patients with hyperthyroidism caused by Graves disease is most likely to have which of the following biochemical markers
a) increased T3 and T4
b) decreased T3 and T4
c) high TSH
d) no changes in T3 and T4
e) hyponatremia
a) increased T3 and T4
What is the sonographic characteristic of Hashimot’s thyroiditis?a
a) atrophic thyroid tissue with homogeneous echotexture
b) multiple hypoechoic micronodules
c) bilateral enlargements of the thyroid with multiple small cysts
d) hypertrophy of the thyroid gland with homogenous echo-texture
e) hyperplasia with fluid levels
b) multiple hypoechoic micronodules
Hashimotos disease is a chronic disease of which of the following glands
a) pancreas
b) thyroid
c) adrenal
d) prostate
e) thymus
b) thyroid
What is the most common malignant tumor of the thyroid gland
Papillary carcinoma
What is the second most common thyroid cancer
Follicular carcinoma
The superior thyroidal artery is a branch of the
a) internal carotid artery
b) external carotid artery
c) vertebral
d) innominate
b) external carotid artery
The functional unit of the thyroid is called
a) follicle
b) nodule
c) lobule
d) lobe
a) follicle
The thyroid gland is considered normal size if the
a) AP measurement is < 2cm
b) width measurement is < 3 cm
c) length measurement is < 4 cm
d) volume is < 30 ML
a) AP measurement is < 2cm
A benign thyroid adenoma is associated with _________ calcifications while malignant adenomas are associated with ________ calcifications
a) punctuate, coarse
b) punctuate, fine
c) large, coarse
d) eggshell, punctuate
d) eggshell, punctuate
Which of the following is an immune system disorder that commonly affects the salivary glands
a) Kasabach- Merritt syndrome
b) Klippel-Trenaunay-Weber syndrome
c) Epstein-Barr syndrome
d) Sjogren syndrome
d) Sjogren syndrome
A solid nodule in the left lobe of the thyroid that measures 2cm AP and 1 cm width is most suggestive of
a) papillary carcinoma
b) adenoma
c) anaplastic carcinoma
d) colloid cyst
a) papillary carcinoma
The functional unit of the thyroid gland is called______
a) follicle
b) lobule
c) lobe
d) nodule
a) follicle
Calcitonin is produced by which of the following types of cells
a) parathyroid parafollicular
b) parathyroid follicular
c) thyroid follicular
d) thyroid parafollicular
d) thyroid parafollicular
The______ gland is located under the mandible and is drained by the _______
a) submandibular, stensen duct
b) parotid, stensen duct
c) sublingual, wharton duct
d) submandibular, wharton duct
d) submandibular, wharton duct
-Partoid gland= located anterior to the ear and drained by the stensen duct
- submandibular gland= located under the mandible and drained by the wharton duct
- sublingual glands= located under the tongue
The thyroid normally produces the most of which of the following hormones
a) T3
b) T4
c) thyrotropin
d) TSH`
b) T4
An increase in which of the following hormones causes increased calcium resorption in the small intestines?
a) calcitonin
b) thyroid stimulating hormone
c) T4
d) parathyroid stimulating hormone
d) parathyroid stimulating hormone
A top normal thyroid isthmus measurement would be
a) 6 mm
b) 4 mm
c) 6 cm
d) 4 cm
a) 6 mm
The left common carotid artery is a branch of which artery
a) left vertebral artery
b) left subclavian artery
c) left innominate artery
d) aortic arch
d) aortic arch
The superior thyroidal artery is a branch of the______
a) innominate
b) external carotid artery
c) internal carotid artery
d) vertebral
b) external carotid artery
The _____ gland is located anterior to the ear and is drained by the ________
a) submandibular, stensen duct
b) submandibular, wharton duct
c) parotid, stensen duct
d) sublingual, wharton duct
c) parotid, stensen duct
The thyroid gland is considered normal in size if the
a) volume is <30 mL
b) AP measurement is < 2 cm
c) length measurement is < 4 cm
d) width measurement is <3 cm
b) AP measurement is < 2 cm
While scanning the thyroid, you note a 1.5 cm hypoechoic, midly heterogenous nodule that appears to be posterior to the lower pole of the right lobe of the thyroid. There is a distinct fascial plane between the thyroid and the nodule. There are no other nodules identified on the exam. Which of the following most likely describes the findings?
a) brachial cleft cysts
b) goiter
c) normal esophagus
d) parathyroid adenoma
d) parathyroid adenoma
A thyroglossal duct cyst is most commonly found:
a) near the angle of the mandible
b) posterior to the ear at the level of the thyroid gland
c) within the isthums of the thyroid gland
d) on the midline neck superior to they thyroid gland
A thyroglossal duct cyst is most commonly found:
a) near the angle of the mandible
b) posterior to the ear at the level of the thyroid gland
c) within the isthums of the thyroid gland
d) on the midline neck superior to they thyroid gland
d) on the midline neck superior to they thyroid gland
Zenker diverticulum can be mistaken for:
a) a dilated bile duct
b) a bowel obstruction
c) the appendix
d) a thyroid mass
d) a thyroid mass
Increased thyroid volume is associated with
a) chronic hepatitis
b) radioactive iodine treatment
c) chronic renal failure
d) thyroxine treatment
c) chronic renal failure
Which of the following is least likely sonographic characteristics of papillary carcinoma of the thyroid
a) multiple cystic areas within the mass
b) cervical lymphadenopathy
c) hypervascularity
d) microcalcifications
a) multiple cystic areas within the mass
A solid nodule in the left lobe of the thyroid that measures 2 cm AP and 1 cm width is most suggestive of
a) papillary carcinoma
b) adenoma
c) anaplastic carcinoma
d) colloid cyst
a) papillary carcinoma
Which of the following correctly describes papillary thyroid cancer
a) most masses are complex cysts with thick septations and nodule formation
b) associated with colloid cyst formation
c) has a very high mortality rate
d) most commonly presents as a hypoechoic mass with calcifications
d) most commonly presents as a hypoechoic mass with calcifications
Which of the following correctly describes how to aid in differentiation of a thyroid adenoma in the lower pole from a parathyroid adenoma
a) thyroid adenomas are hypoechoic and parathyroid adenomas are hyperechoic
b) thyroid adenomas are hypovascular and parathyroid adenomas are hypervascular
c) thyroid adenomas are hyperechoic and parathyroid adenomas are hypoechoic
d) thyroid adenomas are homogenous and parathyroid adenomas are heterogeneous
b) thyroid adenomas are hypovascular and parathyroid adenomas are hypervascular
Hypophosphatemia is a clinical sign of
a) renal failure
b) hyperparathyroidism
c) internal hemorrhage
d) hyperthyroidism
b) hyperparathyroidism
A patient presents for a neck ultrasound due to swelling under the right angle of the jaw and anterior to the ear. She also complains of a dry mouth, dry cough and dry eyes. These clinical findings are most suggestive of
a) hashimoto thyroiditis
b) hemolytic anemia
c) graves disease
d) sjogren syndrome
d) sjogren syndrome
Which of the following is related to renal failure and vitamin D deficiency
a) hyperthyroidism
b) nephrocalcinosis
c) pulmonary HTN
d) secondary hyperparathyroidism
d) secondary hyperparathyroidism
